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Achilles Tendonitis Options: Tenex Procedure - PRP Injection (Read 136 times)

aroy11462


    I tore my right Achilles tendon in 2004 and had surgery on it. I have had Achilles tendonitis on my left foot on and off over the last five years. This past September it got really sore while playing tennis, and I could tell there was serious risk of a tear on the left side. I went to see an orthopedic surgeon and he suggested I stay away from running and tennis for a few months. I also saw a physical therapist who gave me stretching/strengthening exercises. I still feel like the tendon is pretty weak. When I rub my fingers along the lower part of the Achilles with some force there is still some soreness. I am going to see the doctor for a follow up visit next week. In our last appointment he said if rest and stretching didn’t help the next possible steps were a PRP injection or a Tenex Achilles procedure. We also talked about the possibility of getting custom orthotics. Has anyone had positive experiences with a PRP injection or the Tenet procedure. Any input would be greatly appreciated.Achilles Tendonitis

    HermosaBoy


      And you can quote me as saying I was mis-quoted. Groucho Marx

       

      Rob

      bhearn


        I've done PRP but for high-hamstring tendons. I THINK it helped. Or maybe I was just healing by then anyway.

         

        I have had Tenex for my right Achilles. Again, I think it helped. Recovery was longer and slower than I had expected, but still much less than for the full cut, scrape, and reattach. There is still occasionally some pain and tightness. But overall, now it's not limiting me very often. The left one, on the other hand...

         

        The last time I was at my foot doc (not the one who did the Tenex, as he never thought there was enough science behind it), he remarked that people are not doing Tenex very often anymore. Instead they are doing... something else, something similar, whose name I've forgotten. Another made-up proprietary name though (Tenex actually means percutaneous tenotomy).

        waterfordrider


        Team Effort

          Just reading your post makes me hurt. About 19 years ago I injured my achilles doing something else but the running kept it irritated. I took enough time off the completely heal and then started running again very slowly. I started with a 1/4 mile and after 3-4 runs with no pain i moved my distance up a 1/4 and repeated until I finally reached a decent 5-6 mile run. Second morning after a nice 6 mile run, a slight soreness had returned. The next  days run confirmed it. Crap!! Took time off to heal and same process, same result. What to do? When the scales started screaming, hey, fat boy, time to do something!! I got on a bicycle and have not looked back. I have been riding since 2003.  Any  soreness I might have had in my achilles when I started to ride went away and I simply do not have any more trouble with the achilles. I have noticed that as a high school softball umpire when I do a double header and have a particularly active game when on the bases I will still have a little soreness in the achilles that night or maybe the next morning but that soreness goes away very quickly. I don't know anything about the injections but long term I am skeptical.

          Good luck with whatever you decide to do.

          www.runninngahead.com/groups/5000MC/forum

          aroy11462


            Just reading your post makes me hurt. About 19 years ago I injured my achilles doing something else but the running kept it irritated. I took enough time off the completely heal and then started running again very slowly. I started with a 1/4 mile and after 3-4 runs with no pain i moved my distance up a 1/4 and repeated until I finally reached a decent 5-6 mile run. Second morning after a nice 6 mile run, a slight soreness had returned. The next  days run confirmed it. Crap!! Took time off to heal and same process, same result. What to do? When the scales started screaming, hey, fat boy, time to do something!! I got on a bicycle and have not looked back. I have been riding since 2003.

             

            Thanks for the input.  I actually have been spinning with a Peloton cycle the past few months, but I miss running and tennis.  Cycling doesn't bother my Achilles at all.

            aroy11462


              I've done PRP but for high-hamstring tendons. I THINK it helped. Or maybe I was just healing by then anyway.

               

              I have had Tenex for my right Achilles. Again, I think it helped. Recovery was longer and slower than I had expected, but still much less than for the full cut, scrape, and reattach. There is still occasionally some pain and tightness. But overall, now it's not limiting me very often. The left one, on the other hand...

               

              The last time I was at my foot doc (not the one who did the Tenex, as he never thought there was enough science behind it), he remarked that people are not doing Tenex very often anymore. Instead they are doing... something else, something similar, whose name I've forgotten. Another made-up proprietary name though (Tenex actually means percutaneous tenotomy).

               

              Thanks for the input.

                I've dealing with the aftermath of an achilles injury for about 5 years now. I did not go to a doctor, but maybe I should have. I limped on the thing for a couple months before I started trying to run again. The two things that actually helped were the eccentric heel drops, and rolling it on a wooden rolling pin (on my butt but then lifting it and holding weight with my arms, bad ankle on the pin, working up to crossing my good leg over the bad one and putting more weight on it while rolling).

                I go through long periods of no pain; as long as I don't try to do any significant speedwork. Twice in the last few years I got cocky, thinking it MUST be all healed up by now, and went to a track and did some repeat 200/400s and irritated it again. Currently, I have gone on up to 20 mile runs and 60 mile weeks without any pain at all, but I haven't attempted to do any speedwork other than maybe 5:00-6:00 pace for short stretches of longer runs. Most of my runs are 7:00-8:30 pace.

                 

                Yes, 5 years later and I'm still dealing with it. Get it fixed RIGHT asap, even if it requires you to skip out on running for 3-6 months; that would be worth it to avoid YEARS of trouble.

                60-64 age group  -  University of Oregon alumni  -  Irreverent and Annoying

                ch17


                It's Tuesday every day

                  I've dealing with the aftermath of an achilles injury for about 5 years now. I did not go to a doctor, [edit]

                   

                  I go through long periods of no pain; as long as I don't try to do any significant speedwork. Twice in the last few years I got cocky, thinking it MUST be all healed up by now, and went to a track and did some repeat 200/400s and irritated it again. Currently, I have gone on up to 20 mile runs and 60 mile weeks without any pain at all, but I haven't attempted to do any speedwork other than maybe 5:00-6:00 pace for short stretches of longer runs. Most of my runs are 7:00-8:30 pace.

                   

                   

                  Ooh, this could be me. So, question, SB: do you try to race? If so, do you try to get faster at racing by racing? --Thanks, Christine


                  SMART Approach

                    I tore my right Achilles tendon in 2004 and had surgery on it. I have had Achilles tendonitis on my left foot on and off over the last five years. This past September it got really sore while playing tennis, and I could tell there was serious risk of a tear on the left side. I went to see an orthopedic surgeon and he suggested I stay away from running and tennis for a few months. I also saw a physical therapist who gave me stretching/strengthening exercises. I still feel like the tendon is pretty weak. When I rub my fingers along the lower part of the Achilles with some force there is still some soreness. I am going to see the doctor for a follow up visit next week. In our last appointment he said if rest and stretching didn’t help the next possible steps were a PRP injection or a Tenex Achilles procedure. We also talked about the possibility of getting custom orthotics. Has anyone had positive experiences with a PRP injection or the Tenet procedure. Any input would be greatly appreciated.Achilles Tendonitis

                    You probably have a tendonosis component causine chronic soreness. This is commin and often gets diagnosed as tendinitis. There may be no inflammation. Have you had your doc analyze with musculoskeletal ultrasound (MSKU). Like Bhearn, i had high hamstring tendonosis and received PRP with fenestration (poking tendon with needle) and had success. MSKU showed ZERO inflammation in my tendons just diseased tendons with microtears.  I would lean toward PRP  to help the diseased tendon. I also agree with eccentric strength work also. Very important. The goal is to get more healthy fibers there and get them realigned. Do you research on the best doc to do this. I wanted a doc that that had a lot of experience and could  guide the PRP in the correct locations utilizing the MSKU  on monitor.

                    Run Coach. Recovery Coach. Founder of SMART Approach Training, Coaching & Recovery

                    Structured Marathon Adaptive Recovery Training

                    Safe Muscle Activation Recovery Technique

                    www.smartapproachtraining.com

                       

                      Ooh, this could be me. So, question, SB: do you try to race? If so, do you try to get faster at racing by racing? --Thanks, Christine

                       

                      I don't race. If I need to know how fast I am, I'll do a time trial. I might do a short ultra in March just to make it official that I did one. Also, it's only fast stuff up on my toes that triggers my achilles, so a 10k-marathon race wouldn't hurt me, I think.

                      60-64 age group  -  University of Oregon alumni  -  Irreverent and Annoying

                      ch17


                      It's Tuesday every day

                        Alrighty. Thanks for the info. Good luck with the short ultra, should you do it! --Christine

                         

                         

                        I don't race. If I need to know how fast I am, I'll do a time trial. I might do a short ultra in March just to make it official that I did one. Also, it's only fast stuff up on my toes that triggers my achilles, so a 10k-marathon race wouldn't hurt me, I think.

                          Alrighty. Thanks for the info. Good luck with the short ultra, should you do it! --Christine

                           

                           

                          I should clarify that my genetics are geared more toward 400-1600m; I'm a horrible distance runner.

                           

                          My achilles prevents me from training or racing at my strong distances. To train for longer races, such as 10k and up, or maybe even 5k, long intervals at goal pace or slightly faster would suffice. No need to run a bunch of 400's at 4:00-4:30 pace in order to train for a 10k where you'll be running 6:30 pace (in my case). 1000m repeats at 3:50-4:00 would be plenty fast for me without irritating my achilles much.

                          60-64 age group  -  University of Oregon alumni  -  Irreverent and Annoying

                          Blaf


                             

                            Great post at the right time.

                             

                            Can someone give me an advice or opinion. I started having issues with AT on left side 7 weeks ago. I know that it was caused by running too much on trails and running too much too soon in general.

                             

                            I took a couple weeks off and that did not fix the issue. Well, morning pain is gone, no issues when I get up any more.

                            After seeing my chiropractor (he is a good one), started running 3-4 times a week, but slower than usual. What happens now is that I get into the run without pain. During the run I experience light sensation (2 from 1 to 10) on top of the heel, where AT joins the heel) after 10 or so minutes which is gone after 5 minutes. I can finish my run, but after the run, my AT is inflamed and very sensitive (painful) on touch. If I do not touch it, there is no pain. I ice it, do foam rolling on the calf and next morning I am fine and ready for the next run. After each run pain is less and less, but I wonder if I should run at all. My chiropractor tells me that I need to keep running so my tendon keeps sliding through the sheath.

                             

                            What do you guys think, will my after run pain be gone eventually?

                            Age: 52

                            Runner since 2012

                            Marathon PB: 3:40:32


                            SMART Approach

                              Keep an eye On it and monitor. My recommendation in meantime over next month.....

                               

                              * Easy running only

                              * start doing eccentric (negatives) training for calves. Don't overstretch on lowest part of movement.

                              * Warm up achilles before activity. You want to avoid micro tears during activity. This is so important-moist heat, hot water is good or best while moving ankle/foot and light easy dynamic movements stretches before a run. Avoid static stretching before run. Also walk some before running.

                              * After run, some light stretching of calf/achilles. You can do your negatives post run also.

                              * Icing is optional. It will do nothing to enhance healing. If it makes you feel better, limit it to 10 minutes.

                               

                              If at any point you notice a worsening of symptoms, you need more time off with rehab of strength and flexibility work

                              Run Coach. Recovery Coach. Founder of SMART Approach Training, Coaching & Recovery

                              Structured Marathon Adaptive Recovery Training

                              Safe Muscle Activation Recovery Technique

                              www.smartapproachtraining.com

                                sorry Blaf; but I would see a doctor instead of a chiropractor about medical issues, but to each his own.  I'm sure you've read a bunch of stuff on achilles, and it sounds like you have the inflammation phase rather than a rupture. The Rest Ice Compression and Elevation method should clear you up in short order. If you continue to stress it in it's inflamed condition it may result in more micro-tears and more damage, and eventually into scar tissue like I have. Warming the tissue and NOT stretching before running should help a bit. The whole plantar/achilles/calf is one big system, and since tendons do NOT stretch, the only relief for reducing tension on the system is by stretching the calf. Supporting the plantar so it doesn't move as much and tug on the achilles will also help; extra arch support or taping. These are short term things, you need to wean yourself off them after you've healed up, and then start strengthening the achilles via eccentric heel drops (the only scientifically proven "fix" for achilles, everything else is speculative at this point) in order to prevent it from reoccurring.

                                60-64 age group  -  University of Oregon alumni  -  Irreverent and Annoying

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