Tendinopathy? Anyone had it?

LKArgh

Just when I thought I was finally fully recovered from an injury that happened almost a year ago, I started having symptoms again I just saw a specialist in sports injuries, who is sure this is Achilles tendon tendinopathy. He wants to verify with an MRI and if it is indeed tendinopathy, he suggests enzyme injection therapy. Has anyone ever heard or tried this? I come up with very few links when googling it (the dr did tell me it fairly new) and I wonder if anyone has tried it?

queenliz99

I had tendinitis in my neck, unbelievable pain. I feel bad for you, I know it sucks. What worked for me was some physical therapy, cortisone shots in my neck, prescription lotion called Voltarin and rest. Lots of rest. Driving was a bear, however. My fifteen year old was my side view mirror,LOL.

Enzyme injection therapy have not heard of either but I want to see if anyone chimes in. Curious

I hope you feel better soon.

tomatoey

Aw, aggelikik, sorry. Yes, lots of experience with tendinopathy, in multiple places, but not much in completely healing, and none in the procedure you're talking about. I often backslide, and reinjure (even being really careful, even doing exactly the things my physiotherapist wants me to do) and have to go back to the beginning (i.e. rest).

The only thing that seems to work is taking a LOT of time off and not using that body part, or reducing strain on it with braces/orthotics. And modifying activities. Physiotherapy helps, but I think more so in the way of pain management (via electroacupuncture), and strengthening muscles related to the complex in question so things are more balanced and the tendons take less of a beating bc of imbalances or compensations. (When I don't backslide, that is.) I don't know if there's so much healing of damaged tissue itself. Some kinds of massage, and eccentric exercises, are supposed to do that (i.e. remodel wonky tissue), but I don't know...

I've never heard of enzyme injections, but I've read about platelet-rich plasma injections (mixed results) and prolotherapy (no substance injected, just needling of the tissue - same mixed results).

There is stem cell research going on, that appears to be the most promising in terms of actually healing or rebuilding the tissue, from what I've read. Is that what he's talking about? There's a company in the US doing a big study, just on Achilles injuries, actually. I'm sure there's something similar happening somewhere in Europe?

Good resource: www.tendinosis.org (am sure you've seen this, though?).

LKArgh

tomatoey wrote: »

Aw, aggelikik, sorry. Yes, lots of experience with tendinopathy, in multiple places, but not much in completely healing, or in the procedure you're talking about. I often backslide, and reinjure (even being really careful, even doing exactly the things my physiotherapist wants me to do) and have to go back to the beginning (i.e. rest).

The only thing that seems to work is taking a LOT of time off and not using that body part, or reducing strain on it with braces/orthotics. Physiotherapy helps, but I think more so in the way of pain management (via electroacupuncture), and strengthening muscles related to the complex in question so things are more balanced and the tendons take less of a beating bc of imbalances or compensations. (When I don't backslide, that is.) I don't know if there's so much healing of damaged tissue itself. Some kinds of massage are supposed to do that (i.e. remodel wonky tissue), but I don't know...

I've never heard of enzyme injections, but I've read about platelet-rich plasma injections (mixed results) and prolotherapy (no substance injected, just needling of the tissue - same mixed results).

There is stem cell research going on, that appears to be the most promising in terms of actually healing or rebuilding the tissue, from what I've read. Is that what he's talking about? There's a company in the US doing a big study, just on Achilles injuries, actually. I'm sure there's something similar happening somewhere in Europe?

Good resource: www.tendinosis.org (am sure you've seen this, though?).

Thank you. Yes I did see this link, and it appears to be what he was talking about, although it sounds just too new to be something he would try on me. Then again he works with a few well known athletes and teams, so maybe he does have access to brand new treatments. I have already changed my exercise routine, basically became a swimmer instead of a runner (which I enjoy, but miss the running too), have spent a small fortune in all sorts of physical therapy (electrotherapy, accupuncture, heat, strengthening routines, massages) and I am definitely getting sick of it!

tomatoey

aggelikik wrote: »

tomatoey wrote: »

Aw, aggelikik, sorry. Yes, lots of experience with tendinopathy, in multiple places, but not much in completely healing, or in the procedure you're talking about. I often backslide, and reinjure (even being really careful, even doing exactly the things my physiotherapist wants me to do) and have to go back to the beginning (i.e. rest).

The only thing that seems to work is taking a LOT of time off and not using that body part, or reducing strain on it with braces/orthotics. Physiotherapy helps, but I think more so in the way of pain management (via electroacupuncture), and strengthening muscles related to the complex in question so things are more balanced and the tendons take less of a beating bc of imbalances or compensations. (When I don't backslide, that is.) I don't know if there's so much healing of damaged tissue itself. Some kinds of massage are supposed to do that (i.e. remodel wonky tissue), but I don't know...

I've never heard of enzyme injections, but I've read about platelet-rich plasma injections (mixed results) and prolotherapy (no substance injected, just needling of the tissue - same mixed results).

There is stem cell research going on, that appears to be the most promising in terms of actually healing or rebuilding the tissue, from what I've read. Is that what he's talking about? There's a company in the US doing a big study, just on Achilles injuries, actually. I'm sure there's something similar happening somewhere in Europe?

Good resource: www.tendinosis.org (am sure you've seen this, though?).

Thank you. Yes I did see this link, and it appears to be what he was talking about, although it sounds just too new to be something he would try on me. Then again he works with a few well known athletes and teams, so maybe he does have access to brand new treatments. I have already changed my exercise routine, basically became a swimmer instead of a runner (which I enjoy, but miss the running too), have spent a small fortune in all sorts of physical therapy (electrotherapy, accupuncture, heat, strengthening routines, massages) and I am definitely getting sick of it!

Oh god, I can completely relate. The loss of money and time, the inability to do activities you love, and impact on everyday activities, the depressing feeling that your body is failing/damaged and never going to recover... if it were a broken bone, it would set and heal and be fine, but these tendons and ligaments are so much more complicated.

I think, research it a bit more (Google Scholar?), and if it looks like it even kind of makes sense, take this opportunity!!! And report back!

I'm envious - half the people I've seen in my area are in the stone age as far as all this is concerned. I'm lucky to have a PT who doesn't call it "tendonitis". Still being offered cortisone injections by docs

tomatoey

Scholar results: https://scholar.google.ca/scholar?q=Enzyme+injection+therapy+tendinopathy&btnG=&hl=en&as_sdt=0,5&as_vis=1

Cherimoose

aggelikik wrote: »

I just saw a specialist in sports injuries, who is sure this is Achilles tendon tendinopathy. He wants to verify with an MRI and if it is indeed tendinopathy, he suggests enzyme injection therapy.

An MRI and injections?? First try the basic stuff - eccentric exercises (below), and also wear a night splint, to lengthen the Achilles & calf muscles while you sleep. Get a splint that can incrementally adjust to angles less than 90 degrees, like this:
amazon.com/Adjustable-Plantar-Fasciitis-Splint-Medium/dp/B006L8N71Y

eccentric calf exercises: youtube.com/watch?v=M6EKuuZ7C2E
youtube.com/watch?v=XYl8pOkw-aE

Do you run? If so, avoid uphill runs. It puts more strain on the Achilles. Downhill is ok.

tomatoey

@Cherimoose, I appreciate your perspective on here, a lot. In your experience, is it common for people to fully recover from tendinopathy with standard treatment? As in have no pain, and get all their previous function back? & not relapse? (this has obviously not been my experience)

Ironmaiden4life

OP Tendinopathy is a fairly broad term diagnosis. An MRI will provide your specialist with all the information they need to give you a more accurate diagnosis and location of the tendonopathy, from there your specialist can ascertain causation. It will also show if there is any tear on the tendon which may or may not require surgery. Until that has been done I would refrain from doing anything in case you cause more damage.

I've just come back from tendonopathy of the bicep tendon at the insertion point which had me out of the gym for over 4 months. I went from being able to do lateral raises with 20lb dumbbells and bench pressing 60lb dumbbells to being unable to carry a jug of water in my left hand. Like you the impact on me mentally was devastating and I completley understand the frustration you're going through. The cause in my case was my elbow joint was out of alignment. After 4 weeks of therapy I'm back in the gym, the weights are going back up and I'm pain free.

I refused steroid injections as I felt the risk they carry was too great versus the injury I had, thankfully once I had the correct PT treating me it became apparent I made the right decision. A very good friend of mine spent a year being treated by a PT for tendinopathy in her elbow, including receiving plasma injections, and it wasn't until she an MRI that they found she had a tear that required surgery. She is now fully recovered.

Go ahead and have the MRI then sit down with your specialist and discuss treatment options including getting a second opinion if you need too.

LKArgh

Cherimoose wrote: »

aggelikik wrote: »

I just saw a specialist in sports injuries, who is sure this is Achilles tendon tendinopathy. He wants to verify with an MRI and if it is indeed tendinopathy, he suggests enzyme injection therapy.

An MRI and injections?? First try the basic stuff - eccentric exercises (below), and also wear a night splint, to lengthen the Achilles & calf muscles while you sleep. Get a splint that can incrementally adjust to angles less than 90 degrees, like this:
amazon.com/Adjustable-Plantar-Fasciitis-Splint-Medium/dp/B006L8N71Y

eccentric calf exercises: youtube.com/watch?v=M6EKuuZ7C2E
youtube.com/watch?v=XYl8pOkw-aE

Do you run? If so, avoid uphill runs. It puts more strain on the Achilles. Downhill is ok.

Thank you for the links. I have been doing these exercises plus some with an elastic band since last spring. I thought they worked and was fine, but now we are back to the beginning.
I cannot run at all since last autumn. I had managed a few 10-20 minutes of rather slow runs on flat surfaces the last months, but no more.
This is the 5th specialist I am seeing. No one so far suggested a splint, they said it woudl not help in this case. I will ask again after the MRI.

tomatoey

aggelikik wrote: »

This is the 5th specialist I am seeing.

I've been there too, sorry It's frustrating when the answers don't come easily.

Have you ever undergone a period of total (non-weight bearing) rest (i.e. boot/cast + crutches)? Although movement w/o pain is beneficial, sometimes straight rest is what helps. (It took me a few months of that in order to be able to walk for longer than 5 minutes at a time, w peroneal tendinopathy. This was a few specialists in, and two years after injury.)

I hope the MRI settles questions and provides a direction for treatment.