Achilles still kaput…looking for options.

Achilles painYet another doctor’s appointment last week, and my ortho is starting to run out of ideas.  After my doc spotted necrosis along the backside of my Achilles in an ultrasound, the latest suggestion is prolotherapy, the injection of an irritant (in this case a sugar solution) into the affected area.

The idea is that irritating the area will trigger a bodily response to heal it.  Of course, that was also the main idea behind both the shockwave therapy and the PRP shots I’ve had in the past. 

It seems that the last line of treatment would be an Achilles-lengthening operation, which scares me a bit, to be honest.

The research I’ve done seems to show that clinical trials are inconclusive on prolotherapy.  I wonder if it’s in my best interest to do this, and put myself on the shelf for another few months while recovering (again).

It’s now about two weeks since my last failed run.  I’m still swimming and biking, but I’ve avoided running since then.  I may try to get out for a short one this week, just to see if things have changed, but I doubt it’ll be any different.  I can walk around perfectly normally right now, but the right Achilles just feels different than my other one.  I’m fairly certain I’d make it about a mile or two before things go south again.

Background

My right Achilles simply has not responded to the variety of treatments I’ve received so far.  To this point, I’ve undergone several procedures, including simple physical therapy, shockwave therapy, and a PRP shot to the affected tendon.

I’ve been consistent with the prescribed rehab exercises – mainly eccentric stretches and eccentric lifts.

The latest instance of Achilles pain happened several months after having the PRP shot in January.  With doc’s clearance, I re-started running a little over eight weeks later.  I started slowly, with half-mile runs, increasing distances by a half-mile to a mile on a weekly basis.

Just after I had increased mileage to 6 miles, I experienced that all-too-familiar fire in the Achilles.  After several days of limping and two weeks of RICE*, I only managed to go a mile and a half before it hit again.  Two more weeks off, and it was the same thing:  less than a mile in, the dull pain escalated into the end of a workout, followed by two days of limping.

Decision time

I just want to be able to run again without pain.  Having been a long-time rugby player, I have a pretty high tolerance for pain, and am more than willing to ‘tough out’ a run.  If someone could tell me a way to simply keep the pain to a level that wouldn’t cause me to compensate while running, I’d be happy with that, and just deal with it.

My doc is waiting on me to schedule a date for the prolotherapy.  I think I’m going to request a second opinion somewhere outside the military healthcare system (which I’ve been happy with so far), and see what kind of suggestions I get.

I’m willing to do whatever is necessary to get back on the trail – I just need a definitive answer and a way forward.

 

*RICE, for those who don’t know(!), stands for rest, ice, compression, and elevation.

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