Achilles operation

So I'm sitting on the sofa, feeling a bit light headed because of the pain killers, having had an operation to both my achilles tendons yesterday.

I've had achilles problems for maybe 10 years.  I've run in pain for a long time.  They have stopped me undertaking the training I have wanted to do and have certainly affected my performance.

I have tried everything.  I have done the Alfredson eccentric loading programme (google!) to death, I have done strength and conditioning, changed my running style (from heel striker to fore/midfoot striker), I have cross trained, I have rested...... Nothing worked.  Whenever I ran I had achilles stiffness and ache the next morning, struggling down the stairs and during running I would get pain.  So frustrating.

Last year I read a research paper in the British Journal of Sport Medicine written by Prof H Alfredson about a new technique he was using to treat achilles tendinopathy.  He outlined the various anatomies of the achilles tendon and stated that in 15% of patients, particularly those who did not respond to his eccentric training programme, the plantaris tendon inserted or invaginated into the achilles tendon instead of running parallel to it and then inserting into the heelbone independently.  He then described the operation he was undertaking which involved exploration of the achilles through a small medial incision, looking for this plantaris tendon and if found, then its excision.  Then he would go on to 'scrape' the fat off the back of the tendon where it had become stuck down - which is what happens when the achilles tendon (and other tendons e.g. the patella tendon) develops tendinopathy.

I tracked down Prof Alfredson to the Pure Sport Medicine clinic in Canary Wharf, London, where he does out patient clinics intermittently, when he comes over from Sweden.  And this year in June I went to see him.  He scanned my achilles and proposed that I probably had this problem with the plantaris tendon although he couldn't see it and that I would probably do well with the achilles scrape operation.  I decided rapidly to go for it.  No question.  Partly also because I have friends in Sweden in the Swedish Orienteering team who have already had it done.....and who are pain free.....

I finally had the operation done yesterday.  It is done under local anaesthetic (which was the nasty part).  Once the local anaesthetic took effect, Prof Alfredson got underway on my left achilles and within 10 mins had established that I did indeed have this varient plantaris invagination into my achilles.  He resected 5cm of the plantaris tendon (a very unassuming 2mm wide tendon when shown to me) and then proceded to scrape the fat off the back of my tendon.  I couldn't feel anything but it 'felt' right to be cleaning up the tendon and removing all this stuck down tissue.  Apparently it was well and truely stuck.  The same problem was found on the right side as well. 

One hour later and I was back in my posh room waiting for my dinner (the nurse wouldn't let me go home unless I'd eaten, had a drink and had a pee.  I didn't like to point out that I'd only had a local anaesthetic...but I was happy to oblige as I had salmon and chips ordered!)

I am allowed to walk about in the first week only, range of movement exercises and concentrating on getting the swelling down.  Then next week I can start to cycle/spin (gently!) and then after that I can start to jog if I can - but this may not be possible until week 8.  It's very individual.

I've had this problem a long time and as the left side was worse than the right, my left glutes don't fire as well as the right so I intend to take this opportunity to attend to my strength and conditioning and make sure I am ready to return to running.  But prior to the op, pain aside, I was running well especially now that I am back working with Nick Anderson of 'runningwithus' who provides training programmes and coaching.

So I'm excited about the prospects.  I can only hope...and obey rehab orders!  This will be a test of whether the doctor can follow her own advice!!