Strength & Mobility (Physio) 15:00 [3]
First appointment with Josh Carty, a physiotherapist at the Newmarket clinic where I saw the sports medicine doc in August. I think I'm going to like working with him. Today's plan was assessment and treatment planning for the insertional Achilles tendinopathy on my right foot.
He said it's time to move on from eccentric heel drops to tendon-loading therapy, i.e. exercises with dumbbells on alternate days to allow time for rest and rebuilding of the tendon. He also gave me the first of five planned shockwave treatments. The exercise program is expected to last 12-16 weeks but after the shockwave is finished, I probably won't need to go in person. Wisely, he emailed me an app with my assigned exercises so he'll *know* if I miss doing them.
Random notes so I remember:
- For now, I should avoid stretching/flexing my feet so a lot of yoga exercises are out.
- Additional strength exercises are encouraged.
- It's OK if I run; we'll find out by trial and error whether my foot prefers running on the same day as the exercises or on the rest days.
- Ice to reduce inflammation from running - probably in the evening on the day of a run.
- As with my left foot, the pain may be largely coming from the retrocalcaneal bursa.
- Based on my ultrasound and his assessment, I don't need to worry much about sports causing further damage to my Achilles insertion. However, since I'm sometimes told that I'm limping from inflammation, I could mess up my biomechanics and injure a different joint. So that's the main reason to avoid pushing too hard. This, in particular, was a relief because I've imagined my faulty, calcified Achilles tendon fraying into little threads if I run too often.
- I should bring running shoes to the next appointment so he can watch me on the treadmill. He doesn't believe in making too many changes to natural gait but there could be an obvious issue.
- A lot of patients say they have high pain tolerance but many of them - usually men - do not, lol! I may not be much of an athlete but apparently I scored high on pain tolerance during today's treatments. I'm Scottish - I like to get my money's worth. ;)