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Achilles Tendonitis rehab

Posted by JHF on 6/28/00 at 23:53 (022618)

See the following site:

http://www.nismatorg/ptcor/eccentric_achilles/index.html


Re: Achilles Tendonitis rehab

Nancy S. on 6/29/00 at 04:24 (022620)

Hi JHF -- I clicked on the address and was told that nismat.org is 'unknown.' Is there a typo somewhere? I'd like to go there, thank you --Nancy

Re: Achilles Tendonitis rehab -- Found it

Nancy S. on 6/29/00 at 04:51 (022622)

Answered my own question, it turns out. Needs to be a period between 'nismat' and 'org' (for future readers). Thanks for this, JHF. Just so I'm clear, what is 'eccentric exercise'? I think I gather it is stretching exercise, but I wasn't familiar with the term before.
The site says two weeks of rest . . . I guess I haven't been complying correctly, since I am resting more but not completely. It is hard with two feet involved. (I imagine two-foot PFers can relate to that!) --Nancy

Re: Achilles Tendonitis rehab -- Anti-inflammatories?

Nancy S. on 6/29/00 at 05:04 (022623)

The web site is of the Nicholas Institute of Sports Medicine and Athletic Trauma.
It doesn't mention anti-inflammatories anywhere, for beginning or for severe cases. I was kind of glad to see this. I forgot to mention when I first posted after seeing the doc. that she recommended 2400 mg of ibuprofen a day -- 600 mg four times a day. I haven't done this, because although I know it's good to reduce inflammation, I'm concerned about possibly masking symptoms even though I'm not sure that actually happens. All throughout PF and now this I've avoided anti-inflammatories (except bromelain and icing, and a 3-day try at DayPro which irritated my stomach).
I'm just throwing this out, I don't know if I'm right or wrong.
--Nancy

Re: Achilles Tendonitis rehab -- Anti-inflammatories?

alan k on 6/29/00 at 07:28 (022626)

I wouldn't worry about masking symptoms-- you already know your injured. If you don't mind the GI risk you should go ahead with what the doc recommends as it may reduce swelling and help recuperation. Just my one cent worth.


alan k


Re: Achilles Tendonitis rehab -- Anti-inflammatories?

alan k on 6/29/00 at 07:30 (022627)

But it's suprising you weren't prescribed something more gentle on the GI like celebrex or vioxx. Maybe you could call them up for a prescription (which shouldn't cost a visit). But then again I don't know how much the meds themselves cost, though.

alan k


Re: eccentric exercise

alan k on 6/29/00 at 07:51 (022629)

Eccentric exersize is when the muscle lengthens during the contraction/resistance. For instance when you do arm curls with a dumbell (no comments about husbands please), lifting the dumbell to your shoulder as you bend your elbow is not eccentric exersize, but when you let the dumbell return down, that is eccentric exersize (so long as you don't just let it drop). The muscle is lengthening, while contraction/resistance is still going on.

Make sure you your medical professional that you are ready for such rehab exercises otherwise you could further harm yourself. You can use a towel, rope, theraband, PFT, or my device (if you can time travel a bit) to do eccentric exercise for the achilles by pointing your toes, then pulling with your tool on the toes/ball of foot while you resist but also 'give in' all the way back to a stretch. This exercise is recommended in the absence of plantar fasciitis, however. It could strain the pf in those who do not respond well to any stretching. In the majority of pf cases it should be fine. A solution, available if you use a device that is soft like a towel or band, is to situate the resistance around the arch rather than the end of the foot. You would have to pull more vigorously but the softness of the implement will form fit to the arch and even give it support. This may help relieve pf strain in some cases.

You need is helping me to get the gumption to keep going with making my wife's therapy available to everyone, and I am only about $1,000 away at this point. I doubt we will make a profit but at least might get back some of the other thousands and also help people like you. Wait till you see it! Its great. I hope you are ready for rehab at the same time it comes out.

Please, please don't do anything without the okay of your professional. Achilles tendonitis has a wonderful prognosis if you follow instructions. Not like chronic PF one percenters like us (but I don't even have pf anymore)..

alan k


Re: eccentric exercise

Rock on 6/29/00 at 09:13 (022634)

Alan,

I might want to reword 'Achilles tendonitis has a wonderful prognosis if you follow instructions.'

to:

'If you do not have PF or had PF in the past then Achilles tendonitis has a wonderful prognosis if you follow instructions.'

I think that the eccentric exercise described would cause a major PF flare up.

Rock, with some Achilles tendonitis (left) and some PF (right).


Re: eccentric exercise

alan k on 6/29/00 at 09:38 (022636)

That's a good point. I thought I made that point earlier in the post but perhaps I was not clear.

thanks!

Please do note that a pf 'flare-up' *may* result from eccentric exercise of this type but not necessarily. This is something to explore on an individual basis by starting slowly, listening to your body, and consulting a professional for advice.


alan k


Re: Achilles Tendonitis rehab -- Anti-inflammatories?

JudyS on 6/29/00 at 10:06 (022645)

Nancy - I would agree with Alan....the purpose of the ibuprofen in treating inflammation is to reduce it, not necessarily to relieve the pain of it although that clearly is part of it's ability. I gotta say though that 2400 seems like a lot - but that may be only because I have one of those tummys that can't hack it! Did you get a prescription for it?

Re: eccentric exercise

Nancy S. on 6/29/00 at 10:10 (022647)

Do not fear, Alan, I'm not going to try anything new until I've started the physical therapy. What a mess. But thank you, I've taken notes from your post and am hoping the therapist will help me figure out what to do when.
Rock worried me a bit there -- achilles tendonitis is not as curable if you have PF? Can it too become chronic, even if I'm not a runner and don't abuse my feet but just try to use them normally?
Alan, you really no longer have PF?? Can you do anything you want, or is TTS still in your way?
You are right, fear of masking symptoms seems silly at this point, I'm tuned in, and I will now take anti-inflams. as the doc. prescribed and see what happens.
I am dying to see what you come up with for rehab! Been waitin' -- I might be ready by August, so try to be ready then, ok?
--Nancy
p.s. I have curled my arms around some dumbbells but they're long gone. For me, meeting my husband blew them all out of the water. luck luck luck

Re: Achilles Tendonitis rehab -- Anti-inflammatories?

Nancy S. on 6/29/00 at 10:31 (022654)

Judy, while you were posting, I was posting my 'ok I'll take them' message. No Rx, she just said ibuprofen and that's what I'll take. It's cheap, and I do take hefty amounts during (for women only) and have never had a stomach problem from them.
Had open barn this morning with my ankle supports and ice wrap on, feet elevated, and my customers had some great ideas. One suggested, after hearing the 'more rest' order, that at this point I might just want to go take a rest in the middle of the road!
--Nancy

Re: my update

alan k on 6/29/00 at 11:26 (022656)

Since you had negative reactions to vigorous stretching I bet that you are a someone who will have to take it easy with the stretching/resistance therapy for achilles work. Of course, more problems (pf and tendonitis) are worse than less problems. However, you can probably expect to fully recover from the tendonitis if you follow instructions and inform, as no doubt you have and will, any professional who is advising you in rehab about your pf condition.

I don't think I have any pf left but I do have tts which is quite uncomfortable and also a trigger point in my quadratus plantae, a deep intrinsic muscle of the foot, which often masks as pf, as noted in the link I gave in a post above. My wife is working on the trigger points with Thai massage and I am back in acupuncture (one day so far) which I am assisting with energy meditations. Due to her sudden cure recently I feel very hopeful.

I also returned to yoga after one year off and had a great time. I took it real easy and stayed off my feet mostly. Still, it was a bit if-fy and I am cautiously going back again tonight. If I can get over the hurdle of yoga (as I did stationary biking) by proceeding slowly and steadily, then I feel I am guaranteed a cure. If I can do a near-full yoga practice I am sure the healing will burst right through the last of this. But one must be patient and sneak up on it, as I have posted in the past.

alan k


Re: my update

Nancy S. on 6/29/00 at 13:14 (022661)

Alan, you sound as though you're on a great path, and I congratulate you. I know you've studied and worked on these problems more than most. I hope yoga, as you sneak up on the remaining pain through it, gives you the final burst of healing you're looking for.
I'm afraid I let the achilles problems sneak up on ME, which was foolish. But I am optimistic in the long run, and plan to work out an honest and consistent and gradual program with the therapist. You're right, I am vulnerable when it comes to stretching and other exercises, and so I will make sure the emphasis is on gentle and gradual.
As you know, I am familiar with meditation, but I'm wondering what you mean specifically by 'energy meditations'? Best of luck to you in the progress you're making.
--Nancy

Re: my update

alan k on 6/29/00 at 14:36 (022664)

The meditations are equivalent to chi kung (or Qi Gong) in a chinese system. It's too complicated to describe here but if someone were interested there are books on Chinese chi kung which give clear instructions on how to recognize, generate, and move chi in the body, which is what acupuncture does, ultimately. If you have the patience it can make the acupuncture more effective, or it can replace acupuncture if you are really diligent.


alan k


Re: Achilles Tendonitis rehab

Nancy S. on 6/29/00 at 04:24 (022620)

Hi JHF -- I clicked on the address and was told that nismat.org is 'unknown.' Is there a typo somewhere? I'd like to go there, thank you --Nancy

Re: Achilles Tendonitis rehab -- Found it

Nancy S. on 6/29/00 at 04:51 (022622)

Answered my own question, it turns out. Needs to be a period between 'nismat' and 'org' (for future readers). Thanks for this, JHF. Just so I'm clear, what is 'eccentric exercise'? I think I gather it is stretching exercise, but I wasn't familiar with the term before.
The site says two weeks of rest . . . I guess I haven't been complying correctly, since I am resting more but not completely. It is hard with two feet involved. (I imagine two-foot PFers can relate to that!) --Nancy

Re: Achilles Tendonitis rehab -- Anti-inflammatories?

Nancy S. on 6/29/00 at 05:04 (022623)

The web site is of the Nicholas Institute of Sports Medicine and Athletic Trauma.
It doesn't mention anti-inflammatories anywhere, for beginning or for severe cases. I was kind of glad to see this. I forgot to mention when I first posted after seeing the doc. that she recommended 2400 mg of ibuprofen a day -- 600 mg four times a day. I haven't done this, because although I know it's good to reduce inflammation, I'm concerned about possibly masking symptoms even though I'm not sure that actually happens. All throughout PF and now this I've avoided anti-inflammatories (except bromelain and icing, and a 3-day try at DayPro which irritated my stomach).
I'm just throwing this out, I don't know if I'm right or wrong.
--Nancy

Re: Achilles Tendonitis rehab -- Anti-inflammatories?

alan k on 6/29/00 at 07:28 (022626)

I wouldn't worry about masking symptoms-- you already know your injured. If you don't mind the GI risk you should go ahead with what the doc recommends as it may reduce swelling and help recuperation. Just my one cent worth.


alan k


Re: Achilles Tendonitis rehab -- Anti-inflammatories?

alan k on 6/29/00 at 07:30 (022627)

But it's suprising you weren't prescribed something more gentle on the GI like celebrex or vioxx. Maybe you could call them up for a prescription (which shouldn't cost a visit). But then again I don't know how much the meds themselves cost, though.

alan k


Re: eccentric exercise

alan k on 6/29/00 at 07:51 (022629)

Eccentric exersize is when the muscle lengthens during the contraction/resistance. For instance when you do arm curls with a dumbell (no comments about husbands please), lifting the dumbell to your shoulder as you bend your elbow is not eccentric exersize, but when you let the dumbell return down, that is eccentric exersize (so long as you don't just let it drop). The muscle is lengthening, while contraction/resistance is still going on.

Make sure you your medical professional that you are ready for such rehab exercises otherwise you could further harm yourself. You can use a towel, rope, theraband, PFT, or my device (if you can time travel a bit) to do eccentric exercise for the achilles by pointing your toes, then pulling with your tool on the toes/ball of foot while you resist but also 'give in' all the way back to a stretch. This exercise is recommended in the absence of plantar fasciitis, however. It could strain the pf in those who do not respond well to any stretching. In the majority of pf cases it should be fine. A solution, available if you use a device that is soft like a towel or band, is to situate the resistance around the arch rather than the end of the foot. You would have to pull more vigorously but the softness of the implement will form fit to the arch and even give it support. This may help relieve pf strain in some cases.

You need is helping me to get the gumption to keep going with making my wife's therapy available to everyone, and I am only about $1,000 away at this point. I doubt we will make a profit but at least might get back some of the other thousands and also help people like you. Wait till you see it! Its great. I hope you are ready for rehab at the same time it comes out.

Please, please don't do anything without the okay of your professional. Achilles tendonitis has a wonderful prognosis if you follow instructions. Not like chronic PF one percenters like us (but I don't even have pf anymore)..

alan k


Re: eccentric exercise

Rock on 6/29/00 at 09:13 (022634)

Alan,

I might want to reword 'Achilles tendonitis has a wonderful prognosis if you follow instructions.'

to:

'If you do not have PF or had PF in the past then Achilles tendonitis has a wonderful prognosis if you follow instructions.'

I think that the eccentric exercise described would cause a major PF flare up.

Rock, with some Achilles tendonitis (left) and some PF (right).


Re: eccentric exercise

alan k on 6/29/00 at 09:38 (022636)

That's a good point. I thought I made that point earlier in the post but perhaps I was not clear.

thanks!

Please do note that a pf 'flare-up' *may* result from eccentric exercise of this type but not necessarily. This is something to explore on an individual basis by starting slowly, listening to your body, and consulting a professional for advice.


alan k


Re: Achilles Tendonitis rehab -- Anti-inflammatories?

JudyS on 6/29/00 at 10:06 (022645)

Nancy - I would agree with Alan....the purpose of the ibuprofen in treating inflammation is to reduce it, not necessarily to relieve the pain of it although that clearly is part of it's ability. I gotta say though that 2400 seems like a lot - but that may be only because I have one of those tummys that can't hack it! Did you get a prescription for it?

Re: eccentric exercise

Nancy S. on 6/29/00 at 10:10 (022647)

Do not fear, Alan, I'm not going to try anything new until I've started the physical therapy. What a mess. But thank you, I've taken notes from your post and am hoping the therapist will help me figure out what to do when.
Rock worried me a bit there -- achilles tendonitis is not as curable if you have PF? Can it too become chronic, even if I'm not a runner and don't abuse my feet but just try to use them normally?
Alan, you really no longer have PF?? Can you do anything you want, or is TTS still in your way?
You are right, fear of masking symptoms seems silly at this point, I'm tuned in, and I will now take anti-inflams. as the doc. prescribed and see what happens.
I am dying to see what you come up with for rehab! Been waitin' -- I might be ready by August, so try to be ready then, ok?
--Nancy
p.s. I have curled my arms around some dumbbells but they're long gone. For me, meeting my husband blew them all out of the water. luck luck luck

Re: Achilles Tendonitis rehab -- Anti-inflammatories?

Nancy S. on 6/29/00 at 10:31 (022654)

Judy, while you were posting, I was posting my 'ok I'll take them' message. No Rx, she just said ibuprofen and that's what I'll take. It's cheap, and I do take hefty amounts during (for women only) and have never had a stomach problem from them.
Had open barn this morning with my ankle supports and ice wrap on, feet elevated, and my customers had some great ideas. One suggested, after hearing the 'more rest' order, that at this point I might just want to go take a rest in the middle of the road!
--Nancy

Re: my update

alan k on 6/29/00 at 11:26 (022656)

Since you had negative reactions to vigorous stretching I bet that you are a someone who will have to take it easy with the stretching/resistance therapy for achilles work. Of course, more problems (pf and tendonitis) are worse than less problems. However, you can probably expect to fully recover from the tendonitis if you follow instructions and inform, as no doubt you have and will, any professional who is advising you in rehab about your pf condition.

I don't think I have any pf left but I do have tts which is quite uncomfortable and also a trigger point in my quadratus plantae, a deep intrinsic muscle of the foot, which often masks as pf, as noted in the link I gave in a post above. My wife is working on the trigger points with Thai massage and I am back in acupuncture (one day so far) which I am assisting with energy meditations. Due to her sudden cure recently I feel very hopeful.

I also returned to yoga after one year off and had a great time. I took it real easy and stayed off my feet mostly. Still, it was a bit if-fy and I am cautiously going back again tonight. If I can get over the hurdle of yoga (as I did stationary biking) by proceeding slowly and steadily, then I feel I am guaranteed a cure. If I can do a near-full yoga practice I am sure the healing will burst right through the last of this. But one must be patient and sneak up on it, as I have posted in the past.

alan k


Re: my update

Nancy S. on 6/29/00 at 13:14 (022661)

Alan, you sound as though you're on a great path, and I congratulate you. I know you've studied and worked on these problems more than most. I hope yoga, as you sneak up on the remaining pain through it, gives you the final burst of healing you're looking for.
I'm afraid I let the achilles problems sneak up on ME, which was foolish. But I am optimistic in the long run, and plan to work out an honest and consistent and gradual program with the therapist. You're right, I am vulnerable when it comes to stretching and other exercises, and so I will make sure the emphasis is on gentle and gradual.
As you know, I am familiar with meditation, but I'm wondering what you mean specifically by 'energy meditations'? Best of luck to you in the progress you're making.
--Nancy

Re: my update

alan k on 6/29/00 at 14:36 (022664)

The meditations are equivalent to chi kung (or Qi Gong) in a chinese system. It's too complicated to describe here but if someone were interested there are books on Chinese chi kung which give clear instructions on how to recognize, generate, and move chi in the body, which is what acupuncture does, ultimately. If you have the patience it can make the acupuncture more effective, or it can replace acupuncture if you are really diligent.


alan k