Yet another partially torn Achilles tendon thread

travlerajm

Talk Tennis Guru
tips and suggestions to get this damaged and scar-tissue-laced piece of rope back to full functionality?
 

GAS

Hall of Fame
While it's torn, rest. After the tear heals, isometric and or eccentric work helps.

And collagen. Lots of collagen.
 

travlerajm

Talk Tennis Guru
Damn....shut it down. Go see a doctor. Resist the urge to keep playing.
That’s a slippery slope. The shut-down approach works great when you’re younger. But once you hit a certain age, the atrophy effects outweigh the gains.

That said, it was probably for the best that the only tennis courts in cannon beach, oregon over Memorial Day weekend were occupied by hordes of PB riffraff.
 

PMF

Semi-Pro
Sorry you are going through this. It's been 8-9 months for me.

If you are able to tolerate it, I would see a physical therapist, and ask them to use a tendon scraper on you. It kind of looks like an ice scraper that people use for their cars, etc. The PT specialist will scrape (hard) on your achilles tendons, heels, and bottoms of feet. Not fun, but it helps get rid of the scar tissue.
 

Purestriker

Legend
That’s a slippery slope. The shut-down approach works great when you’re younger. But once you hit a certain age, the atrophy effects outweigh the gains.

That said, it was probably for the best that the only tennis courts in cannon beach, oregon over Memorial Day weekend were occupied by hordes of PB riffraff.
Oh I no, I am Mr. Rigor Mortis the day after a match. I am fully committed to compression boots and a Theragun.

I just meant to shut it down until your fully healed. The doctor might put you in a boot for a little while to protect it.
 

yossarian

Professional
Sorry you are going through this. It's been 8-9 months for me.

If you are able to tolerate it, I would see a physical therapist, and ask them to use a tendon scraper on you. It kind of looks like an ice scraper that people use for their cars, etc. The PT specialist will scrape (hard) on your achilles tendons, heels, and bottoms of feet. Not fun, but it helps get rid of the scar tissue.
No it doesn’t
 

PMF

Semi-Pro
No it doesn’t

Not sure what you mean, but attached is a video of the procedure. It did help. The first time I got it done, I flinched so hard, I almost kicked my PT person in the face. LOL. The bottom of my feet were particularly sensitive.

 

yossarian

Professional
What does it do?
Novel stimulus that modulates the nervous system and can reduce pain in the short term. It does not remodel scar tissue in the slightest. There is no high quality evidence to suggest that
Not sure what you mean, but attached is a video of the procedure. It did help. The first time I got it done, I flinched so hard, I almost kicked my PT person in the face. LOL. The bottom of my feet were particularly sensitive.

yeah man I encounter it on a daily basis. I know what it is
 
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PMF

Semi-Pro
Novel stimulus that modulates the nervous system and can reduce pain in the short term. It does not remodel scar tissue in the slightest. There is no high quality evidence to suggest that

yeah man I encounter it on a daily basis. I know what it is

Interesting. I remember my PT saying there were different schools of thought on this, but I’ve never heard that one. Is there anything that works better? Full disclosure. Mine came back too. LOL. I‘m guilty of being impatient. Started playing tennis again too soon. Like @travlerajm, seeking solutions.
 

travlerajm

Talk Tennis Guru
My previous bout of Achilles tendinitis issues occurred 6 years ago, when I was in my late 40s.

It was initiated when I played a 4.5 league singles match, without that much singles tennis mileage built up on my legs. It was the rubber match for my league team, and it ended up being a brutal 2.5 hour physical battle of wills. Other guy went into full body cramp chasing a dropshot lob combo into the curtain on match point. He lost that battle, but I lost the war, sustaining mild overuse damage to my Achilles.

I kept trying to play twice a week, but each session seemed to make the injury zip higher up from my Achilles toward my calf. Resting it for a few weeks was ineffective. It always came back, until…

The next year, life sent me an interesting curveball, and I ended up stationed long-term for 8 months in a third world South American country for a work project.

This had rejuvenating powers on my Achilles injury. I was able to play 4x per week 55-minute paid sparring sessions versus teaching pros on the red clay, usually in warm to hot conditions, but in the shade.

The higher frequency of play, combined with shorter session length that didn’t trigger my inflammation cycle, magically healed me fully.

Problem resurfaced this last month after trying to ramp up to singles play following no-singles period.

I’m now hoping to figure out a way to recreate that magic healing schedule in the constraints of my regular northern life.
 
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onehandbh

G.O.A.T.
My previous bout of Achilles tendinitis issues occurred 6 years ago, when I was in my late 40s.

It was initiated when I played a 4.5 league singles match, without that much singles tennis mileage built up on my legs. It was the rubber match for my league team, and it ended up being a brutal 2.5 hour physical battle of wills. Other guy went into full body cramp chasing a dropshot lob combo into the curtain on match point. He lost that battle, but I lost the war, sustaining mild overuse damage to my Achilles.

I kept trying to play twice a week, but each session seemed to make the injury zip higher up from my Achilles toward my calf. Resting it for a few weeks was ineffective. It always came back, until…

The next year, life sent me an interesting curveball, and I ended up stationed long-term for 8 months in a third world South American country for a work project.

This had rejuvenating powers on my Achilles injury. I was able to play 4x per week 55-minute paid sparring sessions versus teaching pros on the red clay, usually in warm to hot conditions, but in the shade.

The higher frequency of play, combined with shorter session length that didn’t trigger my inflammation cycle, magically healed me fully.

Problem resurfaced this last month after trying to ramp up to singles play following no-singles period.

I’m now hoping to figure out a way to recreate that magic healing schedule in the constraints of my regular northern life.
Perhaps a slow warmup, warmer weather and shorter duration when playing singles is the only way for you to keep playing (singles).

Have you had an MRI on your achilles?
 

yossarian

Professional
Interesting. I remember my PT saying there were different schools of thought on this, but I’ve never heard that one. Is there anything that works better? Full disclosure. Mine came back too. LOL. I‘m guilty of being impatient. Started playing tennis again too soon. Like @travlerajm, seeking solutions.
Best thing for Achilles tendinopathy is heavy slow resistance exercise
 

WildVolley

Legend
You could do aggressive depth jumps, and scare it into healing!

Probably best to just keep it under load by getting in plenty of walking every day and then doing slow heel raises and drops on something like a staircase. I'd also do bent leg calf raises to hit the other muscle insertions. Just keep it moving without reinjuring it while it heals. The movement will help get some circulation and lymph fluid moving to the tendon, which is slow to heal.

Eat plenty of quality protein and get good sleep if possible. I'd consider collagen supplements, but I don't know if they actually help if you're already eating a high protein diet. I'd suggest supplementing with vitamin C if you're not getting plenty of fruit and leafy vegetables. I'd also supplement hyaluronic acid.

Probably best to back off the competition while healing. Once it feels stronger, I'd start with low intensity impact, perhaps like jump rope and other sub-maximal hopping, to help stress and thicken the Achilles.
 

travlerajm

Talk Tennis Guru
You could do aggressive depth jumps, and scare it into healing!

Probably best to just keep it under load by getting in plenty of walking every day and then doing slow heel raises and drops on something like a staircase. I'd also do bent leg calf raises to hit the other muscle insertions. Just keep it moving without reinjuring it while it heals. The movement will help get some circulation and lymph fluid moving to the tendon, which is slow to heal.

Eat plenty of quality protein and get good sleep if possible. I'd consider collagen supplements, but I don't know if they actually help if you're already eating a high protein diet. I'd suggest supplementing with vitamin C if you're not getting plenty of fruit and leafy vegetables. I'd also supplement hyaluronic acid.

Probably best to back off the competition while healing. Once it feels stronger, I'd start with low intensity impact, perhaps like jump rope and other sub-maximal hopping, to help stress and thicken the Achilles.
I’ve noticed my entire kinetic chain along the back of both legs, from heel to calf to hammy to glut, has been tighter than usual lately due to more sitting and less running around.
 

LOBALOT

Legend
I’ve noticed my entire kinetic chain along the back of both legs, from heel to calf to hammy to glut, has been tighter than usual lately due to more sitting and less running around.

I completely tore one of my hamstring tendon's up near my rear end while chasing down a drop shot in a USTA match about 5 years ago. When it tore I could feel it pull down into the center/back of my thigh. It hurt like a mofo... I couldn't get up, I couldn't sit, I couldn't walk. I just rolled around the court crying like a baby and eventually crawled off the court and to my car where my wife and son were waiting.

I went to the ER who told me to see an ortho which of course the earliest I could get an appt. was a month later. The guy was an NFL team physician who was known for treating these things and he had me walk about and he said that the surgery/recovery was brutal and I would be non-weight bearing for a year. I was 55 at the time and he said if it were him he would leave it as there are 2 tendons up there remaining.

Other than the orange sized knot in the back center of my hammy it has worked out pretty well other than as you note everything does seem to be tighter and I do seem to get more cramps/pulls than I used to in both legs ironically (Not sure if coincidence).

I am older and probably don't move like you do. If it were me I would see a Dr. and would treat it very carefully as I wish that pain on no one.
 

travlerajm

Talk Tennis Guru
Update:

I agreed to play a usta 4.5 singles flex league match this Sunday, 15 days post latest tweak. Plan is to limit full-body velocity to 70%. Venus is nice club with exclusive membership that I wouldn’t ordinarily get a chance to play at, so couldn’t resist.

Post-mortem report to be posted here.
 
While it's torn, rest. After the tear heals, isometric and or eccentric work helps.

And collagen. Lots of collagen.
There's been no scientific data suggesting ingestion of collagen leads to actual production of functional cross-linked collagen at the site of injury...

It's just a marketing BS claim.
 

GAS

Hall of Fame
There's been no scientific data suggesting ingestion of collagen leads to actual production of functional cross-linked collagen at the site of injury...

It's just a marketing BS claim.

Here's something accessible for you to read


Don't forget to follow the links to the evidence.
 

travlerajm

Talk Tennis Guru
Here's something accessible for you to read


Don't forget to follow the links to the evidence.
I just read the article summary. It says that in one study, collagen supplements increased tendon stiffness. But you see, my problem is that my tendons are already too stiff!

And another study of supplements showed increase in cross-sectional area, but no change in stiffness. But my problem is that my scarred tendon has bigger cross sectional area than my healthier one.

These data suggest I should avoid supplements.
 

GAS

Hall of Fame

WildVolley

Legend
I just read the article summary. It says that in one study, collagen supplements increased tendon stiffness. But you see, my problem is that my tendons are already too stiff!

And another study of supplements showed increase in cross-sectional area, but no change in stiffness. But my problem is that my scarred tendon has bigger cross sectional area than my healthier one.

These data suggest I should avoid supplements.
Now you have me confused. In the athletic training world, tendon stiffness is a sought after quality. Stiffer tendons return more energy, which is why athletes like sprinters do plyometric exercises designed to increase tendon stiffness.
 

GAS

Hall of Fame
Now you have me confused. In the athletic training world, tendon stiffness is a sought after quality. Stiffer tendons return more energy, which is why athletes like sprinters do plyometric exercises designed to increase tendon stiffness.

You're 100% correct.
 

travlerajm

Talk Tennis Guru
It appears there is confusion in the way authors of the cited paper are presenting data.

Tendons get stiffer (more rigid) per unit cross sectional area with age, but that is not what is being measured. If a tendon atrophies, it’s overall stiffness will decrease.
 

GAS

Hall of Fame
Here is a paper that explains what’s really happening to your tendons.

The reference you posted says the same things I've been saying here.
 

travlerajm

Talk Tennis Guru
The reference you posted says the same things I've been saying here.
The reference I posted says “increased stiffness … observed while aging”.

The problem is that different authors are using conflicting definitions of stiffness, causing confusion because some say tendons get stiffer with age, and others say tendons lose stiffness with age.

One group simply measures the stiffness of the whole tendon (which loses stiffness with age due to to atrophy of functional elastic fibers). And another measures the stiffness of the tendon materials (which stiffen with age).

Neither group of authors acknowledges the confusing inconsistency in the literature. Thanks for calling it to my attention.
 

travlerajm

Talk Tennis Guru
An interesting anecdote is that when I went through a bout of Achilles tendinitis 5-6 years ago, the afflicted tendon got thicker in cross section than the healthier one, ostensibly due to scar tissue buildup.

So tendon cross section isn’t a good measure of tendon strength.
 

travlerajm

Talk Tennis Guru
My usta singles match is later this morning. I rested yesterday, and limited my “training” this week to wall sessions. Hoping my stiffened-but-not-dead-yet Achilles can handle it.

Match is indoors at a fancy-pants exclusive club with all-white dress code. First time I’ve had the chance to play singles there. I’ve been preferring a wrist band lately, but didn’t have any white ones. So I made one out of a white sock for the occasion.
 
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