|
|
Re: Achilles tendinosis
|
Logged in as: Guest
|
|
Users viewing this topic:
none
|
|
Login  | |
|
Re: Achilles tendinosis - March 20, 2007 1:30:00 PM
|
|
|
proud
Posts: 944
Joined: March 22, 2006
Status: offline
|
Brian, Ginger et al,
I await the published reports...
|
|
|
|
|
Re: Achilles tendinosis - March 20, 2007 3:52:00 PM
|
|
|
ginger
Posts: 660
Joined: February 26, 2005
From: Melbourne Victoria
Status: offline
|
Brian , I have no experience with Applied Kinesiology, other than to have treated those who had previously sought and were treated with those methods, including various practitioners of "Kinesiology".
My strong suspicion however , viz a viz your comments re L5S1 pressures , is that this attention serves to turn off protective responses at the facet joint leading to resolution of referred events , in a similar way to mobs. I see no reason to abandon mobs however in favour of the AK approach.
Explanations for treatment effects can certainly vary wildly. I'd be happy to learn more of your reasoning related to those you mentioned.
cheers
_____________________________
Ubi est mea anaticula cumminosa?
The Grand Pediculator
|
|
|
|
|
Re: Achilles tendinosis - March 20, 2007 4:43:00 PM
|
|
|
Marc Bronson
Posts: 113
Joined: January 13, 2007
From: Toronto
Status: offline
|
Brian,
AK seems to be quackery with a capital Q. Check out chirobase for a review of it, and let me know if it's practiced this way. I wouldn't use it for many reasons, the least of which is that the theory behind it makes absolutely no sense.
_____________________________
BSc (Hon), DC, Dipl. Med. Ac. CSCS
Integrative Manual Medicine
|
|
|
|
|
Re: Achilles tendinosis - March 21, 2007 3:03:00 PM
|
|
|
allenbr4
Posts: 18
Joined: February 14, 2007
Status: offline
|
Thanks for your opinions.
To be fair, I'm probably not an appropriate rep for AK. I'm certified (100 hour) course, but use very little in practice.
The little bit that I may use, for instance, would be to perform a muscle test, then use manual techniques (spindle cell, GTO) on the muscle to see if I can improve the function, or check to see if a "neurolymphatic reflex" helps to improve function after stimulation.
AK is much more vast than these few techniques, but in general, is based around using muscle testing to gauge responses of the body to certain therapies. AK is quite vast, and I realize that some of the techniques, in the eyes of some, are kinda "out there".
I was very interested hear your opinions, partially because I'm still trying to figure out my own philosophy of care.
|
|
|
|
|
Re: Achilles tendinosis - March 21, 2007 8:02:00 PM
|
|
|
jlharris
Posts: 477
Joined: April 12, 2006
From: Nebraska
Status: online
|
@ginger,
I'm not overly surprised. Am I ready to switch from eccentrics to continuous mobs for Achilles Tendonosis? Not at this time. Mostly d/t having published scientific literature by different authors doing the same treatment both getting excellent lasting results. Hard to give that up for a treatment that I may not be able to replicate.
Please don't read that as me being closed off to the notion of continuous mobs being worthless. Mine eyes have seen to light, and will be constantly inquring and experimenting with CM's for pain.
_____________________________
Jason L. Harris, PT, DPT
My PT Blog
|
|
|
|
|
Re: Achilles tendinosis - March 22, 2007 1:34:00 PM
|
|
|
ginger
Posts: 660
Joined: February 26, 2005
From: Melbourne Victoria
Status: offline
|
Jason, hallelujia brother , dem eyes habseen da light an de light be on you face.
_____________________________
Ubi est mea anaticula cumminosa?
The Grand Pediculator
|
|
|
|
|
Re: Achilles tendinosis - March 30, 2007 10:00:00 AM
|
|
|
Matthew
Posts: 41
Joined: December 5, 2001
From: Regensburg, germany
Status: offline
|
Hi!
My protocol is simple but effective:
eccentric training with very high loads - followed by 5-10 minutes of ice.
I "suffer" from bilateral Achilles tendinosis myself - and the eccentric training works wonders!
The pain is gone completely within the first week - subjective range of motion increases dramatically and walking becomes pleasurable once again.
This in turn always leads me to the point where I stop doing the exercise till pain returns once again another week later.
In my (personal) and professional experience: use as high a weight as possible! One recent study that tried to replicate the findings of the famous Alfredson study couldn't do so. My guess is that they used too little weight. After all the Achilles tendon can withstand enormous forces. To effect any change you need to "show" the tendon you mean business.
As for the possible mechanisms that lead to improved function and even a healing process in the tendon - there was a study that looked at what happens at the biochemical level in tendons that are stressed during inflammatory processes:
J Appl Physiol. 2007 Jan ; 102(1): 11-7
Inflammatory cells do not decrease the ultimate tensile strength of intact tendons in vivo and in vitro: protective role of mechanical loading.
I find this bit encouraging:
Interestingly, mechanical stress, when applied in vitro, protected collagen bundles from inflammatory cell-induced deterioration. Together, our results suggest that acute inflammation does not induce damages to intact and mechanically stressed collagen fibers. This protective effect would not rely on increased tissue inhibitors of matrix metalloproteinases content but would rather be conferred to the intrinsic resistance of mechanically loaded collagen fibers to proteolytic degradation.
They did their study using intact tendons - but I guess the same principle could be in action in damaged tendons as well.
Matthias
|
|
|
|
|
Re: Achilles tendinosis - March 30, 2007 1:33:00 PM
|
|
|
ginger
Posts: 660
Joined: February 26, 2005
From: Melbourne Victoria
Status: offline
|
Mathias ,why not just have the cause dealt with and eliminate the problem. You'll save yourself a lot of pain and the endless round of eccentrics.
The only difficulty will be finding a therapist familiar enough with continuous mobilisation. Good luck.
_____________________________
Ubi est mea anaticula cumminosa?
The Grand Pediculator
|
|
|
|
|
Re: Achilles tendinosis - May 22, 2007 6:10:00 AM
|
|
|
daveclan08
Posts: 8
Joined: May 21, 2007
From: Rep. of Ireland
Status: offline
|
Does anyone have any theories as to why tendinopathy patient experience pain in the A.M.?
Could it be that at rest Neovessels (including nerves) bridge the gap from soft adipose tissue into stronger collagen tissue? Then with walking or Eccentric exercise these are mechanically broken down so the pain disappears for a while?
I've read the Swedish research on Eccentric Ex's and Sclerosing.
What causes Neovessels to grow in the first place? Is it a genetic predisposition?
I'm into my second week of Alfredson's programme and still have some morning pain but it's less severe and does'nt last as long. Once I've done the protocol (20kg) I feel like I could run and hopping does'nt hurt nearly as bad. I plan to keep it going for six weeks and get up to 60KG. Would I get there faster using heavier weights? I'm using 20kg now with little pain - how quickly should I progress?
|
|
|
|
|
Re: Achilles tendinosis - May 22, 2007 6:19:00 AM
|
|
|
daveclan08
Posts: 8
Joined: May 21, 2007
From: Rep. of Ireland
Status: offline
|
P.S.
I have skinny wrists and ankles, and long skinny calves which refuse to grow with lots of weights.
Is Anthropometric Measurements a factor?
|
|
|
|
|
Re: Achilles tendinosis - May 22, 2007 6:59:00 PM
|
|
|
RSBMPT
Posts: 17
Joined: April 24, 2007
Status: offline
|
Dare I enter the debate of local versus proximal source of pan/dysfunction. While I can see where Ginger, Nari and others feel spinal events (facet/Z joint) can be the cause of a distal problem [nociception via local pressure or capsualr stretch, mechanosensitive receptors, and inflammatory mediators, nerve root encroachent] I remain somewhat skeptical as typical Z-joint mediated processes rarely refer pain further than the knee. Interestingly, denervation protentials of the mutifidi are often evident in patients with radiculopathy. Perhaps it just may be (as studies have shown) that the initial noxious event leads to the atrophy and dysfunction of the multifidi leading to increased compression, torsion and shear; leading to an increase in pain presentation. As such, regaining dynamic postural control/core stability would decrease the biomechanical stresses there by mediating the pain felt by the patient. While I don't discount the continuous mob theory, couldn't the same benefits [decreasing loading on the posterior elements] be gleaned from exercises emphasizing trunk flexion and neutral postures, as well as positional release/traction, and stretching to address any pelvic musculature imbalances. Not only should this provide relief but also an independent way for the patient to manage symptoms on their should it be necessary with presecriptive exercise rather than dependence on a therapists skilled application of CM. Just a thought. I know this is an achilles tendinosis post, so just a quick note on that....I am all for eccentrics.
|
|
|
|
|
Re: Achilles tendinosis - May 22, 2007 9:42:00 PM
|
|
|
ginger
Posts: 660
Joined: February 26, 2005
From: Melbourne Victoria
Status: offline
|
Ryan, the best part about the CM method I think , is not just that it reveals referred pain by application of post treatment hindsight, but that the effects are permanent in most cases. Add the benefits of a positive response with CM to the suggestions/ encouragements you mentioned about exercise and I see the light of my own redundancy regularly appear.
_____________________________
Ubi est mea anaticula cumminosa?
The Grand Pediculator
|
|
|
|
|
Re: Achilles tendinosis - May 22, 2007 9:45:00 PM
|
|
|
ginger
Posts: 660
Joined: February 26, 2005
From: Melbourne Victoria
Status: offline
|
Ps, I'm all for eccentrics too , so long as they don't hold loud parties and pinch my sunday paper.
_____________________________
Ubi est mea anaticula cumminosa?
The Grand Pediculator
|
|
|
|
|
Re: Achilles tendinosis - May 27, 2007 10:37:00 AM
|
|
|
daveclan08
Posts: 8
Joined: May 21, 2007
From: Rep. of Ireland
Status: offline
|
Can anyone help with ideas of how much weight to use when doing Eccentric Ex's?
I'm 6 ft 85kg and reasonably fit. Currently doing Alfredson'd programme twice daily with 40kg. Would I get there quicker by upping the weight? Or, should I gradually increase. I dont find the exercises particularly uncomfortable but rather have most difficulty with morning pain. Appreciate any advice!
|
|
|
|
|
Re: Achilles tendinosis - June 2, 2007 9:52:00 AM
|
|
|
Matthew
Posts: 41
Joined: December 5, 2001
From: Regensburg, germany
Status: offline
|
Morning pain is excruciating!
You could start wearing night splints (I didn't); my way to deal with that particular problem was to sleep with my feet outside the bed. That helped a lot since the ankles were no longer flexed.
Matthias
|
|
|
|
|
RE: Re: Achilles tendinosis - August 1, 2007 11:11:21 AM
|
|
|
daveclan08
Posts: 8
Joined: May 21, 2007
From: Rep. of Ireland
Status: offline
|
Has anyone ever heard anything about Dry Needling at the actual site of pain at the Achilles Tendon?
I heard a colleage talking about it but cant find anything on it.
They mentioned the needle stimulating acute healing????
Anyone have any thoughts?
Regards,
David
|
|
|
|
|
RE: Re: Achilles tendinosis - August 1, 2007 5:17:50 PM
|
|
|
yarringtonpt
Posts: 112
Joined: July 4, 2006
From: Waynesville, NC
Status: offline
|
Is it necessary for the tendon thickening to resolve in order to consider treatment successful? I have used eccentrics along with ASTYM and stationary pulsed US with success as far as pain and function goes, but tendon thickening does not seem to resolve.
On the CM note, I used it the other day on a patient with chronic plantar faciitis / failed fasciotomy. She came in with complaints of LBP / sciatica, which for her is episodic. After 5-10 minutes at L4-5, L5-S1 on the involved side, she got up pain free in her lower back and buttocks. Oh,and by the way, she had no foot pain either.
_____________________________
Eric Yarrington, PT, MPT, OCS
|
|
|
|
|
RE: Re: Achilles tendinosis - August 1, 2007 6:51:23 PM
|
|
|
ginger
Posts: 660
Joined: February 26, 2005
From: Melbourne Victoria
Status: offline
|
well done Eric, you will find the same immediate effect with PFS/medial knee pain ( L3 ) as well, these are lasting changes , provided the relevant joint has been successfully restored to normal unprotected movements.
_____________________________
Ubi est mea anaticula cumminosa?
The Grand Pediculator
|
|
|
|
|
RE: Re: Achilles tendinosis - August 2, 2007 6:55:05 AM
|
|
|
daveclan08
Posts: 8
Joined: May 21, 2007
From: Rep. of Ireland
Status: offline
|
To: The Grand Pediculator,
Can you explain to a basic grade physio with no post-grad manual therapy training how exactly you perform CM for Achilles Tendinopathy.
I want to present this info. to a colleague and have them work on my back.
Do you use a simple Posterior/Anterior Mob and what Grade? How long should you continue for?
I appreciate the "doing" can be difficult to translate into words as you probably rely on touch/feel, perhaps you could recommend a text book, diagrams etc..
Would appreciate your advice,
Regards,
David
|
|
|
|
|
RE: Re: Achilles tendinosis - August 2, 2007 7:48:18 AM
|
|
|
yarringtonpt
Posts: 112
Joined: July 4, 2006
From: Waynesville, NC
Status: offline
|
David:
Under the manual therapy thread, search for continuous mobilizations.
_____________________________
Eric Yarrington, PT, MPT, OCS
|
|
|
|
 New Messages |
 No New Messages |
 Hot Topic w/ New Messages |
 Hot Topic w/o New Messages |
 Locked w/ New Messages |
 Locked w/o New Messages |
|
 Post New Thread
 Reply to Message
Post New Poll
Submit Vote
Delete My Own Post
Delete My Own Thread
Rate Posts |
|
0.109
|
Printable Version
All Forums >> [RehabEdge Forum] >> Open Forum >> Re: Achilles tendinosis 
