I encountered three people in the past two weeks that were all self-treating Achilles tendinitis.
They all were getting worse.
They all were making the same mistake.
This is my public service announcement for the week. Many of us employ the treat by consensus plan. We consult Dr. Google. We ask friends. We call family. We listen to trainers that a friend of a friend’s aunt knows. I know I do it. Apparently, some of my friends do as well. Adding to that, we have the voice of our fourth grade gym teacher in our head; “no pain, no gain”.
The consensus/group think treatment for Achilles tendinitis seems to be: stretch till it bleeds.
The calf muscle group is often tight and needs to be stretched. However, overstretching can irritate an injured muscle or tendon. If the pain is where the tendon inserts onto the heel, you can start to weaken the insertion point. My little art project:
My first steps almost every morning for the past several years have greeted me with the soreness that usually comes from plantar fasciitis. My Lyme literate doctor (LLMD) has felt that this pain along with occasional burning and tingling is likely a symptom of Bartonella(a common co-infection of Lyme). Two weeks ago, I began to have symptoms all day that became worse at night. The LLMD wanted to know if any of my symptoms changed, so I called and left a message. Through his nurse, he told me it was the Bartonella and suggested I add either another antibiotic or a herbal mixture called A-Bart. The antibiotics I am already on are supposed to battle both Bart and Lyme, so I opted for the herbal boost.
Before I received the new medicine, I noticed that wearing compression stockings helped. I ordered a pair ofTommie Copper socks that I could wear more comfortably and for longer periods of time.
The compression seems to be the trick for reducing the tingling, burning and aching. Who knew? Well, I am sure someone did, but not me.
The formal name is Jarisch-Herxheimer Reaction. To keep it short, the theory is that there are some pathogens that, when killed off, release toxins. These toxins can make symptoms worse or even add a few new ones. Not everyone has a Herx reaction but some people have very severe reactions that make it impossible to continue treatment. For another blogger’s take click here.
The Trouble With Herxing
After reading some of the stories that Mr. Google showed me, I was a little nervous about the possibility. My LLMD understood that I needed to keep working and functioning at a high level, so he adjusted my protocol to what he thought would work best. [Or, he uses this protocol on everyone, because, it is better than having your patients bedridden and cursing your name.]I also began a preemptive strike. Eating, drinking and vitamining my way to detox nirvana. I have some days that are not as good as others, but that fits the normal pattern of life. I cannot say that I have had an identifiable Herx reaction (knocking on wood right now).
No! Not Bugs!!
The down side of not having a distinct reaction, is that there is no feeling of confirmation that we are on the right path of little bug homicide.
For now, I will be happy with some gradual symptom change.
One of the most common questions I hear is, “should I put ice or heat on it?”
When to ice:
Any new injury is a good candidate for ice. If there is swelling or warmth over the area, ice is a good idea. The cold will help to constrict the blood vessels in the area. This will limit the amount of swelling by decreasing the blood and fluid released into the damaged tissue. The ice will also help to slow nerve impulses. The numbing effect will decrease pain.
Whenever there is a new injury, the body releases chemicals in the area to limit the area of damage and to clean up the injured cells. Some of these chemicals trigger pain signals to be sent to the brain. By applying ice to the area, you limit the amount of these chemicals and the pain signals.
Because blood vessels can also be injured and because an injured area is used and moved less, the swelling that is allowed to accumulate may take awhile to dissipate. The extra fluid volume creates pressure and decreases mobility. That is why it is so important to ice right after something is injured.
Ice for prevention:
After a car accident, the victims may not feel pain initially due to the adrenaline released and other factors. Even if you feel fine, it is not a bad idea to put some frozen peas on your neck for 15 minutes when you get home.
After a hard workout. Many athletes will ice a joint they know gets a lot of work to prevent inflammation and injury. Example: baseball pitcher icing his shoulder and elbow when he leaves the game.
When not to ice: it hurts more than the expected uncomfortable nature of ice, Raynaud’s Syndrome, neuropathy or numbness. Do not apply chemical ice packs directly to skin.