Achilles injury. Any specialists?

eoin ryan

Hi,

I'm wonderin can anyone, maybe who has had an achilles problem and come thru treatment, recommend who they attended please?
Ideally in Dublin area...

Ta

Jnealon

I went to mark kenneally as I knew he had achilles problems himself and he seemed to be managing it quite well.
Tbh there was only so much mark could do for me, I needed to sort out my tight calves which were the root cause of my problems
I had laser done last year and followed that up with eccentric calf drops every day

walshb

I suffer with sore and strained achilles. The only solution for me was not to run for a few weeks. It cleared it. But, it does reoccur.

3D2S

As above, pretty much the same. Have you been doing speed work or hill work you would not normally do? Can add to the already tight calves. Rest initially and gentle regular stretching, then eccentric calf drops worked for me. Don't stop doing these when you are back to regular running and best of luck with recovery:-)

ecoli

Alot of people advocating rest. In most cases this will alleviate the pain but not get rid of the issue. First an foremost should be treating the cause.

Dave Corcoran or Vinny Mulvey would be two that I would have experience being treated with and found good

MisterDrak

Injured both achilles equally in 2011 (dont ask). I seen Dave Corcoran for a good number of sessions, however it was just lots of rest and no running that sorted me in the end...

Boardcore

JNEalon - How did you find the laser treatment? What is the recovery time?
I do the eccentric calf drops regularly, but can't shake the tendonittis, haven't ran in 3 weeks.
The earliest appointment for laser is mid - June, with Pat Leahey in the laser clinic.
Does anyone have any other recommendenations for laser practioniers?

MacSwifty

Boardcore wrote: »

JNEalon - How did you find the laser treatment? What is the recovery time?
I do the eccentric calf drops regularly, but can't shake the tendonittis, haven't ran in 3 weeks.
The earliest appointment for laser is mid - June, with Pat Leahey in the laser clinic.
Does anyone have any other recommendenations for laser practioniers?

I suffered with this for ages Spent a fortune and months with physios excercise and rest but no improvement - I had two sessions with Mr Leahy and the laser and whilst there was some improvement after the sessions the problem reoccured. I was about to quit but I had not tried the dry needling route

This sorted me combined with a foam roller - Good now for two years but would still use the roller a lot i.e. before and after every session

tunguska

A course of action depends on what kind of Achilles trouble you're having. I mean if its insertional then heel drops will make it worse, whereas if its not insertional then heel drops would do the job. If its that bad though your best bet is to get an MRI then you'll know for sure what way you should go with regards to treatment.

sideswipe

ecoli wrote: »

Alot of people advocating rest. In most cases this will alleviate the pain but not get rid of the issue. First an foremost should be treating the cause.

Dave Corcoran or Vinny Mulvey would be two that I would have experience being treated with and found good

+1 for Vinny, he has sorted a couple of similar problems for me in the past.

Tombo2001

Have been to probably a dozen physios at this point (though not to any of the names mentioned above).

Nessa Smyth is the only one that I would recommend of the people I've seen.


Incidentally......isnt there some sort of rule about not giving medical/physio advice on the site.....

kennyb3

tunguska wrote: »

A course of action depends on what kind of Achilles trouble you're having. I mean if its insertional then heel drops will make it worse, whereas if its not insertional then heel drops would do the job. If its that bad though your best bet is to get an MRI then you'll know for sure what way you should go with regards to treatment.

I'd plus one this.

Achilles injury is such a broad term. Knowing what exactly is injured is half the battle.

When you have a chronic problem and have done the round of the various physio's i'd suggest;

1. MRI
2. Go see consultant (Enna Falvey in SSC imho)

Then you'll know precisely what is wrong. Don't trust the radiographer to read it and do a report - these are usually very broad (mild tendonopathy for example - but where?How mild?) . Someone like Enna will go through the MRI from every angle on specialist software. Then you can work out a treatment program.

It took over a year (and about €2k) before I finally went to him and he found a small split in a tendon. Then it was a case of setting about re-habbing it.

No amount of rubbing a tendon will fix it if it's badly damaged. I also found Laser quite good - more a case of speeding things up than anything.

Tombo2001

kennyb3 wrote: »

I'd plus one this.

Achilles injury is such a broad term. Knowing what exactly is injured is half the battle.

When you have a chronic problem and have done the round of the various physio's i'd suggest;

1. MRI
2. Go see consultant (Enna Falvey in SSC imho)

Then you'll know precisely what is wrong. Don't trust the radiographer to read it and do a report - these are usually very broad (mild tendonopathy for example - but where?How mild?) . Someone like Enna will go through the MRI from every angle on specialist software. Then you can work out a treatment program.

It took over a year (and about €2k) before I finally went to him and he found a small split in a tendon. Then it was a case of setting about re-habbing it.

No amount of rubbing a tendon will fix it if it's badly damaged. I also found Laser quite good - more a case of speeding things up than anything.

Can I ask......how did you end up spending €2k and over a year to find this out?

How many physio sessions did you have before this was discovered?

How many hours did you spend doing strengthening/ stretching exercises over the 12 months before you found out?

kennyb3

Tombo2001 wrote: »

Can I ask......how did you end up spending €2k and over a year to find this out?

How many physio sessions did you have before this was discovered?

How many hours did you spend doing strengthening/ stretching exercises over the 12 months before you found out?

Pretty easy to spend the money - my injury was pain at the back of the knee from cycling. I went to a physical therapist (as usual) - when they examined me they felt it was my biceps femoris, which in fairness was sore. They reckoned i had a tear and/or tendinitis. I saw them about 7/8 times - say 400e.

I then went to a physio - got ultrasound, stretches, strengthening exercises (bridges etc). 200e

I then went and got an MRI (Euromedic) - it showed up as mild tendonopathy. 200e. So no massive tear or issue I thought.

All the time I was getting worse - more chronic pain - from waking up to going to bed.

I then tried a NMT - got frequency specific microcurrency. I tried dry needling elsewhere too. 300e

I then went to an osteopath - i would have tried anything or anyone - i was really getting desperate. 300e

I'd stand in the sea at portmarnock every night for 20 mins or more for relief.

I went to someone else then reckoned who reckoned i'd pulled the tendon off the bone a bit but this was 6 months later or so.

I then went to see Dr Leahy, got one bout of laser and that got me about 60% better but still not right (150e). He confirmed I had a tear in the tendon.

I went back and got more but wasn't really any better (150e).

So I went to another physio, got another MRI referral and another MRI (200e). Again nothing massive reported.

In the mean time I was getting regular massage just to ease the pain.

But then I read about Eanna, booked an appointment, and took my MRI disk to him. He spent about 10 mins examining me (my leg), then reviewed the disk and showed me the couple of cm white line right through my biceps femoris tendon where it attached onto the bone - a split in the tendon right in the middle. Very unusual it that it was lontitudinal rather than a rupture. Obvious as could be - but not reported on 2 MRI's previously.

Anyway that was about 2k all in all.

It took another 4/5 months of a dedicated physio program - going once every 2 weeks, with me doing exercises every day. Most being eccentric loading of the tendon. It was torture but i'd say my leg is 90% right now - not sure it will ever be 100% - I can run and cycle again now though.

mossym

kennyb3 wrote: »

But then I read about Eanna, booked an appointment, and took my MRI disk to him. He spent about 10 mins examining me (my leg), then reviewed the disk and showed me the couple of cm white line right through my biceps femoris tendon where it attached onto the bone - a split in the tendon right in the middle. Very unusual it that it was lontitudinal rather than a rupture. Obvious as could be - but not reported on 2 MRI's previously.
.

just finished a round of treatment in the SSC, not with Eanna but with Andy Franklin miller, one of the running specialists out there, nothing but good things to say about them went from no running in Jan or Feb to being back on 3 a weeks now with no pain.

Tombo2001

kennyb3 wrote: »

Pretty easy to spend the money - my injury was pain at the back of the knee from cycling. I went to a physical therapist (as usual) - when they examined me they felt it was my biceps femoris, which in fairness was sore. They reckoned i had a tear and/or tendinitis. I saw them about 7/8 times - say 400e.

I then went to a physio - got ultrasound, stretches, strengthening exercises (bridges etc). 200e

I then went and got an MRI (Euromedic) - it showed up as mild tendonopathy. 200e. So no massive tear or issue I thought.

All the time I was getting worse - more chronic pain - from waking up to going to bed.

I then tried a NMT - got frequency specific microcurrency. I tried dry needling elsewhere too. 300e

I then went to an osteopath - i would have tried anything or anyone - i was really getting desperate. 300e

I'd stand in the sea at portmarnock every night for 20 mins or more for relief.

I went to someone else then reckoned who reckoned i'd pulled the tendon off the bone a bit but this was 6 months later or so.

I then went to see Dr Leahy, got one bout of laser and that got me about 60% better but still not right (150e). He confirmed I had a tear in the tendon.

I went back and got more but wasn't really any better (150e).

So I went to another physio, got another MRI referral and another MRI (200e). Again nothing massive reported.

In the mean time I was getting regular massage just to ease the pain.

But then I read about Eanna, booked an appointment, and took my MRI disk to him. He spent about 10 mins examining me (my leg), then reviewed the disk and showed me the couple of cm white line right through my biceps femoris tendon where it attached onto the bone - a split in the tendon right in the middle. Very unusual it that it was lontitudinal rather than a rupture. Obvious as could be - but not reported on 2 MRI's previously.

Anyway that was about 2k all in all.

It took another 4/5 months of a dedicated physio program - going once every 2 weeks, with me doing exercises every day. Most being eccentric loading of the tendon. It was torture but i'd say my leg is 90% right now - not sure it will ever be 100% - I can run and cycle again now though.

That kinds of sums up the difficulties I have with physios.

There diagnostic skills are too haphazard.

You go in, they take down you're details, they ask you "where does it hurt"....stretch this way, stretch that way.......oh it must be X.....

Where X is something that can be treated by 6 sessions of physio and half an hour daily of strengthening.....

But the thing is, often it isnt X, its Y.

By the time you have found that out, you've spent €400....

I feel that physios are good at treating injuries that are going to get better anyway.

ecoli

Tombo2001 wrote: »

That kinds of sums up the difficulties I have with physios.

There diagnostic skills are too haphazard.

You go in, they take down you're details, they ask you "where does it hurt"....stretch this way, stretch that way.......oh it must be X.....

Where X is something that can be treated by 6 sessions of physio and half an hour daily of strengthening.....

But the thing is, often it isnt X, its Y.

By the time you have found that out, you've spent €400....

I feel that physios are good at treating injuries that are going to get better anyway.

Again I think this comes down to the practitioner you go to.

There are some who have excellent differential diagnostic skills compared to others (currently using one of Eanna's books on the matter and find its a great resource) and will attempt to go through a comprehensive list of possibles and aim to rule as many as possible out. For some people this can be overkill as there quite often it is a simple issue

There are some who through experience rather than an ignorance will tend to jump towards certain injuries if you present with the symptoms. This is just out of human nature. If a physio/sports therapist has 100 runners come to them with calf injuries and 95 of them present with the same symptoms and benefit from the same treatment there can be a assumption made without differential diagnosis

However I would say if you are not seeing improvement after 2-4 sessions and the therapist/physio does not delve further to rule out other possibilities it would start to ring alarm bells.

Also your last sentence I would say that while the pain may subside on its own the cause of the issue will very very rarely fix itself. The body has a great capability to heal itself, most of the time a physio/therapist will just help facilitate that recovery.

Jnealon

Boardcore wrote: »

JNEalon - How did you find the laser treatment? What is the recovery time?
I do the eccentric calf drops regularly, but can't shake the tendonittis, haven't ran in 3 weeks.
The earliest appointment for laser is mid - June, with Pat Leahey in the laser clinic.
Does anyone have any other recommendenations for laser practioniers?

I found the laser great but it's not for everybody. Make the appointment as you can cancel it at anytime and go to a physio who has experience with achilles injuries, they'll advise if laser is for you or not.
Calf drops everyday, we're talking hundreds, bent and straight leg and some foam rolling have helped me manage it so far

Onion11

Thank you so much for the advice here, Kennyb3, am going to give Enna Falvey a go!

kennyb3

Is Enna Falvey still the person to go to?

It's ironic that I'm asking when I was the one mentioning him earlier (I saw him for another issue).

I've had Achilles issues on and off for 10 years but never done anything substantial about it as usually just end up managing/resting it.

The left Achilles is the issue and is now thickened. I'd like to get back running regularly - currently a mix of running / gym and golf but it's bothering me and no hope of running more than twice a week.

I've gone to physios on and off for it - massage and dry needling but never got a proper rehab/stretching work.

I've tried googling for an Achilles specialist to no avail.

The SSC has gone mad expensive - 85e for 45 mins physio so just wondering if there are other experts/specialists in the area?

Ceepo

kennyb3 wrote: »

Is Enna Falvey still the person to go to?

It's ironic that I'm asking when I was the one mentioning him earlier (I saw him for another issue).

I've had Achilles issues on and off for 10 years but never done anything substantial about it as usually just end up managing/resting it.

The left Achilles is the issue and is now thickened. I'd like to get back running regularly - currently a mix of running / gym and golf but it's bothering me and no hope of running more than twice a week.

I've gone to physios on and off for it - massage and dry needling but never got a proper rehab/stretching work.

I've tried googling for an Achilles specialist to no avail.

The SSC has gone mad expensive - 85e for 45 mins physio so just wondering if there are other experts/specialists in the area?

Where are you based?

kennyb3

Ceepo wrote: »

Where are you based?

North county Dublin but no issue travelling if it's to see somebody who really knows what they are doing

Ceepo

kennyb3 wrote: »

North county Dublin but no issue travelling if it's to see somebody who really knows what they are doing

There's a new practice open in Donabate.
Functional Patterns Dublin.

They will look at your posture and biomechanics.
Identify areas of restrictions etc.
Cant recommend the guys highly enough.

I don't know there precise address but I can get it for you.

WayneEnterprise

I went to Aidan Woods when I injured my achilles and he was great. 1.5 years on and no issue with it since (touch wood)

https://www.pearsestreetphysio.com/aidan-woods

kennyb3

WayneEnterprise wrote: »

I went to Aidan Woods when I injured my achilles and he was great. 1.5 years on and no issue with it since (touch wood)

https://www.pearsestreetphysio.com/aidan-woods

Mind me asking what was involved? Was it loads of stretches and a rehab program?

Did you go many times?

WayneEnterprise

kennyb3 wrote: »

Mind me asking what was involved? Was it loads of stretches and a rehab program?

Did you go many times?

I had about 6 sessions with him.

The first session he assessed the problem, monitored my movement when doing certain stretches etc. He gave me a plan of exercises which I had to go through during the session so he could see if I was doing them correctly. Then at the end of the session he worked on the achilles and calf directly to loosen it out.

I would then have to do that set of exercises at home during the week and when I'd go back in for the next session, I'd do them again while he assessed me. He would then alter the plan and make it more difficult as time went on based on how I was progressing. Every session ended with him manually working on the achilles and calf.

Overall I was delighted with the progress and haven't had an issue since.

kennyb3

WayneEnterprise wrote: »

I had about 6 sessions with him.

The first session he assessed the problem, monitored my movement when doing certain stretches etc. He gave me a plan of exercises which I had to go through during the session so he could see if I was doing them correctly. Then at the end of the session he worked on the achilles and calf directly to loosen it out.

I would then have to do that set of exercises at home during the week and when I'd go back in for the next session, I'd do them again while he assessed me. He would then alter the plan and make it more difficult as time went on based on how I was progressing. Every session ended with him manually working on the achilles and calf.

Overall I was delighted with the progress and haven't had an issue since.

Thanks for the detailed reply. That's exactly what I'm looking for!

ArtieFufkin

I'm just over an achilles injury. Amongst other things I used gelatine and vitamin c to help rebuild the collagen in the tendon. Might be helpful to you as it is not specific to the type of achilles injury.

There's a fair bit on the benefits of it here:
https://www.scienceofultra.com/podcasts/58

Sam the Sham

I'm also just over an achilles injury (at the insertion point). Injured in late June 2018. Only now getting close to where I was.

The single thing that most improved my injury was this: https://www.amazon.co.uk/gp/product/B00B0V8OLK/ref=ppx_yo_dt_b_asin_title_o04_s00?ie=UTF8&psc=1

Not super comfortable to wear but did wonders for stretching the achilles without any effort on my part.