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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
5, 2007 - I had a little
setback today with my achilles. Last night I decided to see
how far I could plod. I went 4 miles. Snail pace with
walking in between. Today wasn't good. Limping like I
was several months ago. It's been 74
weeks since I've had a
meaningful run week. I can hardly believe it. The
blessing out of this is I have become much more aware and thankful
for my good health. You can lose it at any moment.
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.
ACHILLES TENDINOSIS OF THE MID-PORTION -
RIGHT ACHILLES
TENDON (May 2007-Present)
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.
March 17, 2008
Tweaked my right AT a bit at the St.
Pete 12K. My streak of 40 mi weeks comes to an
end.
April 14, 2008
I stepped out this evening to meet up with a friend for a run, and, boy did my leg ache. I made it one block. I am beginning to wonder if it's a stress fracture. I've had two before and this does feel like one. I know Donna will be very bummed when she reads this, but I may have to pull the plug on St. A's as well as the rest of the season. I've been thinking for some time about biting the bullet and getting my right achilles fixed. This would be a pretty good time to get that over with. I now know what not to do as far a rehab goes. So, rather than taking a full year to recover I bet I can be back in the saddle by late winter. Then, I'd be in great shape. Never having to deal with bum achilles tendons again. Yea, I think I'm gonna do it. You know, when this is all said and done, I will be mentally tough as nails.
May 3, 2009
 I
decided to run the OC Half Marathon this morning. It
recently dawned on me that I hadn't raced the
distance in almost 8 years! That's what achilles
tendinosis does. Sucks the life out of your running
game. My goal was to peg 6:00 miles and see how far
I could go at that pace. I hit mile 1 at exactly
6:00 and held until the last half where I picked it
up just a shade. After all these years of running, I
know pace. I can run a 6,7 or 8 minute mile with
pretty good accuracy on feel alone. So, I don't need
a bunch of expensive gadgets or gizmos of dubious
effectiveness. Besides, I can't stand being wired to Garmins, ipods or heart rate monitors. (I can't
stand being wired, period!) In my opinion, those
things just limit your options. They force you to
set artificial boundaries around your training. And,
I believe I've got enough boundaries to deal with
just living life. Training, to me,
is a period of absolute freedom. So, I just like to
go with the flow, run how I feel and simply enjoy
the journey without beeping and bleeping electronics
strapped to my body. Anyhow, I finished a shade
under 1:18 on a pretty hilly course. My finish was
interesting as it consisted of a quarter mile full
on, eye popping, gut busting sprint to the finish
against a young kid who I barely clipped at the
end. Quite a painful but satisfying experience.
June 29, 2009
Ran about 10 mi this afternoon on a really nice trail by my house. Unfortunately, my right achilles is really getting whacked. It hurts pretty badly now and I've been limping around since. I always knew the right would would go one of these days. So, one of these days must be now. It's probably near decision time. Do I try to hobble through the pain with half-assed training and lame race results. Or, do I suck it up, go get surgery and sit out another year while I heal? If I go with surgery, it'll take several months of doctor visits and preparations. I'll throw away more $ in prepaid race entry fees. It'll be August 2010 before I can think about running again. But, I'll only be 44. I should have 1 or 2 good years of hopefully high finishes ahead of me. That should be good enough, right? Oh, well. We'll see.
July 12, 2009
 I 'raced' the Carlsbad Triathlon this morning. I finished out of the top ten. It was probably one of the worst races of my life. I felt awful. It left painful reminders of an old Clermont sprint race I did back in 2000. My head wasn't in it and my right achilles is shot. Decided to shut down the season and go for the surgery. We're making a doctor's appointment this week and I'm sure I'll be sliced sometime within the next month. Obviously, I won't be running for a while afterward. If the last surgery is any indication, I'll be hobbled until March/April 2010. This is fine with me because I want to get away for a while and do some other things. Definitely not racing in the Elite category anymore. It requires too much dedication and training time, both of which I am sorely lacking.
July 23, 2009
 Went to Dr. Bob who performed Topaz on my left achilles in 2006. For my right AT today, he gave me platelet rich plasma injections (PRPs). Entire procedure took under an hour,
including separating my plasma (right) from the
platelets. Got my fingers crossed. If this doesn't work, I'll go back to him for Topaz.
December 2009
Had surgery on my right achilles December 1st. Dr.
Bob said that the right tendon resembled the left
one he operated on in '06. He cleared away the
retinaculum and sheath, sewed up a small tear in the
tendon and topazed it. Hope to be running in 6
months..
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