The Achilles
heel has provided legendary pain and symptoms. Achilles ruptures have been
taking down great warriors and athletes for centuries. My heart hurts when I
see patients go through the agony of the physical, mental and emotional impacts
of this injury. What if these problems could have been avoided or prevented?
This newsletter is looking to accomplish just that, a plan for the prevention
and reversal of Achilles tendinopathy.
Historically, Achilles pain was diagnosed as Achilles tendinitis. Research on painful tendons in the late 1970s discovered there was no inflammation when looking under a microscope. For decades these problems have been misdiagnosed and mistreated.
The Achilles
problem is called tendinosis, which is a degenerative condition resulting from
excessive load and decreased blood supply. The tendon becomes tender or
painful, the collagen becomes disorganized, and the strength decreases.
Who is at risk for
this type of injury?
People who are in an environment with repetitive use or higher
demand. Especially people on their feet all day for their occupation, runners, or athletes that involve frequent jumping (e.g., basketball,
volleyball, crossfit).
One in five athletes with Achilles tendinopathy are under 45
years old. When it comes to competitive athletes, one in four will have an
Achilles injury in their lifetime. Competitive runners have an even higher risk
of tendinopathy, as high as 40-50 percent.
Why is Achilles
Tendinosis important?
Healthy tissue can tolerate the daily activity and training
loads. Degenerated, thickened adhered
and weaker tendinosis tissue will not tolerate the load increasing the risk of
a full rupture. 97% of all soft tissue injuries and tears happen in degenerated
tissue.
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| Achilles Tendinosis on Left: Degenerated & Thickened |
What can I do?
If you or anyone you know have any
history of pain in your Achilles, heel, or the back of your ankle… Do this Now.
Action Step: No seriously, stop andcheck yours!
How can Dr. Matt Buffan help
me solve this problem?
Solving the problem requires three things.
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| Best method to reduce tendinosis tissue |
1. Decreased activity
2. Adhesion release treatment
3. When the tendon demonstrates
healing and tolerance to basic daily activity, eccentric exercise can be added into your routine
If the steps above are not followed in their specific order,
your problem will not be resolved and returning to training or daily activity
will be delayed. I have worked with patients who go through multiple rounds of
poor management, which includes periods of rest as long as two months and/or
poor exercise selection. The results for these patients who do not follow the
steps in order end up realizing their problem continues when they re-introduce activity.
Are there any other
areas where this problem is common?
Yes, lateral elbow tendon (“tennis elbow”), hamstring tendon
attachment, and knee tendon.
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| "Tennis elbow" |
