achilles tendon

[Judith Mollet]

Hi there, thought I'd reply as you don't seem satisfied with one answer (can't blame you really but....)

" havent noticed any improvement since I visited the PT yesterday, so I guess it will take more than one visit"

It will take more than a couple of visits and you are going to have to be patient and probably rethink your hobbies and active exercise for a good while. And it's not just the physio time spent with a physio but your re-managing everyday that will heal. Ever heard of time will heal?..physios help advise you and facilitate healing that nature provides and hopefully do the right things to make the process as optimal as possible.
" dont know if this will have any bearing on this injury, but I am 60 yrears old, used to be in the forces and USED to jump from aircraft (my akles and knees used to take a real pounding) but has never stopped my exercising and I havent suffered any problems over the years"
OK, you have given your legs a pounding and you have got away with it till 60 which is super. The training with 45k was too much. You overdid what the structures in your lower leg were then prepared to take. The Treck was done and I'm sure it was worth it but was also too much as the irritation continued and you also pulled a muscle that was really trying it's best to keep going. . This is a very individual thing in the end. Yeah, there are probably many 60 year olds who do masses of sports and get away with it. Not everybody can. (I'm only 4 years behind you and had to learn a while ago that the body doesn't take it all) So you have a problem that may sit in various structures, not just in one. 1. Any or many of your lower leg muscles can have chronic problems in function due to chronic inflammation, triggerpoints, tears at whatever level etc. 2.The fascia, which is the white membrane stuff you see in a piece of raw meat and surrounds every muscle like a sheath can become structurally changed and /or /not give the required give allowing the muscles to function. It can in fact become effectivly too tight for the muscles contained (google "compartment syndrom" even if it's not your diagnosis at present) 3. If your feet seem to turn inwards downwards or pronate special orthopaedic inner soles might be a good answer to manage them as once the bony arch and its supporting ligaments fall too much it's pretty impossible for you to regain them with exercise. Feet turned down influence knee and hip function (and more). No big deal, they just have to be the right ones for your feet made by someone who knows what he/she is doing. 4. The tendon itself can be inflamed, acute or chronic. Slightly raising the heel with the aid is OK for a start.
You have then 4 differents sorts of structures in your leg that need looking at, assessing, treating and lets say rebalancing. The structural make up of tendons, muscles, fascia, bone and ligaments is different and the treatment/mending and time span of is not the same.
Ultrasound as part of the treatment is OK but as a part only. Frictions may be OK but not for ever and ever as friction itself is aggressive and can cause in the end more problems (CAN) There are also various gentle so called Myofascial Methods which a physio can use to help soft tissue recovery and regeneration. Aggressive methods and "alot" of stretch and exercise may aggravate more than help but not being on site it's impossible to assess you online. "More" and "longer" treatment or sport massage may not help more than "less"
I'm not sure how old how experienced and how trained your physio is and can't pass judgement. You can check if the physio is a Chartered Physiotherapist and maybe somehow find out about the range of CPD he or she has done, or in what sort of situation he/she works otherwise. The Physio will be doing the best it can. Maybe another could do it better, give this one a chance (phew, earns more than me here in Switzerland!) and keep your eyes open for other ones.
"I really thought I would have more replies, I thought this website was for PT's to pass on help/information or even opinions, oh, well back to google or yahoo [/QUOTE]"

Well maybe this long answer may provide some background of understanding for you. Take it slowly, this thing doesn't do with a quick quick fix, allow the body to repair itself so that you can return to being active. And treat your body with respect, you'll want to remain active till 90 so it's worth it! regards JM

[Derrick241]

Judith Mollet

Now this is more like the reply I was hoping for
I have had 3 visits with my PT, each time its painful, but the next day, I can actually walk, he has given me a range of exercises to do to stretch and strengthen the tendons, its going well
I think my PT is in his 30's he does seem as if he knows what he is doing, he looks after Ruislip Rugby team, he was recommended to me by a guy in the gym I use
He has only used the ultra sound once, but does the frictioning each time, along with a deep tissue massage on the calfs, I'm not going to say its enjoyable, it takes my breath away
He has looked at my boots and the wear on them, he has said I wont need orthotics, but I should keep on walking, not running yet or carrying anything, and not to rush, a stroll, he reckons I will know when I can do more
I know I have used my legs a bit more than some and in some unusual ways and carried some ridiculous weights, but thats army life
Maybe the trek was a bit too much and may cost me in the long run, but seeing what I saw was worth it (you may disagree)
My mates wife is a sports masseur, she gives my legs a massage every other day (the PT says that is good) then heat packs for 10 minutes
After every walk, he told me to put on ice packs (I have told him I dont want to take the pain killers, he agrees) so far, my achilles tendons are getting more flexible, well, I can walk without pain, I have done 5k without incident, but I do stretches along the way
Incidently, I do these stretches about 4-5 times a day, I dont wear shoes or slippers around the house
The stretches I do are as follows, place my toes on a brick or step, put my heel on the ground and push my knee forward until I can feel the tendon stretch, hold for 10 seconds, then change over, I do this 3 times on each leg, it seems to be working
Then, stand on a step, raise up on both feet on my toes, so it compresses the tendon, then lower so my heel is below the level of my toes, hold for 10, then raise up, again 3 sets of 10

My PT is quite happy with the exercises I am doing, he has said, that not to expect a miracle, but it will heal in time (everyone has said 'give it time'

I am in no rush, now, I keep doing the exercises, the strolls, but I am really looking forward to putting on a ruck sack with 10 pounds in it, I know then I am geting better, then istead of just lumping it on my back, work into it, a bit at a time

Thanks again for the lengthy reply, it was really appreciated