Achilles pain

Whilst my research focus is mainly on back pain, I have  a lot of clients with  Achilles tendinopathy, i though i might as well add a few  articles with advice on remedial treatment for sore achilles.

If you are going to a party and want to show off, you simply must drop the name  Silbernagel into the conversation. He is quite famous in coming up a type of training to help with Achilles Pain. He was part of the team  who researched “A Randomized Controlled Study Continued Sports Activity, Using a Pain-Monitoring Model, During Rehabilitation in Patients With achillies tendonosis” published in Am. J. Sports Med. 2007

That team tried this protocol:

Phase 1: Weeks 1-2 Patient status: Pain and difficulty with all activities, difficulty performing ten 1-legged toe raises

Goal: Start to exercise, gain understanding of their injury and of pain-monitoring model Treatment program: Perform exercises every day

  • Pain-monitoring model information and advice on exercise activity
  • Circulation exercises (moving foot up/down)
  • 2-legged toe raises standing on the floor (3 sets × 10-15 repetitions/set)
  •  1-legged toe raises standing on the floor (3 × 10)
  • Sitting toe raises (3 × 10)
  • Eccentric toe raises standing on the floor (3 × 10)

Phase 2: Weeks 2-5 Patient status: Pain with exercise, morning stiffness, pain when performing toe raises

Goal: Start strengthening Treatment program: Perform exercises every day

  • 2-legged toe raises standing on edge of stair (3 × 15)
  • 1-legged toe raises standing on edge of stair (3 × 15)
  • Sitting toe raises (3 × 15)
  • Eccentric toe raises standing on edge of stair (3 × 15)
  • Quick-rebounding toe raises (3 × 20)

Phase 3: Weeks 3–12 (longer if needed) Patient status: Handled the phase 2 exercise program, no pain distally in tendon insertion, possibly decreased or increased morning stiffness

Goal: Heavier strength training, increase or start running and/or jumping activity Treatment program:

Perform exercises every day and with heavier load 2-3 times/week

  • 1-legged toe raises standing on edge of stair with added weight (3 × 15) • Sitting toe raises (3 × 15)
  • Eccentric toe raises standing on edge of stair with added weight (3 × 15) • Quick-rebounding toe raises (3 × 20)
  • Plyometric training :Phase 4 Week 12–6 months (longer if needed)

Patient status: Minimal symptoms, morning stiffness not every day, can participate in sports without difficulty

Goal: Maintenance exercise, no symptoms Treatment program: Perform exercises 2-3 times/week

Guess what: you practice pain!!!

Its the same with anything, the more you practice, the better you become: perfect practice makes perfect performance.

But, this great secret of super performers (practice, practice, practice,) is the same for those with chronic pain. The better you get at sending pain messages, the more it hurts.

This is great if you are  a masochist, but sucks  a bit  for the rest of us.

“Simply put, pain that persists can become chronic because your neurons become more efficient at transmitting pain signals. The strengthening of connections between neurons through repeated use is called Long Term Potentiation, (LTP).

Dr. Darnall said “The results also underscore the importance of non-pharmacologic psycho-behavioral treatments for chronic pain and also for anxiety,” she added. “When people learn skills to decrease the physiological markers of anxiety or stress, they are simultaneously treating pain.”

Anxiety amplifies pain, so it seems there is  a lot in that tree hugging hippy crap of relaxing and thinking happy thoughts: certainly being negative and depressed does not help your pain

Read another review here

Lumo lift

Am i a fan of http://www.lumobodytech.com/ ?

Hmm, I need to think about this.

The proposition seems logical. A system that “knows” when you are holding  a static “correct posture”and holds you to it.

I think my only reservation is the idea that there is a correct  static posture. Certainly you need a stiff core, but your position when seated,  is best often  changed  ( see some of the observations by McGill).

But, if it  reduced your slouching by  say  15 minutes a day , and encouraged you to learn a bit more about your posture, and improved your general back hygiene,  the £80 seems totally worth it.

But, It could fall into the Standing desk error. There are very few safe static postures!  if you work at a desk, rotate between kneeling, sitting, sitting side on, standing ,holding a lunge.

I suspect , having tested a similar system ( the computer’s camera kept your head in a frame) that its  possible to get a “good reading” in as much as you haven’t “tipped” the sensor, but, you have  actually collapsed your back.

Ill try and test that out with this product.