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Ibuprofin injection in Achilles tendinopathy

Discussion in 'Biomechanics, Sports and Foot orthoses' started by Simon Spooner, Feb 20, 2006.

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    Currently working with female elite marathon runner. She has long history of achilles tendon problems. She had seen loads of people to no avail and eventually found me. I have treated successfully with FFO's- she v. happy to be running again. She came to me today for review and new devices (ultra-light for racing) she reported that she is 90% better, but still some slight stiffness. The R achilles is still enlarged and she has been advised by UK athletics that an ibuprofin injection may be helpful. She is a little reluctant, but is obviously being advised by her coaches. Does anyone have experience of this or know of outcome studies.

    Thanks in advance.
  2. I have never heard of using ibuprofen injections before, Simon. Having had this same condition a few times during my racing career and treated quite a number of them, I would have her do TID stretching, BID icing, have her wear shoes with a slight heel during the day (no flat heels or barefoot), and stay away from anyone that wants to inject anything around the Achilles tendon in this elite runner.

    Don't worry about localized Achilles induration as long as she can train and race without pain since most of them eventually resolve over time to have a near normal "feel". However, especially in my female runner patients, I tell them to keep their hands off their Achilles tendons and not rub it unless they need to (which they don't really need to). For some reason, I have noticed that my female runners/athletes love to "touch and feel" their injuries a few times a day whereas male athletes generally don't worry about it as long as they can run and play on it. I think that many times it is just better to tell them to let their bodies heal these things on its own without them poking on it a few times a day.

    Good to see that your orthoses helped this runner. Another positive outcome for foot orthoses in runners...in other words, "It is the orthotics!"
  3. Kevin,

    For someone who is keen on definitions and accuracy I am somewhat surprised by your sudden use of the unexplained acronym ;) . In other words my naeivity means that I don't know what you are talking about when you say BID and TID? :) Could you put this into English please? I have her iceing and she feels this has helped. Interestingly, her running gait consists of a forefoot lateral strike, followed by midfoot contact and then the briefest and lightest heel contact. Her ankle joint dorsiflexion is fine- really better than most, but her hams are v. tight and she has been using PNF type stretches for these. As for the injection my feeling on this is similar to yours, I just wondered if this was something emerging as a line of action. What advantage would this offer over systemic delivery anyway?

  4. Sorry: TID- three times a day; BID- two times a day

    Many forefoot strikers get this injury. I try to raise the heel a little, incrementally, to see what plantar foot angle works best for them in getting rid of the Achilles tendon pain without causing other problems.
  5. Thanks. Have done that. Started with small heel raise and have incrementally increased. No matter how much I increase the raise the kinematics seem to stay v. similar so far... (ahh the old kinematics vs kinetics argument I hear you say: I'm actually using her as an example of this in some teaching I'm doing soon) Will keep you informed re: progress. Her real goal is selection for Olympics 2012- come on you Brits, bring on the Games! But to stay in contention she needs to loose 50 secs off her half marathon time this year.

    Best wishes,
  6. Admin2

    Admin2 Administrator Staff Member

  7. Craig Payne

    Craig Payne Moderator

    I asked a physiotherapist, Dr Jill Cook, who has done a lot of work on this to comment on this thread and this was her response:
    ... thanks Jill
  8. Speaking of acronyms (and unknown abbreviations) in this thread, Dr. Spooner, how about the following???:

    FFO, PNF, v., R
  9. Sorry: Functional foot orthoses, proprioceptive neuromuscular facilitation, very, right. ;)

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