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achilles tendonitis

 
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achilles tendonitis - June 19, 2008 3:51:23 AM   
annpsu25

 

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Currently working with a 53 y.o male runner who had been diagnosed with achilles tendonitis 2 weeks ago.  I have given him a few stretches and some seated DF/PF, US, MA, and have progressed him over the past few days from the bike, elliptical, and today we started the treadmill at 4.0 mph x 5min. Pt has been given heel lift and is being iced after treatment.  Pt is doing very well and does not c/o of pain or discomfort, but has stated "he can't believe how much better he feels."

What other treatment options are available and what have you found to be beneficial in athletes with achillies tendonitis?

< Message edited by annpsu25 -- June 19, 2008 3:58:37 AM >


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Allisha
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RE: achilles tendonitis - June 20, 2008 7:59:48 PM   
buckeye

 

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Glad you are having success, but the quick relief sometimes comes back to bite you. Is he on anti-inflammatory medication? A steroid dose pack or non-steroidal medication can sometimes give excellent relief and the athlete can return to activity quickly. Unfortunately, this may not allow you to address the issues of why the Achilles pain occurs.
There may be a proximal component - from the lumbar spine through the hip and knee - causing problems. Or lack of pronation control. Or simple overuse or rapid change in his running/training.
Was this patient recently on fluoroquinolone antibiotic? Achilles tendinits and ruptures have increased frequency with use of certain antibiotics.


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RE: achilles tendonitis - June 20, 2008 8:42:54 PM   
Tom Reeves DPT ATC

 

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agree with Buckeye on that one.  you have to figure out why the symptoms started.  Was it simply one bad step? or was it shoes that were used beyond their time? tight gastrocs? bad feet? funky running surfaces? All of the above?

I have had success with microcurrent as an adjunct to the mechanical stuff you are doing and I mentioned above.

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RE: achilles tendonitis - June 20, 2008 9:13:22 PM   
annpsu25

 

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Thank you both for you replies.  I will be sure to ask him these questions on monday.  We started him on ionto today and put him on the treadmill doing a light jog to see how or if he was able to tolerate it.  And he def. did not tolerate it.  I also started manual hamstring stretching - as i know that most runner have tight hamstrings, sure enough he was tight.  Microcurrent is very interesting, I'll have to pull that information out of my school notes.

This man was running the 100 meter dash, about 25 meters into it is when he felt the pain- and obviously did not finish the race.

He is wants to get back to work and running soon and is very impatient.  He is following his HEP, heel cord stretches, MA, etc.

Thank you both for your input.  I'll have more to say monday night =)

< Message edited by annpsu25 -- June 20, 2008 9:19:10 PM >


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RE: achilles tendonitis - June 23, 2008 1:09:40 AM   
bonez

 

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There have been some posts on this site earlier regarding the use of eccentric loading to assist in recovery as well. Tom I would be interested to hear about the micro current use. It has kind of fallen off the radar on my screen lately.

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RE: achilles tendonitis - June 23, 2008 8:30:31 PM   
buckeye

 

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53 y.o. running the 100 m dash - must be a serious runner.

Probably a greater risk of Achilles tendon rupture at this age with intense exercise - sprinting, jumping, etc. I  think there might be evidence of increased risk with the tendinitis.

I think the eccentric exercise studies are for tendinosis.

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RE: achilles tendonitis - June 23, 2008 8:49:07 PM   
Tom Reeves DPT ATC

 

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Bonez,

I have been using microcurrent since 1991.  I realize that there has not been much positive research regarding microcurrent lately but I have not seen a well set up study, using parameters that have been clinically effective.  I did one of my internships with Lynn Wallace PT in Cleveland and he was one of the pioneers with clinical application of microcurrent. 

Things that I saw in his clinic were amazing.  I am one of those who is very skeptical of the claims of modalities.  I saw an ad for the Accuscope and thought it sounded like true snake oil.  I saw microcurrent do much of what was claimed.  It is not a substitute for sound mechanical evaluation and modification of poor movement patterns but it does accelerate the healing process.


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RE: achilles tendonitis - June 24, 2008 2:16:10 AM   
bonez

 

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quote:

ORIGINAL: Tom Reeves DPT ATC

Bonez,

I have been using microcurrent since 1991.  I realize that there has not been much positive research regarding microcurrent lately but I have not seen a well set up study, using parameters that have been clinically effective.  I did one of my internships with Lynn Wallace PT in Cleveland and he was one of the pioneers with clinical application of microcurrent. 

Things that I saw in his clinic were amazing.  I am one of those who is very skeptical of the claims of modalities.  I saw an ad for the Accuscope and thought it sounded like true snake oil.  I saw microcurrent do much of what was claimed.  It is not a substitute for sound mechanical evaluation and modification of poor movement patterns but it does accelerate the healing process.




Using what kind of parameters and for what phases of recovery?

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RE: achilles tendonitis - June 24, 2008 2:20:10 AM   
bonez

 

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quote:

ORIGINAL: buckeye

53 y.o. running the 100 m dash - must be a serious runner.

Probably a greater risk of Achilles tendon rupture at this age with intense exercise - sprinting, jumping, etc. I  think there might be evidence of increased risk with the tendinitis.

I think the eccentric exercise studies are for tendinosis.

I agree completely that at this stage there is an inflammatory compoenent but he is likely a serious runner and is of the generation that has trained hard for years (often incorrectly) so complete his recovery this form of exercise I understood was reported to increase the remaining tendon strength.

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RE: achilles tendonitis - June 24, 2008 6:10:33 PM   
buckeye

 

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bonez --- I hope I did not offend you with my post. No offense is intended.

I agree with using the eccentric exercises - just pointing out the literature supporting eccentric exercise for tendinosis. 

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RE: achilles tendonitis - June 24, 2008 7:35:41 PM   
bonez

 

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quote:

ORIGINAL: buckeye

bonez --- I hope I did not offend you with my post. No offense is intended.

I agree with using the eccentric exercises - just pointing out the literature supporting eccentric exercise for tendinosis. 


No offense taken!!

(in reply to buckeye)
Post #: 11
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