Flash stated previously that Dr. Siff recommended alternating the use of Ice & Heat (as opposed to the oft overuse of just ice) on certain injuries & trouble spots.
What protocols do forum members suggest? A protocol of Ice, Heat, Ice, Heat, Ice (all for 3 minutes) was suggested to me.
Thoughts?
The reasearch is very clear about use of ice for longer then 15 minutes…I can’t argue about the results and feel that contrast methods should be used for neurological results…not metabolic responses.
anecdotal evidence tells us that contrast methods are better, structured research that has been repeated many times does not exist.
any protocols to share Sharmer?
You can’t do open heart surgery with contrast showers Sharmer…each has it’s own place.
Every morning, i do the following
This is my approach to managing/treating achillies tendonitis.
hot bath-only submerge the calfs and achillies ( 1 minute)
Cold treatment, submerge lower limb in feezing cold pool( its the middle of winter now) ( as long as you can tolerate. The first time may only be a matter of seconds, after the 2,3,4 time you can extend the time up to 30 seconds or more.
Massage calf
repeat 4-5 times
Do 1-2 sets 5-10R of eccentric calf raises
stretch 1 set of 30seconds of soleus-calf-achillies stretch.
I may repeat the 6 steps, two or three times a day.
The key to success is sticking to the protocols 7 days a week. Results will be visible in a matter of days depending on the severity of the pathology.
… and I presume you ice after #6 before you finish also?
The use of ice afterwards depends on several factors
e.g
Ice by it self can leave the lower limb stiff, i think ice massage is a better option because it alleviates this problem.
Just a few questions Sharmer,
Sharmer how do you do the eccentric exercises?
Eccentric exercise is recommended for tendinopathy, but how, because if you did it with heavy weights it would hurt??
no 23,
Massage therapy should
Mostly performed on the soleus and gastroc, it is tightness in these muscles that is a leading cause of tendonitis.
massage performed in a horizontal lying position is not preferable because the immediate reponse is venous pooling in the lower limb when the athlete stands up. Venous pooling> leads to swelling >odema.
Self massage is the best option with AT. Some examples of self massage are:
rolling pins, use of smooth circular surfaces. They do seem bizarre
methods of massage yet are the most effective on the basis;
#maintain horizontal position
#easily adhered to and can be done daily.
massaging directly on the tendon because they apply more concentrated force per cm squared.
Pressure is force per unit of area.
or p = F/A where p = pressure, F = force, & A = area.
Smooth large circular surfaces are ideal for massage on the AT since the forces are spread out more evenly.
Higher concentrations of force on the AT leads to ^ swelling, inflammation, pain.
(n.b use oils, to reduce friction)
Jimbo UKdec
I wouldnt do heavy eccentric calf raises.
My advise is single leg calf raises with no weight: emphasize a slow eccentric phases. The number of reps 5-10, 2-3 sets.
The purpose of slow eccentric CR is to rehabilitate the AT so it can tolerate the demands of sprint work.
Heavy lifting has it roles in the strength programs for sprinting however general
types of lifts are prefered. Heavy lifts serves the purpose of creating hormonal conditions promoting hypertrophy: specific movements should not be heavy as they serve the purpose of rehabiliation and not hypertrophy.
When the AT gets stronger the volume of ECR can be reduced because higher volumers of sprint training will apply the eccentric forces.
Its important to know that the limitations of strength from AT is caused more by neural factors, such as increased activation of golgi-tendons. Plyometrics can inhibit the activation of golgi-tendons and allow the lower limb to generate higher forces.
Strange rehab program…
JimboUKdec
Eccentric exercise is recommended for tendinosis, but how, because if you did it with heavy weights it would hurt??
Yes it will hurt initially. Start with bodyweight then increase each session. I had bilateral achilles tendinosis last year & started an eccentric strengthening program on physio advise following an ultrasound.
I did eccentric standing & seated calf raises at 3x10 each leg. I dropped the seated ones after 2-3 weeks as my calves were very tight & I wasnt recovering well from this exercise. I progressed from bodyweight to a machine weight of 140kg. Each increase in weight was a little painful at first, but with each session the pain diminished.
At about the 4th week of eccentric exercises my physio recommended I start some light running which was painful. At the same time I intoduced ankle hops over 10m & med ball throws. With each session the pain diminished. Took approx 10-12 weeks before there was no pain in a given session. However had tight calves/achilles in the morning for months.
Rough time frame
Week 0-8: very little improvement with treatment. Achilles very tight & painful in mornings.
Week 10: ultrasound. Commence ecc. exercises. Morning pain & stiffness continue.
Week 14: commenced light running. 6x10m ankle hops, 3x100m tempo (slow & painful). Did tempos every alternate day. Morning tightness & pain diminishing.
Week 19-30 (up to March 2003): able to run at 90-95% over 50m. 10x100m tempo increased to 10x200m. Ecc. calf exercises 1xpw & calf raises 1xpw. Gradual progression to full training. Only plyos were ankle hops. Morning pain/stiffness almost disappeared.
Currently no pain (only slight pain in left achilles on palpation).
That was my experience. It was slow but I did get better with eccentric exercises, & a gradual progression to full training. I didnt compete but will this year. The slow progression was due to not keeping off my feet long enough when the pain originally started.
llenny
llenny - good program, great to hear you’re recoerving well.
I feel you must do ecc wgt trg.
Personlly I can’t see the logic in performing many calf rasies - excessive raises will require even more stretching to prevent the calf from tightening.
In fact I would belive too many calf rasies would over time put incresed tnsion on the AT - no?
I would use fingers to xfriction the tendon, using a rolling pin sure spreads the force - but does it not make more sense to fricton the actual area of tendonosis?
llenny does Ultra-sound have any effect on the AT at all?
Did I not read recently that US had lmited effect on the actual tendon?
no 23
Re ultrasound (diagnostic tool). The diagnostic imaging ultrasound was used to check the health of my tendons. There was minor thickening in the left tendon with no tears or lesions & the right one was normal appearance.
You are right there is limited benefit from ultrasound (used in physio) for tendinosis hence the ecc. calf raises. Tendonitis may have better results from ultrasound. I should mention that the ankle hops were double leg ankle hops.
llenny