mb6606 is right, this is a very correctable condition if you understand the origins of the problem. First, though, is to eliminate some more serious structural issues than just muscle confusion. From that point it is just a matter of better negotiating the tensions of the hips and legs that contribute to the symptom, in this case plgolfers formidable discomfort; for others the symptom might have manifested differently.
plgolfer, I would also like to know if you have pronation in your foot placement. I am sure you have discussed much of this with your PT so let's work with what you know and then make applications of good information specific to your case.
I find the majority of people are unwilling to follow through allocating the necessary time and effort it takes to correct a problem. It takes work and most problems are fixable.
mb6606 is right, this is a very correctable condition if you understand the origins of the problem. First, though, is to eliminate some more serious structural issues than just muscle confusion. From that point it is just a matter of better negotiating the tensions of the hips and legs that contribute to the symptom, in this case plgolfers formidable discomfort; for others the symptom might have manifested differently.
plgolfer, I would also like to know if you have pronation in your foot placement. I am sure you have discussed much of this with your PT so let's work with what you know and then make applications of good information specific to your case.
Vickie
Hi Vickie,
I am actually plgolfer's wife, and I forgot to sign my name which is Odile. Sorry for the confusion.
Vickie, I am so glad to read the replies to my letter. This is really a great site, referred to me by my husband. Already I am feeling relieved that there could be a solution. So to answer your questions:
How is your weight?
I am 5ft 7 high and weigh 63 kg.
What types of therapy did you use and for what duration?
Firstly I have had this problem since 5 years.
I do have the left foot a bit shorter since my childhood and my hips are not level. My feet are very arched, and I am not sure that I have pronation in my foot placement. The doctor says that I have short tendons. I have been wearing heel support orthotics to help relieve my tendons. The pain is not severe and I feel my ankles stiff out of bed in the morning. Pain is not due to sudden movement. but will appear gradually from midday to end of day. I can feel my tendons specially the left, are hot and swollen. When I touch them it's painful. I have a knot on my left tendon.No popping or cracking sound in the tendons. No use of natural products or arnica.
MRI reports "mild fusiform thickening of both Achilles tendons with no significant intra substance signal changes. Appearances are consistent with chronic bilateral tendonitis, On the left, the maximum thickness of the tendons measures 9 mm and on the right 7.5mm. ( The normal values range from 4 to 7mm.) A small amount of free fluid is noted posterior to both talar bones suggestive of bursitis. No othe significant abnormality, no osteochondral lesion and the othe tendons around the ankle joints appear intact."
Therapy have been:
1 Using ice everyday and antiinflammatory gel. This has been quite useful in reducing the pain.
2 Oral antiinflammatory medicines, and acupuncture.
3 1st shot of cortisone in 2002, and the tendonitis seemed to have been resolved.
4 In 2006, tendonitis reappears and I started the same process as in 1,2 above, and I had 15 massage and ultrasound treatments of my ankles. That seemed to work for the right ankle but it was not efficient for the peritendonitis of the left.
5 In December 2006, I decided to have a second shot of cortisone injection. I had 5 weeks rest from golf. The pain disappeared. Inflammation was gone @80%. But now since end of March, the tendonitis is back and its again the left ankle which is more swollen.
I realise that this is a long reading for you. Thanks in advance for your patience and dedication.
Odile, You are so great with sharing your information and there is much to consider. Beyond the amount of time you have suffered some of your symptoms and indicitive of an advancement in the condition. These issues are more complicated and require more careful speculation before you just set out on a program. So before I move forward, and now that I know how indepth you will be, allow me to ask a couple more questions. Any way you can send me a few pictures on the pm of the front of your thighs to your feet from the front and the side, to your hips would be even better in form fitted clothing? This would answer the issue of pronation and give me some ideas of your hip instability; and I assure you this is a part of the origin. Secondly. If you kneel on the floor and sit your buttocks on your heels; can you do it without pain and is the front of your ankle on the floor or is it all too difficult to straighten out your ankle, and where is the most discomfort? How soon after you added the heel cups did you see relief and do you wear them in all your shoes? Do you have an orthodic in your golf shoes? Would you say that your calves feel tight? You didn't mention any exercises you are doing from your therapy. I'd like to know what has been applied, what you've continued and avoid redundency. Often the effectiveness, or lack thereof, illuminates our process.
Cortisone is a great relief and notorious for loosing it's effectiveness over time. I am surprised you received such a short reprieve. It just further indicates that your only choice is to do the work of bringing your legs into conjuction to alleviate your ankle disorder. It is the only way to avoid an actual rupture. But you already knew that.
Look forward to reading more. Vickie
P.S. I promise I will get to some recommendations soon. It's always a little easier when I can see the whole body function and do some testing. I appreciate your patience.
Wolfman (whom I believe is a podiatrist if memory serves me correctly) hit the nail on the head. Steroid injections of the Achilles tendon are a HUGE NO NO. Sometimes a brief course of oral steroids may help, but I would never allow anyone to inject mine. Will defer to podiatrists/orthopedists/Vickie for further discussion. Dr Dave
Wolfman (whom I believe is a podiatrist if memory serves me correctly) hit the nail on the head. Steroid injections of the Achilles tendon are a HUGE NO NO. Sometimes a brief course of oral steroids may help, but I would never allow anyone to inject mine. Will defer to podiatrists/orthopedists/Vickie for further discussion. Dr Dave
Yes, I am a podiatrist. Since this was originally addressed to
Vickie, I was going to stay out of the thread.
When I saw that she had been injected at least twice, I couldn't refrain from replying!
I will add my other 2 cents if asked. Although, I must say I am interested in Vickie's whole body evaluation and recommendations.
Yes, I am a podiatrist. Since this was originally addressed to
Vickie, I was going to stay out of the thread.
When I saw that she had been injected at least twice, I couldn't refrain from replying!
I will add my other 2 cents if asked. Although, I must say I am interested in Vickie's whole body evaluation and recommendations.
Steve
Dear Steve,
Please do send in your comments/advice. You are most welcome. Many thanks in advance. Odile
Odile, The good doctors are reminding me of something I always hope people remember when they are writing on the site. Your condition is real, and in this case advanced, and good medical supervision is not only smart but required. To have a doctor you trust and who can follow your process is necessary to get the best advice; even if it's not always what you want to hear.
Likewise the doctors have pointed out the rare use, and often misuse, of cortisone; especially for this largest tendon in your body. In addition to potentionally weakening the tissue you are masking the pain on your feet, which are so consistently used and can be a recipe for disaster. You took five weeks away from your athletics which makes you a perfect patient but I'm guessing you didn't lay around with your feet up and eating Bon Bon's.
I have a man I worked with a few years ago with nearly the same symptoms you are suffering almost down to the detail but within a shorter time frame. His had rapidly deteriorated. however, and was being directed toward surgery to remove the degenerative tissue at the nodule site; I think it's called debulking, atleast that is what his doctor called it. He had already had a cortisone shot but was put on crutches for protection against his tendency to do to much activity with four sons under the age of 15. The next step could have been casting both legs; it has it's own set of problems. The doctor felt certain there was a surgical room with his name on it.
On the one hand he was almost ready to try anything, surgery included, but decided to put 100% into an alternative. And so we trained together for almost a year continuously and then saw each other about every four months to adjust his work over the next year. I called him yesterday to see how he was doing, two years later, and to be sure I had an accurate memory. Basically he is better than even when we stopped training as the healing process takes time and he continued to do the work necessary to perpetuate the progress. He said the most painful aspect of beginning a program of self healing was that it was so little in the beginning and he was feeling so motivated and also that he had to change doctors until he found one that respected his choices and was still willing to take his case and then treat him if a turn around wasn't possible. Sometimes good science is just necessary if a condition has reached an irreversible stage or if the patient can't follow a strict and consistent protocol. You have to go into self-healing with this thought or irresponsible choices can insue.
I am a big champion of natural remedies and have great respect for good medical science.The natural process is slower, as you are assisting the body in it's self-regineration. The natural approach takes more participation on the part of the patient both in terms of attention and time (mb6066 referred to this phenomenon). In a natural approach you have to look at the body as a series of systems that work together in perfect orchestration. If one system is down you can bet there are other systems effecting the process. In natural treatments it is ineffectual to isolate the treatment to the symptom, i.e. the affected area. The medical community can go to the symptom and make a near immediate correction with proper rehabilitation and the outcome can be very positive. But in these cases the rest of the systems should still be evaluated to see why one part of this perfect orchestration failed. This is the way nature and nurture can work together in perfect harmony.
If you catch it in time you may get to see the wonder of our human physiology. If the condition is too advanced, you may see the wonder of medical advancement. Just remember that nurture always incorporates nature; and visa versa. It's the law.
Wolfman, please do not refrain from sharing your expertise. This is not my site. I am strictly a moderator and can only share the experiences and learning that I have. I do not have a medical degree and your input is invaluable. I will always share my piece of the pie but we all benefit from each other. I was actually glad you put your alert on the cortisone. I was waiting to get a complete picture to provide a full post and your insight would have been shared by me.
I was in the process of writing my post when you submitted yours and just had to add yet another. My last post was inspired by your sharing along with Dr. Dave's. One of the things that I love about being on LBG is that there exists a respectful appreciation of everyone's improvement; both on the golf course and in our other life.
Great to have you on this thread. This is 'ME' inviting your valuable '2 cents'. Vickie
Hybrid Mode
