Achilles Pain and Treatment

[Pulse]

Cortisone has been associated with tendon degradation, decreased healing capabilities of the tendon and tendon sheath, and atrophy of the surrounding muscle structures, etc. As V12 said, it can stay in the area for a very long time, and cause degradation over an extended period of time. The more chronic tendons usually do not present with much inflammation (if at all), so to be so aggressive with cortisone is almost nonsensical, even though commonly advised. Get a proper diagnosis including ultrasound so that some visualisation can be done on the state of the tendon structure.

[footdoc]

What the Doc said, eccentric muscle strengthening and up to 12 weeks of offloading, rest and rehab. Do a Google search for information by tendon guru Prof. Jill Cook and her tendon injury continuum it helps to understand the pathology of the tendon better. Not just inflammation, degeneration too. If you understand the pathology you will understand why cortisone is a bad idea. My 2 cents worth.

Edited July 31, 2014 by footdoc

[Big John]

Thank you all for the input. I went to see the quack and was diagnosed with Retrocalcneul Bursitis. Interesting to learn more about the anatomy - and good advice from hubbers to get me there. Unfortunately I'm off the bike for two weeks, and have icing, stretching, foam rollering to do. Lucky for me, it was not, in fact, the achilles so that is good news.

[V12man]

Thank you all for the input. I went to see the quack and was diagnosed with Retrocalcneul Bursitis. Interesting to learn more about the anatomy - and good advice from hubbers to get me there. Unfortunately I'm off the bike for two weeks, and have icing, stretching, foam rollering to do. Lucky for me, it was not, in fact, the achilles so that is good news.

If that's the correct diagnosis (that's not a common diagnosis in cycling) then you DEFINATELY should have a professional bike setup done when it's resolved - sometimes it's a question of a couple of millimetres the difference between injured and not injured.

[Superfly1]

Cortisone has been associated with tendon degradation, decreased healing capabilities of the tendon and tendon sheath, and atrophy of the surrounding muscle structures, etc. As V12 said, it can stay in the area for a very long time, and cause degradation over an extended period of time. The more chronic tendons usually do not present with much inflammation (if at all), so to be so aggressive with cortisone is almost nonsensical, even though commonly advised. Get a proper diagnosis including ultrasound so that some visualisation can be done on the state of the tendon structure.

My physio sent me for a sonar scan and I was diagnosed with paratenonitis on Wednesday. Basically the sheath that is inflamed and not the tendon. The doc suggested the cortisone injection. I now postponed it after reading this as I think I must get another opinion. Has anybody suffered from paratenonitis and how long did it take to heal? I've been going for physio for more than two weeks now. Seems to be getting better and I am dying to get back on the bike! Need to make a call on that injection before Monday...

Edited August 1, 2014 by Superfly1

[Pieter1]

Hey man. Have you tried a foam roller?

[BarHugger]

If that's the correct diagnosis (that's not a common diagnosis in cycling) then you DEFINATELY should have a professional bike setup done when it's resolved - sometimes it's a question of a couple of millimetres the difference between injured and not injured.

 

+1

 

Also have a look at your shoes.......the heel support section and the effect it has on that specific area of the heel. Also cleat position (as stated before)

 

For now........HEAT and ICE contrats therapy is your friend

[Big John]

 

+1

 

Also have a look at your shoes.......the heel support section and the effect it has on that specific area of the heel. Also cleat position (as stated before)

 

For now........HEAT and ICE contrats therapy is your friend

Thanks. Physio also told me about the shoes, and this makes a lot of sense. Next would be pro bike fit. For now, restful weekend with feet up and plenty icing and stretching. Also, will get foam roller and loosen up these damn calves (whole leg actually needs it!)

[TALUS]

Thank you all for the input. I went to see the quack and was diagnosed with Retrocalcneul Bursitis. Interesting to learn more about the anatomy - and good advice from hubbers to get me there. Unfortunately I'm off the bike for two weeks, and have icing, stretching, foam rollering to do. Lucky for me, it was not, in fact, the achilles so that is good news.

Retrocalcaneal Bursitis is a completely different diagnosis. It can be treated by several means. Also read up on "pump bumps" and Haglunds' deformity. All different pathology in the same area.

[Swart Kat]

 

Why never cortisone injection? I was told today by a doctor and physio to get one. What do I need to know?

 

I had the same problem and today still my achilles aint right. I went for an cortisone injection, but if done wrong, BBBIIGG problems! 10sec after the injection all pain was gone! Went for fisio for months after that just to get it back into shape. Achilles is a bitch......

[Sulli]

I had a cortisone injection today, and yes all the pain is gone and is feeling better. Doc said I may be good in a week or so, the main thing is to not blindly inject into the tendon. The doc used an Ultra Sound to pin point where to inject around the tendon in five dif spots.

 

I voiced my concern about the injection and this forum, as he is a cyclist, unlucky for you guys he said that he doubts there are any doctors posting on this forum

 

Will let almal know how it goes, but definitely think things change per case.

[BarHugger]

Sterkte......hope it works out well.

[V12man]

 

I voiced my concern about the injection and this forum, as he is a cyclist, unlucky for you guys he said that he doubts there are any doctors posting on this forum

 

He might just be a little wrong on that....... just a tad.... Please be aware that even if you now have no pain, that the underlying issue still exists, and that you must resolve - if you don't then we may well hear a rather loud "twang" soon.

[NotSoBigBen]

I had a cortisone injection today, and yes all the pain is gone and is feeling better. Doc said I may be good in a week or so, the main thing is to not blindly inject into the tendon. The doc used an Ultra Sound to pin point where to inject around the tendon in five dif spots.

 

I voiced my concern about the injection and this forum, as he is a cyclist, unlucky for you guys he said that he doubts there are any doctors posting on this forum

 

Will let almal know how it goes, but definitely think things change per case.

 

I am of the opinion there are a few very knowledgable people here some of whom are doctors or some other professional with the necessary training/certifications

[Weppie]

...if you don't then we may well hear a rather loud "twang" soon.

 

And a kick in heel....???

[V12man]

And a kick in heel....???

There will also be an associated scream and quite possibly some crying......... followed by some surgery and a hospital stay..... and several weeks in a boot.... followed by extensive and long winded rehab....