achilles tendon injury

[davbla]

Just looking some advice on Achilles injury I picked up 4 months ago,
Which has caused lots of early discomfort, With lots of Physiotherapy it has removed most of the scar tissue, but I still have a small lump( size small pea) that has developed on the Achilles 2 cm above the heal, Today it is still there Probably a little smaller but (very evident first thing in the morning) but after some Stretching and eccentric exercises I am doing it disappears slightly Leaving Small signs of scaring AFTER A NUMBER HOURS THE LUMP WIL RE APPEAR

I have now been told not to worry about the lump as it will go away after time,
I have been told to carry on Eccentric Program etc for next 12 weeks

I have tried to be brief with information but please let me know your Thoughts

[Heidi]

Hi,

Basically the lump is not really an issue. As long as the tendon itself appears to be healing and the pain is decreasing then I really wouldn't worry about the lump. This will go in time.

[davbla]

Thanks for the Reply Heidi

Although the lump will go in time this is Still a Tender area after Eccentric exercise, Not Pain Is this normal after 4 months

Secondly there is a constant Discomfort again Not Pain Most times

As for the" Is Tendon Healing” I don’t have an answer know
Are there any symptoms that would tell me?

[Heidi]

It isn't unusual for the tendon to ache still during or following exercise. This should be improving though?

Signs of healing are simply less pain, less inflammation (redness and swelling) and an increased range of pain free movement

[davbla]

Thanks Heidi

To be honest ,I do not think I am much better than I was 4 months , Even when injury happened over a number weeks I was still managing to do some running , It was went the Lump appeared I thought it would be better get it looked at I case it was serious
I never really lost the Function , as there has been very little stiffness in flexibility or movement I was not in any acute pain It is more or less a dull ache with discomfort , The strange thing is I struggle to identify the exact spot apart from the lump on the tendon 2 cm from the heel The discomfort feels All around the area of Achilles tendon to heel area, today I have been on my feet most of today through work ,I am just glad to get my shoes of As this lessens the discomfort , I have been wearing orthotics for last 4 months as well with No real results this was a recommendation from PT , Do you think a scan would help to diagnosis the problem

[Heidi]

Have you had plenty of massage to the calf and tendon and ultrasound to the tendon as well as your exercises? I have found this treatment in combination with stretching and eccentric strengthening to be the most effective treatment for achilles tendinopathies.

To be honest I don't think a scan is really worthwhile and they tend not to be offered freely and are expensive to pay yourself. Your symptoms match that of an achilles tendinopathy and these things can take time to heal. If you haven't had the kind of treatment I mentioned above then I suggest that this is your next step.

Good luck

[davbla]

Thanks Heidi

Some deep tissue massage was done on tendon 4 months ago for the scar tissue but no massage on calf
but a good point as this week i have had a lot of discomfort and my calf is a little tight when doing eccentric excerises , I have stopped excerises just now for it to settle down again , But It does feel as if the tendon and heel area is inflamed at the moment

[davbla]

Hi Heidi

I was fortunate enought to get a MRI scan on achilles yesterday
here is the feedback ,

Findings:

There is marked hyperintense signal changes of the Achilles tendon at the level of its calcaneal insertion.
There is mild thickening of the distal third of the Achilles tendon with streaky hyperintense signal change.
There is no evidence of full thickness or partial thickness interruption.
Bone marrow, cortex and articular cartilage appear normal.
All other visualised tendons, muscles and ligaments are intact and normal in their width.


Conclusion:

The above findings are those of insertional tendinitis of the Achilles tendon.
Mild tendinopathy of the distal third of the Achilles tendon is also noted.
There is no evidence of full thickness or partial thickness tear.




Any thoughts
Thanks

[Heidi]

As expected to be honest. I think all you can do is to continue with the exercises and other treatments you have been given. If you get no benefit from these, perhaps try a new course, maybe acupuncture or something?

[davbla]

Hi Heidi

looking for some advice, my achilles feels a lot better but still having lots of discomfort in the back heel area when on my feet ad doing eccentric excerise, looking at my mri pics it looks like heel is quite prominent compared to other pics ive seen on the web although there was no mention in my report i got,

please see pic attached could this be causing the discomfort,

thanks

[Heidi]

Hi
I'm not trained to read MRI scans so I can't really comment on this. Is the pain under the heel or on the back where the achilles attaches to the heel?

[davbla]

Thanks Heidi,

When i am On My Feet for long peroid , there is Discomfort at Back Heel but I also feel it Coming from Bottom heel as if there is No Shock absorber , Its like walking on Concrete

My Achilles Feels not to bad , Hence the reason why i am thinking may have missed something