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My scumbag Achilles.
I feel like we have a very poor model of how tendons work / become injured / heal.
Certainly the bog standard advice that your doctor gives you is completely useless. RICE (rest,ice,compression,elevation) is worthless for athletes suffering from tendonitis. Yes, even the R in RICE is bad. You can rest your achilles for 2 weeks and see zero improvement.
Here's the latest fuck you from my Achilles tendon.
After a couple years of quiet, my Achilles suddenly flared up playing tennis. The next day I am limping badly and despite rest (and eccentric calf lowering) this shit lingers for weeks. I can't really play tennis at all which is bad because I have a tournament coming up and I'm going to be playing several matches in one weekend.
Well, the tournament happened and my Achilles was - mostly fine somehow. I took two ibuprofen each day and I guess that was enough. Despite a huge amount of volume over the weekend, my Achilles is in the same state as it was last week, achy but not debilitating.
I've tried everything. Ice, heat/ice, voodoo flossing, eccentric calf lowers, stretching, rest. Nothing really works to cure the Achilles, although foam rolling the calves seems to help prevent further injury. In the end, my Achilles just suddenly gets worse or better for no reason.
One day, someone will figure out a treatment that actually works for tendonitis.
Full disclosure, not a doctor, just a guy who likes to avoid chronic injury. A good way to combat chronic pain is to figure out where the jarring, abrupt movements are in your sport of choice. For instance, I run, so much of my abrupt impact comes from my gait and my foot strike. I'm not as familiar with tennis, but I imagine a lot of quick sprints and turning on a dime to reposition. Really meditate on these movements, try and understand them in detail, because we are going to reverse them.
Most injuries are a result of deceleration. When you stop abruptly, you are putting immense strain on joints. Your whole body mass is working against your velocity, which imparts force directly onto the small tissues holding your bones together. When you do this over and over, you end up with chronic aches and pains, and oftentimes injuries. Knees are bad for this, as are ankles, because of their role in movement and deceleration and for whatever reason nobody seems to recognize the real solution: Train your deceleration muscles.
Strong muscles prevent injury. It's common sense: a weak guy lifting a heavy weight is far more likely to hurt himself doing so than a strong guy lifting a heavy weight. The same principle applies with deceleration: a weak joint is more likely to get hurt than a strong joint when strong forces are applied. I always recommend kneesovertoesguy (three minute video) because he just absolutely nails this philosophy, and he's a living example of how to retrain and fix severe, chronic, muscular-skeletal issues. Hope this helps, chronic injury is no fun! The more we can what we love the better, eh?
Thanks, I'll check it out!
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Yep current medical understanding of injury is terrible, and doctors are way too confident at trying to perform surgeries when they don't know shit. Beware.
I'd say movement and exercise is the key to tendonitis in my experience. To be fair I'm also a big body/mind guy, a la John Sarno. I've dealt with chronic pain for almost ten years so I have been through all sorts of different treatment programs. Ultimately just developing more fine-grained bodily awareness and relaxing with yoga + working on my emotional state have been the only things that helped me.
Agree, and I think everyone should get at least 2 opinions before surgery. But I think things are getting better. A teammate recently tore her ACL. Her doctors are avoiding surgery due to evidence suggesting that surgery doesn't have better outcomes.
A philosophical question about disorder: Who do you take advice from, the person who has lots of problems or the person who never has any? For example, if I have tendonitis, do I talk to the guy who does PT every day and wears 7 braces. Or do I talk to the guy who has never been injured?
Personally, I want to be a healthy person, not a person that overcomes illnesses. So I try to emulate the guy who waltzes through life without a care in the world. But then I get injured and I end up asking the knee brace guy which PT he uses.
Really hard to figure out the correct path, I guess. I do believe mind/body connections are important.
Yep I don’t blame you, chronic pain is weird! I would take the advice of the body builders as well.
I just lurk here in the shadows waiting for people to fall through the cracks of mainstream exercise science, then I pounce!
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I very much relate to this. I have various off-and-on soft tissue injuries. They mostly seem to come and go for no apparent reason. I've seen doctors for a particularly bothersome one, got an MRI and blood test, only to be told basically, :shrug: I have no idea what's going on, there's nothing to be done. I don't think conventional medicine has much of anything to help with these sort of issues.
At least for me, usually working through it as much as I can is a lot more helpful than any form of treatment. I've had this with certain movements in my knees, one big toe (yeah, I know, weird, but it kind of makes walking tricky), one wrist, and I don't think anything else for a while. The usual pattern is that it starts hurting when I put force on it in some particular way. Trying to avoid putting any force on that joint, and most other typical treatments, doesn't seem to help much. It seems to help a lot more to try to use the joint as much as I can anyways, avoiding whatever specific movement makes it hurt the worst. Usually after keeping on it for a while, the painful motion just stops being painful.
It feels like this is getting a bit rambly, but I basically agree that we don't seem to have any real idea how tendons etc work, and that unconventional things like the use pattern I described seem to help more than anything with as little overall inconvenience as possible.
I have some similar weird ones... Like some tendon under my left knee (only the left!) randomly starts hurting like hell when just walking. No strain, no exercise, nothing. And then if I work it a bit and put some light weight on it, some squats, etc. - the pain disappears. If I just rest it, it also comes away in a while, but takes much longer, like hours or even a day. And it could be gone for weeks and then return randomly again. I mentioned it to several specialists and they're mostly "huh, yeah, it's weird :shrug:".
Yeah that's pretty similar to what mine is like
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Yours sounds like it behaves more like an actual injury. Mine tends to feel better when I'm using it, and tends to flare up when I'm not using it.
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