Thursday, October 26, 2017

Avoid Your Achilles' Heel

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.
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.
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.
"Tennis elbow"