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Below
is somewhat of a living document detailing what has
become my anatomical nightmare. There are big
time gaps between these updates. That doesn't
mean my tendon problems were at bay. Basically,
I've had tendinosis going on 9 years and, save for a
few precious moments, it's been the bane of my
exercise existence. If you have it too, I feel
for you. If you have it bad, I really feel for
you. Tendinosis sucks. It sucks because of
the pain and it sucks because doctors don't know jack
about it or how to cure it. Podiatrists think
they can cure you with orthotics. Bullshit.
Orthopedics think they can cure you with drugs and
physical therapy. Bullshit. Nothing cures
this crap. It's with you for life. Accept
it and move on. I've tried everything that's
available in the U.S except surgery. Results
have been temporary at best. [I
wrote this during a time of frustration.
Consider this a living document.]
July
4, 1997 (Sunrise Duathlon) -
I tore
my left Achilles tendon during this race. Man,
did that hurt. It hurt so much that if one were
to touch my tendon with a feather it would drop me to
my knees. So, rather than do the smart thing and
immediately go to a doctor, I decided to do nothing
for a month but limp around in extreme pain. I
finally got smart and became proactive. I first
went to an orthopedic surgeon who wanted to put me in
a cast for six weeks. Thank god a physical
therapist I met talked me out of that and into giving
physical therapy a try. Prior to this, I was
skeptical of physical therapy, but it sure helped me.
I went religiously 3 nights per week for about 2 1/2
months. Each time, I received massage,
ultrasound, iontopherisis and did a number of
stretching and strengthening exercises. It
worked, and by November I was back to running again.
On
June 7, 2003 (Davis Island Sprint Triathlon) - I
really stressed the left tendon in a race and could
barely walk for two days. It has been more or
less bothering me ever since. I can run, but I
wake up very sore, can't fully support myself standing
on my left foot toes and feel that annoying pain
throughout the day. I ran out of Bextra but a
buddy of mine had a few extra Vioxx tablets and gave
me some. I held off taking it until a week later
because I don't particularly like taking drugs, but
now my right tendon is a bit hot too.
One
thing I've noticed that really helps, believe it or
not, is to swim. Something about kicking soothes
the tendon. Every time I get out of the pool,
both Achilles feel so much better. I can press
on them with my fingers with relatively little pain
and can almost stand on my toes pain free. Of
course, this doesn't last but a few hours, but I swear
it works. Try it.
December
'03 Update: I went through PT for a few
weeks in late October and early November to try to fix
my aching tendons. This time the PT didn't do
jack. What ultimately helped me was a daily dose
of eccentric calf exercises, heat and cross-frictional
massage - all performed by myself or my wife. I
also added heel lifts in my shoes. I think that
was the panacea. Now, I continue to stretch and
perform eccentric exercises several times a week.
So far, so good.
January
'06 Update: Yes, Achilles Tendinosis has
become a frequent visitor. Stretching, icing, heating,
massaging, icing again...doesn't help. I even went to
the NTC to get my biomechanics analyzed but recent
studies now show that having faulty biomechanics
doesn't mean you'll get tendinosis of the Achilles.
Based on my experiences, the only thing that works is
NOT RUNNING. There is a successful new procedure being
done in the UK and Australia but not in the U.S.
because the chemical used, Polidocanol, is illegal in
the States. It basically shrinks the new cells
manufactured by AT thus killing the new nerves that
supposedly cause the pain. Until "sclerotherapy"
of the Achilles makes its way over here, I am stuck
doing heavy-load
eccentrics for 12 weeks. If the eccentrics
don't get me back to running the way I want, I'm going
for surgery. What's to lose?
May
'06 Update: The decision is made. Surgery is
the only option I have at this point.
July
'06 Update: I had rf coblation (
Arthrocare's Topaz
MicroDebrider)
performed on my left AT by Dr. Babak Baravarian. His
article
in Podiatry Today caught my attention and,
after seeing several local doctors who told me that
they could not do anything for my tendinosis, I
decided to contact him. After his review of my MRIs
(which were FedExed to him in Santa Monica), Dr. Bob
told me that he could get me back to a competitive
level and that was all I needed to hear. Immediately
upon my return from a cycling excursion in the
Pyrenees, I flew out to UCLA, had the surgery, and
then flew back. Twelve days after the procedure, I
took the
stitches out myself.
Pics are below for
those with a
strong stomach.
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August
'06 Update: One
month and eleven days after surgery and I'm walking
normally, riding my bike hard, swimming and lifting
weights. Hope to be running soon. The pain
is gone.
November
'06 Update: Guess I spoke too soon. In
August, I had no pain whatsoever. My foot was
still stiff and the tendon was weak and swollen about
twice the size along the scar line, but I did feel
pretty good. I was motivated and full of
positive vibe. September was a pretty good
month, too. But, I started to feel a little of
that old pain in the tendon. Shrugged it off as
no big deal. Come October, it was consistently
sore and I was back to walking with a shuffle - no
capacity to 'push off' with my foot using a normal
gait. I still have not run since July 4th.
My tendon is still too weak. I think that all
the cycling I've been doing may have been too
much. So, I backed off and basically have become
a fat ass for the past 3 weeks. I'm beginning to
think there isn't much of a running future left in
these legs. I still do a hard massage every
morning. I force myself to walk normally as much
as I can. I bought a pair of Puma H-Streets for
my morning walks with Donna - trying to see if walking
barefoot-like will make a difference. I also
have started using a TEN's unit once in a while.
But, that's like taking vitamins. I'm not very
good at consistency. I had hoped to be running
by now. I'm afraid it may be another month or
two until the tendon is strong enough to handle
running load. We'll see. Tendon is still
pretty swollen along the scar line but less so than in
months past.
Mid-November
'06 Update: When
I was being prepped for surgery I was given and IV
with antibiotics and a 'relaxant' to make me feel,
well, relaxed. Right before I was put under, the
anesthesiologist said he was going to give me a 'nerve
blocker' that would ensure no pain would be felt
post-surgery for up to 48 hours. As I was laying
on my belly I was told that I'd feel a sharp pain in
my upper leg and then my foot would flop around
uncontrollably. That's exactly what happened,
and it's the last thing I remember before I woke
up. A sharp pain up around the back of my knee
and then a foot flapping like a fish out of
water. Anyhow, I really think this nerve blocker
(identified on my medical bill as a trigger point
injection) lasted far longer than 48 hours. I
think it worked for a month. Rereading these
posts, I had forgotten that I spent some time in the
weight room, walking and bike riding so soon after
surgery. Probably not the smartest thing to do
and it may have set me back some once the blocker
finally wore off. Things have been going very
well this past week. I started 'running'
again. First, 2 minutes, then 5, then a half a
mile. Today (the 18th) I ran 1 mile. January
18, 2007 - 6 month Post surgery update: Ok.
What began as a promising cure has ended in failure by
all meaningful measure. Today is 6 months post
op. What do I have to show for this half
year? I've got a nice 3 inch scar, a swollen and
sore tendon and a limp. Things started out so
well. I felt so good those first months after
the procedure. Looking back, I cannot point to
any one thing that I may have done to hinder healing
and cause a relapse. I haven't really pushed
things. I've attempted a few very easy and short
runs. Not much cycling. I've been really
good about being careful. However, I simply have
not cured. It's funny how one can accustom
themselves to insidious things. I walk most of
the day with a limp. I can't run. My
tendon is always very sore. And, yet it's become
normal. My quality of life has reduced a notch,
and I'm dealing with it. I've forgotten what
it's like to walk without pain. I no longer
expect to be able to blithely head out for a 10 mile
run like it's no big deal. A trot around the
block is classified as break-though. Sure, some
days are better than others. Occasionally, I
have a great day and it gives me hope. In a
sense, false hope. Because, ain't nothin' gonna
change at this point unless I find a miracle
cure. I've been fairly religious about the
painful eccentric exercises, but they seem to make
matters worse. I can't figure out why the tendon
swelling hasn't subsided after six months.
What's left to try? What am I missing?
Sclerosing neovessels with polidocanol using doppler
color ultrasound is what's left. Unfortunately,
polidocanol isn't FDA approved in the United States
and that means I may have to take a trip to Canada or
Europe. Stay tuned. January
27, 2007 I
feel silly after rereading my last post. If I
didn't know me and happened upon this website I'd
think the author is mental. It's been a crazy
couple of weeks. I've gone from hobbling in pain
to feeling better than I've felt in years in a matter
of days. What a swing! Why did this
happen? Hell if I know. I'm just an
ongoing experiment. Actually, I have some
ideas. First, maybe my expectations for recovery
were unrealistic. I thought I'd be perfectly
cured and back to running within 2-3 months post
surgery. Maybe I did do too much in the
beginning. Maybe that arbitrary 'cured by' date
on my calendar affected reason. At the time it
didn't seem so. But tendons are so slow to
heal. Most people say it's 9 to 12 months to
recover. I thought I was better than that.
Apparently not. So, why did I experience such a
swing these past few weeks? And am I destined
for disappointment with relapse? Let's
analyze. First, I followed Alfredson's 12 week
painful eccentric exercise program fairly religiously
(for 10 weeks). I missed a few days here and
there. The most memorable outcome of this
program was the fact that my tendon was always very
swollen and, although the program seemed to make the
tendon feel better early on, I was definitely getting
worse those last few weeks. The procedure I
followed was: 3x15 reps straight leg followed by
3 x 15 reps bent leg eccentric calf raises twice per
day on each leg - morning and evening. I used a
squat rack with weight. I used enough weight so
that there was pain (sometimes significant pain) in my
tendon for at least the first three sets. Every
few weeks, I increased weight - lack of significant
pain on first few sets would trigger weight
increase. Often, after the evening set, I would
head out for a 1 or so mile run at a very, very slow
pace. Things seemed to improve a bit until weeks
9 and 10. At week 10 I decided to quit. I
was regressing and in a lot of pain. Three days
after I quit my tendon began to feel pretty good.
Really good. I mean like I've never felt so
good. I sleep with a boot to keep my foot
dorsiflexed. Each morning, before I arise I
stretch my legs while laying in bed. This has
always elicited some pain in my achilles. I used
it as an indicator of how the day would unfold.
Would I be limping today or not? Anyhow, that
fourth morning I stretched and felt nothing. I
thought it was a fluke. Then I got out of bed
and actually walked like normal! If that wasn't
enough, I actually walked down the stairs with body
weight on both feet! Unreal! It has been
years since I did that. So, now it has been an
entire week. I've run a bit on 5 of those
days. Still no pain. Still walking up and
down those stairs. Keeping my fingers crossed
that maybe, just maybe, things are different this
time. Aside from quitting the eccentrics, I've
embarked on a religious stretching routine - holding
each stretch for 5 minutes at a time. Mostly
hamstring and quadricep work. I've also taken a
naproxin each morning. The swelling around the
scar has substantially reduced. Perhaps this
TOPAZ procedure really has done the trick. Maybe
I hindered my recovery by doing too much too
soon. Maybe the eccentrics helped. Maybe
they didn't. We'll see. To be
continued..... March
14, 2007 I
think I can finally say I'm cured. To all you
specialists out there who shrugged your shoulders and
told me nothing could be done, I moon you. Dr.
Baravarian and his TOPAZ worked. There were many
months where I didn't believe. Many, many, many
frustrating days. Disappointing days. Ups
and downs. Failures and futility. Over the
past month, I started to incorporate regular running
into the regime. Started with a few
minutes. Built to several miles. Last
couple of weeks I ran some 4 and 5 milers. Those
early ones still required stopping because my tendon
would get a little bothersome around the 3rd
mile. However, the last few runs I've run very
hard and had no problems. I ran 6 miles nonstop
tonight and really pushed it. I didn't have to
stop once and felt no pain during or after the
run. It has been years since I experienced
that. Will not post here again unless problems
resurface. Hopefully, this chapter of my life is
over. May
21, 2007 The
good news is my left achilles is holding up like a
champ. I've raced a few triathlons. Run
several 8 milers (could have done more). Cycled
a ton of miles. No pain at all! The bad
news is my right achilles hurts. I have to
decide now whether to forgo another season and have
surgery on the right. I'm going to mull it over
a few weeks before making the call. July
9, 2007 I
took some down time in early June. As of today,
however, I've run 20 days in a row. Joke mileage
but it's been consistent. Left tendon is still
stellar. I still do eccentric calf raises 3-4
times per week and try to stretch daily. The
true test is coming up in a few weeks when I reach 40+
mi/wk. I've decided to pass on surgery for my
right achilles. It's very manageable at the
moment and I don't want to miss another year of
running. It's enough of a struggle to get back
in shape with the loss of last year. Hopefully I
can get another year out of it.
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