Let me tell you about this Achilles tendinitis I’ve got.
My first couple of steps in the morning are flaming agony. After working it and gingerly stretching for a while, it subsides to a dull ache, and I’m good for about a half hour of cautious hobbling. After that, though, the pain builds and builds, until it’s like slamming my heel down on a white hot knife.
I’m not saying this because I’m fishing for sympathy. I spent over an hour and a half today limping through the Darwin exhibit at the AMNH. The pain I suffered through tells you a) how stupid I am to overdo it (I’m paying for it now, I tell you) and b) how good that exhibit is.
It follows the development of Darwin’s thought and demonstrates the evidence that led to his conclusions. It is completely uncompromising. It makes a few nods to the modern evidence at the end, and does mention the creationist objections briefly, as the nonsense they are…but it’s amazing how solidly the case can be made for evolution using just the 19th century data.
And then, or course, there are the artifacts. Darwin’s microscope. Annie’s box(amzn/b&n/abe/pwll). Bits of his notebooks. Darwin’s walking stick. It was glorious stuff.
I strongly recommend it. Even if the exhibit is also full of psychopathic badgers with acid-dripping claws ripping at your ankles. It’s really worth it.
PZ, you need to ice the tendon and take some ibuprofen to decrease the swelling. I’m not a doctor, just someone who’s had a lot of tendonitis.
PZ, I note that some Dishonest Tool has used PhotoShop to remove the Horns, Flaming Eyes, and Glowing Pentagram from your portrait of Darwin.
Please allow me to extend my sympathies for your not being better designed.
TorbjÃ¶rn Larsson says
It is quite awful.
The first episode I had was when running for training, without knowing the use for stretching. I had gotten away with it as youngster but when I started again after my military service it quickly developed. It took several years until it stopped reemerging. Stretching is essential.
The second episode was when hanging on to a pair of favourite shoes with badly worn soles. Good footware is essential.
I hope I know enough to avoid a third episode.
PZ, I’m sure you’re enjoying the Darwin exhibit, but I’d like to caution you to be very careful and always travel in the middle of your group while there.
The environment in New York City is very competitive, and if you’re seen on the outskirts of your herd, especially limping, the predators will move in and try to bring you down.
Remember that the human foot did not evolve in a pair of Hush Puppies (or Nikes either).
And then, or course, there are the artifacts. Darwin’s microscope. Annie’s box. Bits of his notebooks. Darwin’s walking stick.
Did you ask if you could borrow the walking stick? :)
I was in NY in March and was very excited to go to the Darwin exhibit (worth the two hours in rush hour traffic). The people I was with were very patient. They were already in the gift shop at the end before I was half way through! Silly me reading all of the hand-written pages. :)
Have you thought of renting a wheel chair for times like this?
I’m sorry to hear of your pain.
I realize it’s not much consolation, but think of how elegantly your torment demonstrates the inelegancies of human design.
Mike Fox says
I had some AT problems and found that it was much improved with better arch support. Good luck and keep thems feets up!
badgers ripping at your ankles?
weasels ripped my flesh.
I am usually a lurker but I went through all that typekey stuff because I too had agonizing achilles tendonitis for years. Nobody seemed to understand, knives, needles agony in every step. My hubby took us on our usual tramp, tramp vacations, I had to clean up after the donkeys every day and on and on. Yes, many museums. A commentor said to go barefoot but my doctor said that is what caused mine, that and flip-flops. It was years before it finally went away and I still wear shoes with heels even in the house. I used to look at people walking in the street and think “that’s ankles” or “that’s knees”. I don’t do that any more. anyway just wanted to say I never miss your wonderful blog and wanted to encourage you that if you wear high heels (not THAT kind) and take anti-inflammatories it will probably go away sooner or later. I sure hope it does–I hate to think of you suffering this way.
PZ — is this an acute injury (e.g., the result of a slip on the Minnesota ice) or a chronic thing? I agree with the ice and NSAID suggestions, but if you have persistent problems with this, you can also try inserting a 1/4″-thick, non-compressible heel lift under the sockliner of the affected foot. You can make this out of whatever you want — I’ve even used a plastic latter opener. This helps prevent the tendon from being stretched through its normal range of motion. Also, stay off hilly terrain. And if you’re planning to head to Suluth to run Grandma’s Marathon later this month, bag it and wait for the Twin Cities Marathon in the fall…
I’ve run many marathons and I’ve never yet had tendonitis thankfully, but I do have this sore on my lip that’s just killing me. Each morning I drink coffee from my colorful Museum of Natural History Darwin mug and it provides instant relief from my lip problem. I brew the coffee with Lourdes water and I’m not sure whether Darwin’s name on the mug or Our Lady are responsible for the mild relaxation of symptoms I enjoy. Occasionally I drink from a Wonder Woman mug which causes me to break out in a massive boner. Well, perhaps not massive, but it never fails to get a big laugh.
My experience is that an evaluation by a good sports physical therapist who works with legs did wonders, providing I do the prescribed exercises as often as prescribed. From assorted bad “wrecks” (falling horses and the like), I was all out of kilter with recurring episodes of tendonitis in my knees and feet. If I slack off because of lack of time and motivation, the problems start coming back.
John Protevi says
I have found very good results doing the exercises prescribed here: http://tinyurl.com/mbf4q
The basic idea is to strengthen the calf muscle to increase stability at the ankle joint. It’s based on some good recent biomechanics studies. Highly recommended.
I’ve had crystaline tendonitis as an adolescent and a recent bout with it in my shoulder, so I can sympathize. For the last bout I was given a topical NSAID, worked wonders without having to take the @%&@#! pills.
Hopefully that exhibit will go travelling….
Bro. Bartleby says
Wow! Evolution in action! The image of an atheists “… limping through the Darwin exhibit…” is most excellent, expecially with the “flaming agony” — the makings of a Jonathan Edward’s fire and brimstone sermon! Alas, we at the monastery are not of the fire and brimstone camp, but we do offer are prayers for a speedy recovery. And a tip from Bro. Sedwick, “Try wearing cowboy boots and walk bowlegged, it will lift the heel off the ground and relieve the painful muscles and tendons.” That also, a most excellent image!
John Protevi says
Further to my 11:38 post: of course, the acute inflammation has to subside before you do any of the recommended exercises. To do that, you have to rest it. So NO stretching! (That only *seems* counterintuitive. But stretching is intuitive ONLY IF the problem is tightness. But the problem isn’t tightness, it’s weakness.) You can and should use ice, and topical analgesics. I used good old Aspercreme. And shoes, perhaps with Dr. Scholls inserts for a little lift to shorten the tendon, to give it time to heal. THEN (sometimes 6-10 weeks, sometimes longer) you can begin. You can tell the inflammation is gone when you can run your thumb and index finger with good pressure along the sides of the tendon with no pain. Until then, no exercises! (Have I said that before?) I tried the exercises too soon, before the inflammation subsided, and got myself another 8 weeks of pain. Actually, the exercises at that website are pretty advanced. Start with simply standing on one foot (barefoot) on a hardwood floor. Just flex the hamstring on the other leg and stand there. You’ll start wobbling pretty good after 10 seconds or so. Build up to being able to stand with good stability on one foot for 30 seconds, alternating with the other leg, for 3 sets. Then you should be ready for the dynamic work. Good luck and patience, patience, patience!
John Protevi says
One last thing. The base problem is weakness. To protect your tendon your calf muscle tightens during the acute inflammation phase. So your calf muscles ARE tight now, but that’s not the base problem.
Sure. Then I’ll tell you about the link between Achilles tendon pain and high cholesterol.
Is it one or both tendons? If one look into having the joint immobilized somehow until it has an opportunity to heal. I’m no physician, but from your description of the pain it sounds like a muscle tear. If it is, then that ankle needs a period of rest. Which means, at the least, hopping around on crutches, and at the worst tooling about in a wheelchair. But check with your doctor first.
You may be able to limit the pain by preventing foot drop. Don’t let your feet go past 90 degrees (the angle when you are standing) while you are sleeping. This way all the tendons in your feet and ankles do not get a chance to start to “freeze-up”. I do not cry in the morning anymore.
Look on the bright side, PZ. Thanks to House, limping atheistic curmudgeons are now sex symbols.
…I do have this sore on my lip that’s just killing me. Each morning I drink coffee from my colorful Museum of Natural History Darwin mug and it provides instant relief from my lip problem. I brew the coffee with Lourdes water and I’m not sure whether Darwin’s name on the mug or Our Lady are responsible for the mild relaxation of symptoms I enjoy
It’s probably just that someone snuck some acyclovir into your coffee and that reduces your HSV viral load temporarily. That or the heat makes your lip feel better.
PZ: This web based advice is all good and well as far as it goes, but I’d strongly suggest you see a sports medicine doctor or internist about this problem if it continues. None of us has examined your ankle and therefore any advice any of us gives is suspect. Get it properly taken care of.
I’ve had both patellar and achilles tendonitis, so I definitely understand that you are not exaggerating when you say it feels like a hot knife. That describes it perfectly. My knees were so bad that they were actually hot to the touch.
Went to the doctor and he told me to raise the seat on my bike, use smaller gears, and keep riding. Have you tried any of that?
Oh, wait. Wrong forum. Sorry.
Seriously, though, I am about 6’2″, and a few years ago, let myself balloon to nearly 210 lbs. Many people my height can carry 210, but not me. My knees, ankles and hands felt bad all the time. So I decided to lose weight, and it worked. I’m currently at 175, which is still too much for me (really, it is), and I’ve been pain-free for quite a while. It took me several years to lose that much.
So take the ibuprofin/naproxene/etc, for sure; ice if you can; stretch; and ask yourself, Do I need to lose weight? I haven’t seen you in person, but I cannot believe how much better knocking off 35 lbs made me feel.
PZ Myers says
This is a recurring problem, and I know the cause: it’s a period of forced inactivity following any of that good exercise stuff. I’ve seen doctors and I’ve had physical therapy. I know from painful experience that complete rest of the joint is the worst solution — it tightens up and would have me bedridden for weeks, followed by weeks more of painful stretching exercises. I’ve found that works best is to work through the pain with anti-inflammatories and very light exercise (walking) that keeps the joint somewhat mobile. That recipe ends a flareup in days. It’s a bad few days, but far better than the alternatives.
We went to Britain summer 2004. One of the things we did was the “behind the scenes” tour of the Darwin Center at the London Museum of Natural History. Awesome.
Our plan is to go to NYC this summer – and now you tell me there’s a great Darwin exhibition there. It’s all in the timing…thekeez
I know something I hadn’t before.
In that case, make sure to set aside at least an hour each day for a walk.
TorbjÃ¶rn Larsson says
“But stretching is intuitive ONLY IF the problem is tightness. But the problem isn’t tightness, it’s weakness.”
Hum! Stretching has always worked for me. Come to think of it, these episodes started after I was able to grow decent muscles in late puberty. Muscle growth completely reversed so now I have the contrary situation; easy growing strength, (too) easy getting (bunched) muscles. Perhaps both weakness and tightness applies?
John Protevi says
Hi PZ, you have to find what works for you. But if this is a recurring problem, it seems you haven’t yet found what works. It sounds like you can manage symptoms during flareups, but the flareups keep coming. (How often? Are they getting worse? Do they last longer?) Hey, I’m no Dr. Frist when it comes to long distance diagnosis, but it all sounds to me like some deeper problem in the whole kinetic chain involved in walking, from hips through knees and ankles. The biomechanics people say that most PT people don’t know the latest research and so keep prescribing ineffective if not downright harmful stretching, when the problem is that your calf muscles are insufficient strong during eccentric contraction to control the ankle, which makes the tendon work too hard. Sounds reasonable to me. Why not test their theory? What you’re doing now is only managing symptoms and not getting to the root causes. For that matter, just how symptom-free are you right now? Maybe you can walk relatively pain-free, but can you run your thumb and finger along the edges of the tendon with good pressure while the foot is flexed? If that produces pain, there’s still inflammation there and the next flare-up is only a matter of time. Hey, look, you should do what you think is best. I’m just saying the biomechanics people have good research behind them, and offer a good program of graduated exercise they have found successful. So why not try it? (p.s., I don’t own any stock in their company, nor do I get money from traffic to their site!)
PZ Myers says
Again, the recurrence is a clue: it’s every year, early summer. School gets out, I spend less time sitting on my butt, and it’s becoming very predictable that something will bring me crashing down.
I know the cure. Less inactivity during the semesters. It’s just easier to slack off on the exercise when there’s a stack of papers staring you in the face.
TorbjÃ¶rn Larsson says
“The biomechanics people say that most PT people don’t know the latest research and so keep prescribing ineffective if not downright harmful stretching, when the problem is that your calf muscles are insufficient strong during eccentric contraction to control the ankle, which makes the tendon work too hard.”
Sounds reasonable if true. Of course, in the healthy body streching helps grow long and strong muscle.