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PRP Achilles (Tendonosis) anyone? Any Sport Med / Physical therapy Experience?

So I've had insertional Achilles issues for 2+ years...

Ortho says they can Lop it off-grind my heal down/shave up the tendon and re-attach....Might be able to start running/biking in a year or so with 'some' high risk of rupture....

So I did PRP Monday with 6 weeks of No run....

However - Anyone have this done? any thoughts on activity progression? when/if re-start Eccentric loading exercises?

Any help would be awesome.

BTW I have IM SR in ~17 weeks

Dave

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Comments

  • @Jenn Edwards Paging the guru...what do you have to offer Señor Howard?

  • I am no @Jenn Edwards but I did stay in a Holiday Inn last night! Seriously, I had a PRP injection in my biceps tendon last year. It didn't seem to work then, but as I sit here now, I realize writing this that it no longer bothers me. I've also considered it for a hamstring issue. The Doc for the shoulder and one for the Hammy both said no exercise during the process.

    i remember going for a follow up on mine saying how much pain I was in and that it hurt worse than before I had the injection. The doc told me that meant it was working as the pain I felt was inflammation from new tissue developing. They also wanted me doing no exercise on the affected area for 6 weeks.

    As for Eccentric exercises, I don't know, but as difficult as docs are to get on the phone, I'd call mine and at least get a PA or admin to relay the Q&A. I am never good at listening to others, and I wouldn't work out without the docs say so. Hope that helps!

  • Hey Dave - MAN so sorry to hear about that.

    Just to set the stage: I had one of your three issues, you can read more about the deets on my particular situation here. And if you REALLY wanna see what it looked like afterwards, watch the imbedded video. http://jennifermaeedwards.blogspot.com/

    From what you've shared, the detachment, reattachment part would be similar. I was quoted four months to return to running and I sit here at three months JUST starting some "pre running" PT which is supported lower leg hopping kind of stuff. It still hurts and I was told it would, even as I return to running. As I've been instructed, the main litmus test is: The next morning is it worse or better. So far, 9/10 days it's been (ever so slightly) better. When it has been worse, I think about the prior day and don't try whatever that was for another week or so.

    Random (didn't stay at a Holiday Inn either...) I was told by both Drs that there is not much evidence supporting PRP for insertional. I would be careful in your research to confirm INSERTIONAL as some of the stuff is counter to regular Achilles.

    If you did the surgery today, you may have just started to return to running at IMSR time. So, maybe consider bumping it to after if you can limp through (ha) without doing more damage

    Hope that helps and hit me up if you have any further questions!

  • On the narrow question of engaging in an Ironman race on May 10, after six weeks of no running starting Jan 14, followed presumably by some ramp-up time monitored closely by PT...

    I'd look into using the Ironman deferral policy (use you entry fee for next year's race), and entering IM SR for 2020, aiming for a full, injury free recovery to train well for IM AZ in Nov.

    I reflect on my own experience when I was 61/2 (2011) after winning everything I entered for 1.5 yrs, I had to sit out 3 months due to upper body injuries - legs were just fine. I tried to get ready for IM CdA with 6 months training, and fell short on the run. But five months later, I was back to form in Nov @ IM AZ. Two good rules of thumb:

    • Allow an equal amount of time back in training as you are off, to simply get back into good enough shape to start "real" training.

    • Over the age of 50-55 (don't know your age), double the amount of time Drs and PTs tell you it will take to fully heal, or that you yourself were healing @ age 35 and below.

    When it comes to getting whole in the face of actual damage to one's body, humility trumps grit.

  • Thanks everyone....

    S'more info....

    3 weeks now no bike at 8weeks no run and 3 weeks post PRP.

    MRI showed insertion bony edema and distal Achilles tendon splitting of fibers and disorginised healing

    I'm 52 y/o btw.

    Cleared for light bike spin trial.

    No run or calf loading x 3 more weeks :(

    hard to tell if any improvement....my pain was post runs so....havnt tested yet.


    Ill give this a honest try....may have to see about the deferment :( if still not better

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