[This is just a repository for comments to other blogs, as described here.]

Monday, December 10, 2012

Achilles Tendinosis

This entry really isn't in keeping with the use of this blog purely as a simple scratchpad. But I couldn't find another active appropriate site to post this, and I wanted to put it out on the internet in case it might help anyone else with achilles problems.

I had tendinosis, partial achilles tear, ended up with a severe Haglund's deformity (all in my right achilles). Used eccentric exercises, which helped a bit, but eventually the situation required surgical repair. Open surgery with debridement and achilles reattachment.

Though the surgery was necessary, and despite consistent physical therapy, over a year and a half later I was still in a lot of pain and the situation was headed in the wrong direction (i.e. gradually worsening pain and stiffness). I was increasingly accepting that this would be a lifelong infirmity.

I read the medical literature. Various studies had shown that eicosapentaenoic acid (EPA), a dietary supplement from fish oil, could stimulate production of collagen and fibronectin, including in ligaments (e.g. Omega-3 fatty acids enhance ligament fibroblast collagen formation in association with changes in interleukin-6 production Proc Soc Exp Biol Med. 2000 Jan;223(1):88-95). EPA is also an anti-inflammatory. I began taking 2 grams of EPA a day (specifically, I took four capsules a day of a product containing 530 mg of EPA and 238 mg of other omega-3s per capsule). Within a month the pain and stiffness was reduced by 80% and by two months it was entirely gone (and during that time, I was doing nothing else differently). It's now a year and a half later, and I'm still entirely free of pain and stiffness. I don't know if this would work for anyone else (everyone is different, and in an individual case like mine, one can't definitively rule out coincidence as opposed to causality on the part of the supplement), but I thought I'd pass along my experience. Perhaps this might be a useful adjunct in cases other than my own.

Also, EPA slows clotting, so probably shouldn't be used just in advance of surgery.

Addendum:
Another relevant (and tendon-specific) study - The effect of essential fatty acids and antioxidants combined with physiotherapy treatment in recreational athletes with chronic tendon disorders: A randomised, double-blind, placebo-controlled study (Physical Therapy in Sport 2004 Nov;5(4):194–199). In the active treatment (non-placebo) arm of the study, participants with chronic tendon disorders recieved daily EPA (apparently 3 grams per day), plus DHA and GLA, and an antioxidant complex tablet. Both study arms recieved physiotherapy. After 32 days, pain levels dropped to essentially zero in the active treatment arm, but only decreased 31% in the placebo arm.