My Tangle With Tendinopathy | Rob Broulliard

[stef]

​Let's start with the stats: Male, 48, 5'9", 210 lb, 1RM for press 215 lb, bench 350 lb, squat 455 lb, dead 485 lb, and I’ve missed 500 lb six times in the past 3 years. For the past 5 years or so all I have done for exercise are the four main barbell exercises. I’m not sure why my right Achilles started hurting, but it must have started about two years ago. Maybe I was running a bit in the dog park while playing with the dog, but I had no single moment where I remember it grabbing me...

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[Subby]

So were you increasing your squat back to it's normal weight during the prolotherapy? I presume at the end where you're talking about the 4th injection that's the 4th shot of prolotherapy? It reads like your recovery was complicated by the amount of walking you were doing at work. In hindsight was that a factor? I'm assuming you'd be doing 25k+ steps a day in a hospital.

I've never heard that story about Alfredson before, going out to purposely trying to rupture your achilles tendon is batshit crazy. Hard to believe it wasn't till the 1990's that someone had the insight that tendons could be remodeled. Good article though, calling injury recovery a "journey" is a cliche of course, but it really communicated how long and frustrating the process can be.

[Mark Rippetoe]

Good article though, calling injury recovery a "journey" is a cliche of course, but it really communicated how long and frustrating the process can be.

Fuck. I thought I had edited that out.

[Gsquared23]

I treat this condition quite often. I attribute the root cause to the equinus or tight posterior muscle group/Achilles complex. First line for me is a night splint, heels lifts, topical NSAID, runners stretch. Physical therapy and iontophoresis are next. If those fail, surgery is typically the next step which includes a gastrocnemius recession/posterior muscle group lengthening. Recovery is immediate weight-bearing in a walking boot, those people feel really good by three months.

For the patients who are opposed to surgery or are not surgical candidates, a non-articulated gauntlet style custom AFO (ankle foot orthosis, ankle brace, e.g. Arizona brace) limits range of motion of the ankle and therefore decreases the stresses on the Achilles and can can successfully treat this problem if worn for six months or more.

If your Achilles continues to bother you, get it fixed, the gastrocnemius recession can be done through a scope. Although the open incision is probably 5 cm on average.

[Mark Rippetoe]

You want him to get surgery because his Achilles tendon hurts? Seriously?

[Gsquared23]

It depends on his pain level and how much it restricts his life. If it hurts every single day, prevents him from doing or enjoying his physical activity, and is over a 4/10 on the subjective pain field, surgery is a really good option. It’s a 22 minute procedure. Just providing a different perspective.

But the majority of the time it doesn’t come to that, the conservative stuff tends to work for 4.5 out of 5 patients. I always max that out because there are fewer risks.