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minx

achilles tendonitis

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**Shoes: too tight, too loose, poor fit.

**Gait: over or under pronation: Tuli Cup (bilateral), bilat heel lifts, medial post, orthodics

**Stretch Gastrosoleus

avoid toe running

ultrasound, Eletric Stim, transverse friction massage

elastic tape for shock absorb

adjust calcaneus and / or other foot subluxations

Exercise: toe raises

avoid running up or downhill

longer warm-up

ice when acute

 

caused by tight gastrocs, bad shoes, biomechanical defects (subluxation, over/underpronation)

 

rule out: bursitis, fracture, tennis leg, plantar fascititis

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thanks mike--

 

almost certain this is the result of old/bad shoes and underpronation. very acute right now. i'm not wanting to rest it much. trying to figure out how to 'run through' it.

 

avoid running up or down hill? yikes...i don't run anywhere where that's possible.

 

i'll try some massage and stretching. any other suggestion.

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Alternating hot/cold therapy.

 

Probably not a good idea to "run through it" unless you want to make it worse. Find an alternative form of exercise. Walk steps carrying a pack keeping your foot flat.

 

Hey...when are we drinking beer?

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soon! any time next week work for you? give me a call. you were supposed to do that weren't you? or maybe i was and i frigged that up too smirk.gif

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I had this for far too long.

First off: absolutely do NOT 'run through it'. Not unless you want to be one of those cases that medical types shake their heads about and talk about to their other patients.

Second, as Mike said, check your shoes etc esp plantar fascitis. For myself, I had a pretty good case of it which lingered for years because I didn't know what to do about it. Finally, last year, I started seeing a massage therapist about it. He put me through a lot of pain but I'm back to running 6 miles again. If you work down near Pioneer Sq, I can recommend this guy highly.

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I agree with Mike on this, rest, rehab, shoes is key. DO NOT RUN THROUGH THIS. ICE 20 minutes on, 60 minutes off while acute, 2 cycles max, while acute.

I would also look at nutrition, make sure you are getting enough Vit. C, Ca, Mg, GAG's, Bromalain.

 

If really bad and you want to be agressive, use a posterior splint to keep your foot dorsiflexed (calf stretched position). No longer that a couple nights or so. This will keep your achillies at the maximum length overnight when new fibers are being laid down. (usually we sleep with our feet pointed, first step rips all the new fibers or at least damages them).

 

Acute modified training- No hills, no jumping, no speed training, walk on soft surface (trail), slowly increase training to tolerance. (you will know the next day.

 

SubAcute- likely after 1 to 2 weeks- alternate hot cold. (heat before exercise, cold after. See mike's notes above.

 

If that does not work...?...

 

Don't get a steroid injection, apparently it is risky. Good luck.

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Question: why ice a tendon that receives so little blood flow? I've read that heat actually works well, but I'm not sure at what stage (I'm not disagreeing with others here, just simply wondering, that's all).

 

When I had it, I'd actually formed a scar tissue bulge on my right achilles, from trying to "run through it". According to my podiatrist, it was at a point close to rupture at one time, but had dealt with the trauma well, and had protected itself.

 

I am now on custom orthotics, and to deal with the tight plantar facia, my doc recommended massaging the bottom of the foot with a golf ball. Keep one with you throughout the day; when you're off your feet for a while, kick off the shoes and get a massage goin'.

 

My podiatrist also mentioned a "calf stretcher"- a device with some type of band that you can use during periods of sleep; it probably connects to the ball of your foot, and stretches your calves continuously.

 

Replace the shoes every few months, especially if you're using them more than average. Also, see if you can visit a reputable running shop that can watch you jog, and then pick out a shoe that fits your foot pattern (neutral, supination, pronation, etc).

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the tendon is covered in a well vascularize peritendon sheath, as well as the musculo-teninous juntion, and surrounding soft tissues, thus the need to ice days 1-5(7)

 

for achilles tendinitis AND plantar fascitis:

the "calf stretcher" is a straussenberg (sp?) sock. one of the best things you can do. x-fiber massage too (or graston technique). "short foot exercises" like curling a towel w/toes, or picking up a golf ball are helpful. Another method is low freq ultrasound (forget the name) similiar to the kind used to break up kidney stones.

 

prevention: orthodics, heel lifts, tuli cups.

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I am on my feet most of the day and where usually have a pair I wear all the time, should I instead alternate shoes?

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It's better for everyone involved (you and the shoes) if you at least alternate between 2 pairs of shoes.

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if it's a proper shoe for you and you haven't worn it out, then don't alternate. buy your new pair a couple weeks before you trash the old ones and alternate.

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