long term swollen achillie

I think you need physical therapy to strengthen
your ankles/related muscles.

hoops said:

i'm an off and on 45 year old recreational runner (nothing more than a
couple of miles around a padded track), but i'm a very active basketball
player (mainly indoor).

i started to have pain and swelling in my both achillies about 18 months ago
and my orthopedist diagnosed it as Achilles tendonitis and said to stay off
it and pop anti-inflammatories. my left ankle is much worse than my right.

i stayed off it a little bit it...it got better..then i started playing a
bit more aggressively and it came back. then i took a longer stretch off (3
months or so) and it was a lot better.

it began to bother me again this past summer and now i've been out of action
since the end of the summer. i haven't run on it at all and haven't played
any hoops either. occasionally i'll shoot around, but that's been the
extent of my exercise over the past 4 months. it still is sore and still
hurts to climb stairs and such. i can play thru the pain, but it would be
very sore afterwards.

i stretch it, but not aggressively.

the problem is that it (the back of my left ankle) is still swollen - always
swollen. the swelling never goes down..it's just there. it feels terrific
after i beg my wife to massage it for 10-20 minutes, but that's the only
modality that seems to loosen me up. i haven't tried walking on my
treadmill or doing anything to challenge it. i am and have been wearing
store bought heel lifts in both sneakers.

ok..so my question is where do i turn? i casually showed it to a pal who is
an orthopedist, and he suggests rest is the only possible cure, but he can't
really speak to the swelling because he hasn't observed it over time.

i have been thinking about turning to an orthopedic massage therapist. not
sure if what they would do would be different from what a 'regular' massage
therapist would do, but i thought there's a chance it would be a more
focused treatment (also there's the possibility my insurance might cover
part of it if i get a prescription).

other than that, i don't how to proceed. any ideas/thoughts/help/common
histories/etc etc. Thanks!

You might consider:

-losing weight if there's weight to be lost

-changing your style of play somewhat

-regular icing after exercise

-cross-train on a bike instead of running (except for b-ball)

-strengthening the foot with physical therapy, as problems in the foot can
spread up the achilles

-using different shoes with more heel lift for b-ball (and running)

-NOT using anti-inflammatories regularly, as there are rumors that regular
use of anti-inflammatories can make a condition worse if they're present in
the system during exercise

-Also are you on your feet all day at work?

good luck, Tony

hoops wrote in message <[email hidden]>...

Quoted message said:

i'm an off and on 45 year old recreational runner (nothing more than a
couple of miles around a padded track), but i'm a very active basketball
player (mainly indoor).

i started to have pain and swelling in my both achillies about 18 months

ago

Quoted message said:

and my orthopedist diagnosed it as Achilles tendonitis and said to stay off
it and pop anti-inflammatories. my left ankle is much worse than my right.

i stayed off it a little bit it...it got better..then i started playing a
bit more aggressively and it came back. then i took a longer stretch off

(3

Quoted message said:

months or so) and it was a lot better.

it began to bother me again this past summer and now i've been out of

action

Quoted message said:

since the end of the summer. i haven't run on it at all and haven't played
any hoops either. occasionally i'll shoot around, but that's been the
extent of my exercise over the past 4 months. it still is sore and still
hurts to climb stairs and such. i can play thru the pain, but it would be
very sore afterwards.

i stretch it, but not aggressively.

the problem is that it (the back of my left ankle) is still swollen -

always

Quoted message said:

swollen. the swelling never goes down..it's just there. it feels terrific
after i beg my wife to massage it for 10-20 minutes, but that's the only
modality that seems to loosen me up. i haven't tried walking on my
treadmill or doing anything to challenge it. i am and have been wearing
store bought heel lifts in both sneakers.

ok..so my question is where do i turn? i casually showed it to a pal who

is

Quoted message said:

an orthopedist, and he suggests rest is the only possible cure, but he

can't

Quoted message said:

really speak to the swelling because he hasn't observed it over time.

i have been thinking about turning to an orthopedic massage therapist. not
sure if what they would do would be different from what a 'regular' massage
therapist would do, but i thought there's a chance it would be a more
focused treatment (also there's the possibility my insurance might cover
part of it if i get a prescription).

other than that, i don't how to proceed. any ideas/thoughts/help/common
histories/etc etc. Thanks!

hoops said:

i'm an off and on 45 year old recreational runner (nothing more than a
couple of miles around a padded track), but i'm a very active basketball
player (mainly indoor).

i started to have pain and swelling in my both achillies about 18 months ago
and my orthopedist diagnosed it as Achilles tendonitis and said to stay off
it and pop anti-inflammatories. my left ankle is much worse than my right.

.....

Quoted message said:

other than that, i don't how to proceed. any ideas/thoughts/help/common
histories/etc etc. Thanks!

I second Tom's suggestion to get to a physical therapist and Tony's
comments. You need to have the cause of the problem diagnosed, then
probably start foot / ankle strengthening exercises.

You also need to find out what caused it as different people may have
different causes. I'm not a doctor, but here's what I'd do in the
meantime (if you live someplace icy, there may be delays getting to a PT
this time of year):

1. Allow to heal. Maintain some light joint motion to increase blood
flow to the area and allow the healing in a semi-functional manner. (the
massage may be helping this) No motion may have healing occur in a
bunched manner (there's an official term for it, but it (like where my
keys are) escapes my mind at the moment). Yours may not be as bad as
mine was, but I didn't even want to do anything more than walk because
of the pain.

2. I've also soaked my feet in cold water (tap-water cold works for me
for soaking feet, but we have fairly cold tap water. Ice water is a
little too cold for anything more than a quick dip of foot - for me.)
Gently warm it afterwards to restore circulation. If I can do it, I
prefer the localized treatment of swelling (cold water or apply ice or
gel pack), rather than NSAID.

3. Loosening calf / ankle area via massage may be helpful in short term
(not sure if any potential damage), but you need to find cause.

You really need to find out what caused your problem, but in *my* case,
my PT gave me a bunch of exercises to strengthen my foot / ankles and
and improve proprioception. These included ones similar to these
http://www.pponline.co.uk/encyc/0125.htm
In my case, he gave me the full routine 3-D matrix described by Gray
(and probably others before him). The main thrust is single-legged squat
balances (partial), then extending the leg forward, backward, diagonally
behind. Progress includes adding light weights and/or closing eyes (be
careful first time you do this). Others included standing lunges with
foot going front, sideways, diagonally back. Progressions include
quickening the pace, increasing instability of surface, adding weights,
closing eyes, etc.

But these might not be appropriate for you if your AT has a different cause.

Good luck.

Dot

--
The goal is training and adaptation, not destruction and injury.
- John Hardy
http://www.mountainrunning.coolrunning.com.au/misc/training.shtml

i appreciate your suggestions. when i've asked my GP and my orthopedist
about PT, they didn't seem to think that would help much. the place i've
used in the past for PT (for some back issues that don't bother me anymore)
seemed to be more in the mode of helping the patient cure himself and not in
the hands-on mode (no massage modalities). 15 years ago, i messed up an
ankle playing ball and that PTist was all hands on, basically massaging the
ankle for 30-40 minutes and then working it out thru basically isometrics.

would u think something like a trained orthopedic massage therapist might be
a better place to start rather than PT?

also are 'regular' massage therapists typically called upon for this kind of
work? thanks

"Tony" <qtrader2@(remove)hotmail.com> wrote in message
news:CoItd.797$pZ5.779@trndny06...

Quoted message said:

You might consider:

-losing weight if there's weight to be lost

Quoted message said:

-changing your style of play somewhat

Quoted message said:

-regular icing after exercise

-cross-train on a bike instead of running (except for b-ball)

-strengthening the foot with physical therapy, as problems in the foot can
spread up the achilles

-using different shoes with more heel lift for b-ball (and running)

-NOT using anti-inflammatories regularly, as there are rumors that regular
use of anti-inflammatories can make a condition worse if they're present

in

Quoted message said:

the system during exercise

-Also are you on your feet all day at work?

good luck, Tony

hoops wrote in message <[email hidden]>...

Quoted message said:

i'm an off and on 45 year old recreational runner (nothing more than a
couple of miles around a padded track), but i'm a very active basketball
player (mainly indoor).

i started to have pain and swelling in my both achillies about 18 months

ago

Quoted message said:

and my orthopedist diagnosed it as Achilles tendonitis and said to stay

off

Quoted message said:

Quoted message said:

it and pop anti-inflammatories. my left ankle is much worse than my

right.

Quoted message said:

Quoted message said:

i stayed off it a little bit it...it got better..then i started playing a
bit more aggressively and it came back. then i took a longer stretch off

(3

Quoted message said:

months or so) and it was a lot better.

it began to bother me again this past summer and now i've been out of

action

Quoted message said:

since the end of the summer. i haven't run on it at all and haven't

played

Quoted message said:

Quoted message said:

any hoops either. occasionally i'll shoot around, but that's been the
extent of my exercise over the past 4 months. it still is sore and still
hurts to climb stairs and such. i can play thru the pain, but it would

be

Quoted message said:

Quoted message said:

very sore afterwards.

i stretch it, but not aggressively.

the problem is that it (the back of my left ankle) is still swollen -

always

Quoted message said:

swollen. the swelling never goes down..it's just there. it feels

terrific

Quoted message said:

Quoted message said:

after i beg my wife to massage it for 10-20 minutes, but that's the only
modality that seems to loosen me up. i haven't tried walking on my
treadmill or doing anything to challenge it. i am and have been wearing
store bought heel lifts in both sneakers.

ok..so my question is where do i turn? i casually showed it to a pal who

is

Quoted message said:

an orthopedist, and he suggests rest is the only possible cure, but he

can't

Quoted message said:

really speak to the swelling because he hasn't observed it over time.

i have been thinking about turning to an orthopedic massage therapist.

not

Quoted message said:

Quoted message said:

sure if what they would do would be different from what a 'regular'

massage

Quoted message said:

Quoted message said:

therapist would do, but i thought there's a chance it would be a more
focused treatment (also there's the possibility my insurance might cover
part of it if i get a prescription).

other than that, i don't how to proceed. any ideas/thoughts/help/common
histories/etc etc. Thanks!

thank for the reply. i will definitely read the page you suggested.

question tho - the constant swelling in my ankle. i've not been inactive
for 3-4 months. i don't stand on the job and there are days on end when
it's totally at rest other than simple non strenuous walking around...but
the swelling remains.

that's the part that i can't figure out. is this common?

to the medical pros out there, could something like a deep massage break up
adhesions or whatnots and help alleviate the swelling? my thots are to work
on the swelling first before attacking any underlying causes. THANKS

"Dot" <dot.h@#duh?att.net> wrote in message
news:[email hidden]...

Quoted message said:

hoops said:

i'm an off and on 45 year old recreational runner (nothing more than a
couple of miles around a padded track), but i'm a very active basketball
player (mainly indoor).

i started to have pain and swelling in my both achillies about 18 months

ago

Quoted message said:

Quoted message said:

and my orthopedist diagnosed it as Achilles tendonitis and said to stay

off

Quoted message said:

Quoted message said:

it and pop anti-inflammatories. my left ankle is much worse than my

right.

Quoted message said:

....

Quoted message said:

other than that, i don't how to proceed. any ideas/thoughts/help/common
histories/etc etc. Thanks!

I second Tom's suggestion to get to a physical therapist and Tony's
comments. You need to have the cause of the problem diagnosed, then
probably start foot / ankle strengthening exercises.

You also need to find out what caused it as different people may have
different causes. I'm not a doctor, but here's what I'd do in the
meantime (if you live someplace icy, there may be delays getting to a PT
this time of year):

1. Allow to heal. Maintain some light joint motion to increase blood
flow to the area and allow the healing in a semi-functional manner. (the
massage may be helping this) No motion may have healing occur in a
bunched manner (there's an official term for it, but it (like where my
keys are) escapes my mind at the moment). Yours may not be as bad as
mine was, but I didn't even want to do anything more than walk because
of the pain.

2. I've also soaked my feet in cold water (tap-water cold works for me
for soaking feet, but we have fairly cold tap water. Ice water is a
little too cold for anything more than a quick dip of foot - for me.)
Gently warm it afterwards to restore circulation. If I can do it, I
prefer the localized treatment of swelling (cold water or apply ice or
gel pack), rather than NSAID.

3. Loosening calf / ankle area via massage may be helpful in short term
(not sure if any potential damage), but you need to find cause.

You really need to find out what caused your problem, but in *my* case,
my PT gave me a bunch of exercises to strengthen my foot / ankles and
and improve proprioception. These included ones similar to these
http://www.pponline.co.uk/encyc/0125.htm
In my case, he gave me the full routine 3-D matrix described by Gray
(and probably others before him). The main thrust is single-legged squat
balances (partial), then extending the leg forward, backward, diagonally
behind. Progress includes adding light weights and/or closing eyes (be
careful first time you do this). Others included standing lunges with
foot going front, sideways, diagonally back. Progressions include
quickening the pace, increasing instability of surface, adding weights,
closing eyes, etc.

But these might not be appropriate for you if your AT has a different

cause.

Quoted message said:

Good luck.

Dot

--
The goal is training and adaptation, not destruction and injury.
- John Hardy
http://www.mountainrunning.coolrunning.com.au/misc/training.shtml

Quoted message said:

i'm an off and on 45 year old recreational runner (nothing more than a
couple of miles around a padded track), but i'm a very active basketball
player (mainly indoor).

i started to have pain and swelling in my both achillies about 18 months ago
and my orthopedist diagnosed it as Achilles tendonitis and said to stay off
it and pop anti-inflammatories. my left ankle is much worse than my right.

i stayed off it a little bit it...it got better..then i started playing a
bit more aggressively and it came back. then i took a longer stretch off (3
months or so) and it was a lot better.

it began to bother me again this past summer and now i've been out of action
since the end of the summer. i haven't run on it at all and haven't played
any hoops either. occasionally i'll shoot around, but that's been the
extent of my exercise over the past 4 months. it still is sore and still
hurts to climb stairs and such. i can play thru the pain, but it would be
very sore afterwards.

i stretch it, but not aggressively.

the problem is that it (the back of my left ankle) is still swollen - always
swollen. the swelling never goes down..it's just there. it feels terrific
after i beg my wife to massage it for 10-20 minutes, but that's the only
modality that seems to loosen me up. i haven't tried walking on my
treadmill or doing anything to challenge it. i am and have been wearing
store bought heel lifts in both sneakers.

ok..so my question is where do i turn? i casually showed it to a pal who is
an orthopedist, and he suggests rest is the only possible cure, but he can't
really speak to the swelling because he hasn't observed it over time.

i have been thinking about turning to an orthopedic massage therapist. not
sure if what they would do would be different from what a 'regular' massage
therapist would do, but i thought there's a chance it would be a more
focused treatment (also there's the possibility my insurance might cover
part of it if i get a prescription).

other than that, i don't how to proceed. any ideas/thoughts/help/common
histories/etc etc. Thanks!

Chiropractor. Your bad ankles are probably a sign of your back being out of
line. Do that, and incorporate several figure 8's before and after you run to
strengthen your ankles.