Wednesday, April 28, 2010

Eccentric Exercises for plantar fasciitis & patellar tendonitis (runners knee)

After six months and hundreds of dollars spent treating my running injury under a conventional doctor's care who proscribed solely the treatments paid for by my insurance company has failed, I'm trying unconventional methods. By "unconventional" I mean therapies that are not paid for by my insurance company.

To find these therapies I crowd sourced therapy advice from runners, cyclists and multisport athletes on Twitter. I coined the term "cloud care" to describe my new medical care system that involves free outcome-oriented advice from injury-recovered athletes. Basically, it's asking people what worked for them. The old "conventional" care system, based in large part on what my doctor figured that my insurance company would pay for,  I now like to call "crappy care." I posted the results of my survey on a previous post titled "5 Steps To Heal Plantar Fasciitis".

Since my last post, I've discovered three basic tendon/fascia healing principles:
  • Increase circulation: Rolfing, deep tissue massage, PRP,  and "tennis ball therapy"
  • Increase flexibility: Stretches specific for the injured tendon/fascia
  • Increase stress gradually: Stress the injured area to facilitate tissue repair and regrowth
    Notice how these principals do not include many of the ones proscribed by crappy care: Cortisone, immobilizing the injured area with a cast, daily intake of ibuprofen and icing. What I'm not saying is that these treatments don't work. They just didn't work for me and they cost me and my insurance company a lot of money. In defense of crappy care: the physical therapy and proscribed flexibility, stability and strength exercises did help my injury recover. However, due to poor management of my case, a stress fracture went undiagnosed and the foot pain became worse at month five of crappy care.  Also, I just could not afford more PT after over 20 visits at $40 co-pay each. Below are some links to online sources about some "unconventional" (e.g. not paid for by insurance) therapies that have really worked according to athletes. They are treatments you can do at home for free (with the exception of the deep tissue massage/Rolf Therapy and the PRP therapy).

    Cloud Care Healing Therapies for tendon/fascia injuries:
    1. Rolfing–Rolf Integrative Therapy
      http://www.rolf.org/about/index.htm
    2. Eccentric exercises and tendonopathy treatment research:
      http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2505250/
    3. Eccentric exercises and stretches that worked for by Sigfús Víkþörðson a cyclist who suffered from patellar tendinitis (runners knee):
      http://eccentric-exercises.blogspot.com/2007/12/video-deomonstration-of-eccentric.html
      http://eccentric-exercises.blogspot.com/2007/12/importance-of-daily-stretching.html
    4. PRP (Platelet Rich Plasma) blood therapy to oxygenate fibers with little blood circulation such as tendons, fascia, ligaments to induce faster tissue repair and recovery:
      http://www.nytimes.com/2009/02/17/sports/17blood.html
    5. http://www.google.com/hostednews/ap/article/ALeqM5jDu_yK6FpCreFsGIVMeNVgYcxEmQD9ESBQI00  (concerns about PRP)
    6. Eccentric exercises (strength training by lengthening muscles/tendons) for plantar fasciitis:
      http://www.sportsinjurybulletin.com/archive/rehabilitation-exercises.html  (scroll down half the page to "Problem: Plantar Fasciitis...")
    7. Stretches and more strength training with eccentric exercises for plantar fasciitis:
      http://www.plantar-fasciitis-treatments.com/exercises.php

    Please let me know what works for your tendon injury by making a comment or sending me a tweet @multisportmama. I think more people should know what really works–even if it's not blessed by the insurance companies.

    Here's to hitting the trails, roads or courts again soon!

    Cheers,
    :) A

    10 comments:

    1. Eccentric exercise is THE key treatment that should be tried for those with multi-year chronic patellar tendinitis that won't go away. It worked for me after suffering through several years of terrible knee pain. I now have ZERO pain -- and that includes running, cycling, sitting and walking down stairs. It was the only treatment that worked for me. It is also very affordable! It just requires your time and diligence.

      ReplyDelete
      Replies
      1. How long did it take of doing the exercises and not running? I've not been out very long yet, only a few weeks, but RICE is NOT working! I'm very excited to see something that has worked!

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    Thank you for sharing your thoughts.
    :) A