Archive for the ‘Achilles Tendon’ Category

A nice testimonial

I got a really nice email a few days back.  Here is the gist of it:
Hi Alex,
   I bought your e-book and video on Target Plantar Fasciitis, and it has helped me so much. I have had plantar fasciitis and anterior tibial tendon pain for quite some time. I am a distance runner, running up to 40 miles a week. For several months I had no pain while running (only sore after), but in June it became painful to run. Have spent the last three months trying all of the conservative treatments…night splint, icing, stretching calves several times a day, going to PT, massage therapy. I have been running at a reduced volume with no speedwork or trails, after taking off a few weeks. I started doing [the recommended exercises] 2 1/2 weeks ago, and taking [the recommended supplement], and the pain is gone!
– Sally Boyd

It’s always nice to receive an email like the one above, because it shows just how effective a scientifically-based treatment protocol can be, compared to stuff that’s done just because, well, it’s always been done.  

For example, there is no good reason to ice a tendon that’s been experiencing pain for more than a couple of weeks, because that tendon clearly does not have inflammation as its primary problem. Massage therapy is great for preventing tendon problems from occurring in the first place, but won’t help much once you have chronic pain.  Same thing goes for stretching.  (Actions that prevent problems from happening are not necessarily the same ones that will cure it once the problem is there.)  And I don’t know of any study that shows night splints to be effective for plantar fasciitis – although a lot of companies that make the splints insist that they are.

Yet doctors and other medical professionals continue to prescribe this sort of thing, not only for tendons and fascia but for other connective tissue as well. They’ll even try to shoot your achilles tendon up with cortisone, despite studies that have shown that this will make the tendon more likely to rupture than if it’s left alone.

It’s really a mystery. My guess is that the doctors are just so busy that they simply don’t have time to keep up with the latest research.

But the fact is, about ten years ago a Scandinavian team of scientists discovered that certain specific types of exercise were good for chronically painful tendons…and certain other types were very definitely not good for them.  Turns out that this same protocol can (and does) work for fascia as well.

This is why resting a tendon helps to alleviate the pain; you aren’t doing any of the bad kind of movement.  But of course you can’t just sit and rest forever, which is why you need a well-designed program of the good movements to actually heal the tendons, not just fail to injure them more.  And that’s what the Target Plantar Fasciitis and Posterior Tibial Tendonitis ebook+video package delivers.

Of course, not every method of treatment works for everyone.  If you want to find out whether my product can help you or not, I invite you to take the free, one-minute tendon and fascia test that you can find on this page.  It will tell you very quickly what sort of tendon or fascia pain you have, and what you can do to help get rid of it once and for all.

Do-it-yourself foam-roller for fasciitis and tendonitis

Recently, I’ve seen some videos floating around that promote foam-rolling as a way to cure tendon and fascia pain.  While this isn’t exactly true – foam-rolling can help prevent problems from happening in the first place, but won’t cure anything once the problem has occurred – foam-rolling is still a great idea and should definitely be on everyone’s list of body-work that they do on a regular basis.

If you’re not familiar with foam-rolling, here’s a brief explanation:

Basically, a foam-roller is, well, a tube of fairly dense styrofoam.  That’s it.  Rollers come in various sizes and lengths, but the most common ones are about three feet long and six inches or so in diameter.  Most gyms have them now, and they’re generally encased in blue vinyl covers for ease of washing and so on. The idea is that as you exercise, age, go about your daily activities (okay, as you live), you develop small areas of pain here and there in your body.  The pain comes from something called adhesions, which are places where the fibers in your muscles don’t slide smoothly alongside each other like they’re supposed to, but instead get stuck together, thus creating pain when you try to move in certain ways.  A good physiotherapist can massage these away for you, but with a foam-roller you can do it yourself by placing the affected bodypart on the roller and rolling back and forth a few times with a bit of pressure to break up the adhesion.

Amazon sells foam-rollers, although most of them are a little less rigid than the usual gym version.  This is actually good for people who are new to foam-rolling, as the practice tends to hurt quite a bit in the beginning, and a softer roller can limit the pain.  But once you’re used to it, a soft roller won’t do you as much good as a hard one.

On the other end of the scale is this monster.  It is not for the faint of heart.  It looks – and can feel – like something out of Torquemada’s dungeon, but it will absolutely destroy any adhesions you might have.  If you can stand the pain, that is.

RumbleRoller The RumbleRoller is specifically optimized for myofascial release.  And pain.

In-between are the regular gym rollers.  But if you want something that you can use around the house…as well as pack into your gym bag…as well as easily store away…as well as use for other purposes, then investing in a pair of FatGripz might be the way to go.  I realize that readers of this blog are generally runners, but many of you work out in the gym as well, and Fatgripz are one of the best ways to do great things for your arms.  Not to mention the fact that if you’ve developed tendon or fascia pain in your feet or ankles, there’s a good chance that you might end up with it in your arms and shoulders as well.  (Some people are genetically more predisposed to developing connective tissue pain than others.)  Fatgripz can virtually eliminate this possibility by changing the thickness of the typical gym barbell so that your hands don’t always close to exactly the same degree each time.

It’s kind of hard to roll a small tendon like the peroneal or post tibial, but for the plantar fascia or achilles tendon, foam rolling can be just the ticket to prevent injuries before they happen.  If you’ve already had an injury and have completely recovered, foam rolling can also go a long way toward making sure that injury doesn’t come back again.

But you don’t need a six-foot long roller to get at the soles of your feet or your ankles.  And if you do buy a regular foam roller, you really can’t use it for anything other than, well, foam rolling. FatGripz, on the other hand, are much more versatile.

FatGripz come in sets of two, and they are 2.25″ thick plastic attachments that you can put on a regular barbell to make it into a “fat bar”.  Why would anyone do this?  According to the company using FatGripz will increase both the strength and the size of your arms.  (It’s harder to grip a fat bar than a regular one, causing the arm muscles to work harder even if you’re doing the same exercises.)  For tendon purposes, having a choice of widths for your barbells is an excellent way to prevent repetitive stress injuries – especially in your forearms – if you spend much time in a gym,.

But here’s the other advantage.  You can take one FatGrip, slide a broomstick through it, and make your very own “foam” roller.  While it won’t really do for large areas like the back, the small size makes it ideal for rolling the major tendons and fascia of the ankles and feet.  And it’s a bit harder than your usual foam roller, which is nice.  (If you want a softer version, just wrap a towel around the FatGrip.)

Here’s a picture:

Stick through Fatgrip to make a foam-roller

Use your Fatgripz as a foam-roller.

The smaller diameter of Fatgripz doesn’t make much difference when you’re rolling, and unlike a lot of regular foam rollers, they come with a 60-day money-back guarantee. So if for whatever reason you don’t like the things, you can return them for a full refund.

But honestly speaking, I don’t know anyone who’s returned them. They work great for their intended purpose (in fact, they were named “Training Tool of the Decade”) and – as described above – they also can serve double-duty as a localized foam roller for smaller bodyparts like the soles of the feet. Check out the website here. You won’t be disappointed.

A lot of bad advice out there…

A silly video

I ran across a video the other day and thought I’d write a post about it because it gives a good example of just how much bad advice there is out there among “certified” physical therapists and so on.

Before I start, I want to say that I know (and have used) some excellent PTs, and I certainly do not want to say that everyone in the field is a quack or anything like that. There are definitely some good people out there, and if you have access to a really competent PT, he or she can often work miracles. But on the other side of the coin, just having a certification (of any sort) doesn’t necessarily make you competent in your job. And a lot of people get fooled by labcoats.

Personally speaking, I’ve received enough bad advice from “body professionals” over the years that nowadays when I have to see one I always try to assume that they know what they’re talking about…but I also always ask some pointed questions, just to make sure. I hope that this blog post will make you think about things a little, and encourage you not to blindly accept what you’re hearing the next time you go in for some “body work”.

I’m not going to link the video here, but you can find it on YouTube. Just go to the YouTube site and type in /watch?v=pn6i-_dTX0g after the www.youtube.com part of the URL. The video’s less than two minutes long, but if you don’t want to watch the whole thing I’ll give a brief summary below.

Strengthening a tendon

The video shows a PT who tells you how to “strengthen” an apparently healthy woman’s achilles tendon by using a stretch band. The woman is sitting on a therapy bed and takes the band, loops it around her foot, and then proceeds to exercise the foot against the band by pointing and relaxing her toes.

All this is fine, and the PT makes sure to cover some good points about getting in a full range of motion and so on. The problem is that the band only provides about five or ten pounds of resistance, and the woman in the video who uses the band has got to weigh at least a hundred and twenty.

This may not seem relevant, but think about it for a second. If she weighs 120lbs, that means that every step she takes she is putting 120lbs of pressure on her achilles tendon. How is a band with ten pounds of resistance going to strengthen a tendon when that tendon has far more stress put on it just when the woman walks? (We won’t even talk about how much more than 120lbs each step really is because of acceleration/deceleration forces.) If you can bench press 200lbs without any problem at all, you’re not going to develop more strength by working out with 20lbs.

What’s the point?

So what’s the point of using a very weak stretch-band for this? Basically, unless the woman was injured and spent so much time off her feet that her achilles tendons atrophied to the point that they can no longer support any weight (which would mean that she couldn’t even stand up), there is none. Maybe a polio victim would qualify, but exercising an achilles tendon in any realistic scenario will involve using a decent amount of weight, one that equals a significant percentage of the exerciser’s bodyweight.

Yes, if the woman was injured or is recovering from surgery it makes sense to monitor her level of pain and start out using a lighter weight. But not this light. Using a weak band like that reminds me of the housewives who walk into gyms, start using the one- and two-pound dumbbells, and then wonder why their bodies don’t change. It’s not hard to understand when you realize that the average bag of groceries weighs more than the “workout” weights! They’re not using enough resistance to have any effect on the muscles.

One other point about the video is that the PT says that the stretch band provides “constant resistance” so long as the hands holding the other end of the band remain stable, but this isn’t really true. If you stretch a rubber band out, there is going to be more and more resistance the further you stretch it (until it breaks, anyway). The resistance at the beginning is light, and gets progressively heavier the more you pull.

Admittedly, this is pretty minor. The range of motion that a foot has isn’t very great, and so there won’t be a lot of difference in resistance between the beginning and the end of the motion. But it’s disturbing that a trained and certified PT would say something like this in the first place, when a simple, “Be sure to keep your hands in the same place” would be fine. I think that a lot of times people in positions of authority like doctors and physical therapists have a need to justify what they’re saying to their patients, and sometimes this can lead to a little trouble.

Think for yourself!

In any case, please, if you have a problem with your achilles tendon, plantar fascia or anything else, don’t just blindly trust what someone in a labcoat tells you. Use your common sense and try to think critically about what’s being said.

Author: Alex Nordach

Testimonial

I just received a new testimonial for achilles tendon pain in the mail.  Here’s the full, unedited text:

I found your e-book incredibly helpful!  The videos were great– I don’t think I would have been able to do the exercises properly [without them].  They have been a lifesaver.  I was diagnosed with achilles tendonosis back in 2010 and the doctor had basically told me to just rest it for awhile and then use an anti-inflammatory and ice it after I run.  (I do sprint distance triathlons and 10k runs.)  But it wasn’t helping at all.  I took a year off running and still didn’t get any relief.  In fact, sometimes it hurt horribly just to walk.  I was pretty desperate for some kind of help, anything, because I wanted to be able to run again.  Within two weeks of using your exercises I was completely pain free while walking.  I took up running again (though doing shorter distances) and I continue to use your exercises as “maintenance.”  I still have some pain, especially during and shortly after a run, but the exercises do help me to keep participating in my races, something I was afraid I would never be able to do again.

Thank you!!

Heidi Johnson

I get stories like this all the time.  A person starts to feel tendon pain, and they try to ignore it.  Eventually it gets so bad that they go to a doctor, and 99% of the time the prescription is the same: ice, rest, and some kind of anti-inflammatory medicine.  (In Heidi’s case, this was in spite of the fact that the diagnosis was tendonosis, not tendonitis.  Why use anti-inflammatories if there’s no inflammation?) Although I don’t consider myself an expert at internet marketing or anything like that, I have sold thousands of copies of my ebooks at this point. It’s for one reason: they work.

While no therapy is going to be 100% effective for every single person, the techniques given in Target Plantar Fasciitis and Posterior Tibial Tendonitis have a huge amount of both scientific and anecdotal evidence behind them.  Simply put, if you have long-term tendon or fascia pain that has not responded to conventional treatment, they are your best bet short of surgery.  I have also created a test that is free and will take you less than a minute to complete.  If you’re experiencing tendon or fascia pain that won’t go away, take a moment and fill it out.  It may just save you a lot of time and frustration.

Author: Alex Nordach

Ankle tendon pain

Let’s talk about ankles.

Lots of people complain about “ankle tendonitis”, but what does this really mean? If the pain is in the back of the ankle, just above the heel, then you have a problem with your achilles tendon. If it’s on the outside of the foot, running up the ankle, then you’re looking at some kind of peroneal tendon pain. And if it’s on the inside, running from the instep, under the ankle bone and up the leg a bit, then it’s probably a posterior tibial tendon problem.

Of course, calling any of these conditions “tendonitis” also might not be accurate. If you sprained your ankle and then developed some tendon pain, yes, you likely have short-term inflammation and need to do things like icing and taking aspirin to help combat it. But if you’ve had the pain for more than a couple of weeks, and it seems to be gradually getting worse without any kind of traumatic injury, then it’s much more likely that you have ankle tendonosis.

If you look at the top right of this blog, you’ll see a tendon/fascia test that you can take to determine which one you have. It’s free and will only take a minute – literally. There isn’t even an opt-in, so go ahead and do it now. The results may just change the way you think about your ankle tendon pain.

Author: Alex Nordach

A short discussion about “pattern overload”

I’d like to talk a little bit about pattern overload today.

Fundamentally, pattern overload happens when too many repetitions of a given motion or exercise are performed. You don’t necessarily have to be using a lot of weight to incur pattern overload; your own bodyweight can be more than adequate…as can a one-pound dumbbell if the number of repetitions is high enough. Even typing can become a problem if you fail to alter your hand, wrist, chair and/or keyboard position on a regular basis.

Generally speaking, pattern overload isn’t too much of an issue because even with high-rep activities like running or swimming, each time your foot hits the ground or your hand slices through the water, your body is going to use a slightly changed “groove” when executing the movement. A highly trained athlete might be performing in more or less exactly the same groove for a time, but in the long run, as you begin to tire, your groove will begin to become looser and although this means that your efficiency of movement will degenerate, it’s one way that the body tries to stop itself from incurring an injury.

However, some types of exercise can be relatively worse for pattern overload than others. And this can create discomfort in your tendons and fascia. One example would be exercising on gym machines to an excessive degree. People who work out using free weights have a significantly lower rate of pattern overload than those who work only on machines. The reason? When you’re working with a barbell or dumbbell the weight moves in accordance with your body, but when you’re exercising on a machine your body moves along the machine’s predetermined and fixed weight-track. Even Smith machines, which incorporate a minor level of flexibility, are much more limiting and permit less natural “body adjustment” as you go through your sets than free-weight barbells and dumbbells.

Then, on the other end of the spectrum, there is Crossfit. It’s not that I disapprove of Crossfit in and of itself. I think that the essential idea of Crossfit – do something different each day, and keep good track of your rest times – has a lot of merit, and there’s no doubt that the training is stimulating and fun. But there are some drawbacks as well, particularly when you view Crossfit in relation to tendon injuries.

At base, a Crossfit workout involves choosing two or three exercises for distaff bodyparts, and then doing a lot of those exercises using a predetermined weight for a set time. The down time between sets is normally about ten seconds, and you rotate between exercises. As an example, one of the videos on the website shows three women doing bodyweight squats, then pull-ups/presses on gymnastic rings, then hang cleans with a barbell.

If you simply do too much of a movement, even if that movement is something totally “free”, like swimming, you can acquire tendon and fascia issues if you exercise so much that the amount exceeds your body’s capacity to recover. And this is where I have a problem with Crossfit. Yes, it’s true that on their site they pay a lot of lip service to not doing too much, but the reality is that they use technically complex movements (like cleans) and push to the point where correct form totally breaks down. It’s not the greatest idea for younger athletes, and for older ones it’s an almost sure-fire recipe for injury.

Naturally, you need to push yourself to some extent if you would like to make your body better. But there is a question of degree. Without getting into a long discussion about exercise theory, the bottom line is this: the idea is to provide enough stimulation to create an adaptation response, but not so much that it becomes too difficult to recover from the workout. As the great Lee Haney said, “Stimulate, don’t annihilate.” All too often, Crossfit crosses that boundary.

So if you’re suffering from fascia or tendon pain and have an exercise program (or doing some form of work) that incorporates too much pattern overload — either through limited and unnatural movement or by simply having too much volume — think about ways that will allow you to reduce or get around the problem. (You can take the free test on this page to see what sort of pain it really is.) You don’t have to stop exercising, but you will almost certainly be better off if you find ways to change up your routine a bit.

Author: Alex Nordach

Another great testimonial

This is a testimonial that I received on my other site, Target Tendonitis. Although Bobbi wasn’t suffering from foot or ankle tendon pain, the techniques that she used are completely transferable and effective for the plantar fascia, and Achilles and posterior tibial tendons.

Dear Alex,

Thanks for checking in. Since my last email we’ve been traveling. You’re entitled to some much deserved kudos!!

I feel I made tremendous progress, despite the “pep talk” (not!) the ortho gave me when I told him I was going to follow your protocol. I started with virtually no range of motion and tremendous pain in the elbow & shoulder to full range of motion and completely pain free for normal day to day activity in two weeks. I haven’t started working out yet. When we get home I’ll test it out on some light weights. Of course, I’m a bit nervous. I am a little confused to what my new regime will be. I do enjoy cross fit and wish my gym environment and trainer would be more supportive of what I need to do to modify.

Now, that I understand the idea of healing and maintaining tendon health, I’m excited to work on other areas (knees, back). Although, I am confused about how to target the back…

When we get home, there are many people I’m looking forward to recommending your book. I’ve seen a couple of msg boards out their full of people who could use your help. It’s quite sad to realize how many people have really been suffering for a long time. I won’t give away the secret but will definitely send them in your direction.

Thanks so much! Besides the healing, you’ve also provided me w/a tremendous amount of empowerment.

Sincerely,
Bobbi Casellas

There really isn’t much to add here, except to point out how much more positive your outlook can be once you discover how to take control of your own tendon health. Bobbi is a 42-year-old weight trainer, crossfitter and generally very active. Congratulations to her for taking matters into her own hands and deciding to try something new–despite the advice of her orthopedist!

Author: Alex Nordach

A New Testimonial for Healing Achilles Tendonitis

I received the following testimonial the other day:

Dear Alex:

The book has been very beneficial… I have suffered from stubborn tendinosis three times. The first two ones were elbow tendinosis. I simply did too many pullups. These were not mere “tendinitis” . I aggravated the tendinitis because I didn`t rest enough. The point is I felt it in the morning only, but every morning was worse. So I had to quit pulling for months-well, more than a year-till I decided to perform [the recommended exercise].
I am currently curing from another one in my Achilles tendon. Now I´m better, but I had to stop running from last November to June. It was when I bought your book that I began doing [the recommended exercise], which improved my Achilles a lot.

To summarize : this stuff works and is very practical and easy to implement.

Thanks a lot, man. Tendinopathies really suck, and your book can help many people.

Santiago Ces Garcia

Kudos are due for Santiago, who decided to take control of his own recovery from both elbow and Achilles tendonosis. Congratulations!

The same techniques that helped him get back to working out and running can also help you if you might have plantar fasciitis or posterior tibial tendonitis. If you have either of these conditions, take a minute (really — less than ONE minute) to take the test that will tell you whether the techniques contained in my book will help or not. The test is free, there’s absolutely no opt-in or anything like that, and it might just change your life.

Author: Alex Nordach

The Importance of the Achilles Tendon

If you do some research on the plantar fascia, you’ll find a lot of diagrams like the one below:

Plantar fascia and Achilles tendon

It shows the plantar fascia and the Achilles tendon as being separate structures, which they technically are. But they are not quite as separate as most people assume. Especially in younger people, the plantar fascia and Achilles tendon are actually connected by tendonous fibers. (Although fascia are not officially classified as tendons, they are composed of tendon-like collagen fibers, and are very similar in structure.)

What this means is that any rehabilitation effort for plantar fasciitis or plantar fasciosis should include work for the Achilles tendon as well. If your doctor or therapist isn’t paying any attention to your Achilles tendon and you’re not getting better, this might be the reason.

Target Plantar Fasciitis has a full range of exercises for the plantar fascia, Achilles tendon and the posterior tibial tendon. If you’ve been experiencing tendon or fascia problems for more than about two weeks, chances are that your doctor or therapist hasn’t diagnosed the real nature of your condition. For only $29.97 (less than one visit to a doctor) you can try the techniques in the ebook and full-demonstration video for 60 days risk-free. If you don’t think the therapies given are the most effective and cutting-edge that you’ve ever tried, I’ll refund 100% of your money with no questions asked.