Tina has severe severe tendonosis of both ankles

October 5, 2016

Hi, Have been diagnosed with severe tendonosis of both ankles, ( one heals and the other soon then flares up) after decades of playing squash/r.ball, and the other week had a spontaneous partial rupture of the r.achilles. Have tried eccentric stretching/months of PT/ice/heat regimes/walking boot, but for last 15 mo can’t beat it.

Trad. surgery has been offered, but are there any alternatives without the risk of  surgery to actually cure the problem?


October 5, 2016

Hi Tina – Yes, probably.

Tendons are like 3 years old – they are really unpredictable and one set of rules doesn’t suit all.

The issue is how you manage your load and forces that you transit down through your tendon.

The classic Alfredson eccentric loading program alone will not do what it once said on the tin – and even the big guy himself would testify to that. There are so many differing factors that attribute load discrepancies to your tendon.

If you have a fixed, flexed thoracic spine with poor posture sets it will increase the load through your tendon. If you have poor control of your pelvis and hips it will increase the load through your tendon. If you have poor leg strength it will increase the load through your tendon – and if you can’t deal with the excess in load then you will have pain and ‘osis. Any local treatment to you Achilles will do very little to the bigger picture…..

Some of our good friends, the OS, with their trusty tool bags containing hammers, see everything as nails. I’m not sure you have a structural issue – it may present as a structural problem, but I’m sure you’ve got a functional issue. You need to change the function of the tendon, not just the tendon structure.

Physio’s are also a mixed bag – the good, the bad and the ugly. You need to make sure you see only the good.

Before you even consider anything invasive make sure you’ve fully exhausted the non invasive interventions such as Shockwave Therapy

Hope this has been of some help.

The Guru

Six Physio

Guru Responded

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