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Dr. SH
Dr. SH, Board Certified Physician
Category: Orthopedics
Satisfied Customers: 8703
Experience:  Doctor of Medicine
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I have a weird problem with my Achilles, and I am trying to

Customer Question

I have a weird problem with my Achilles, and I am trying to find a medical professional who has come across it before (to be clear, I am not just after general advice to do with strained Achilles – I have plenty already, thank you.)My problem is that I sometimes strain my Achilles if I "take off" with a twist –
– so, for example, I might be getting out of my chair but also turning off to the right at the same time,
– or even just be standing at a work surface in the kitchen, and then push off on that foot, turning away to my side at the same time.
– Or picking up shopping bags, while twisting towards the door.And it does not require an especially huge push/twist - it just sometimes goes on me.Apart from the "cause", it is then (it seems) an otherwise classical mid-height Achilles strain.I have had this happen maybe 10 or so times in my adult life. Previous occurrences would go away of their own accord after a week or two of rest, and I could then start slowly increasing my use of the foot. But recent occurrences (I am 52) have been lasting months, and the latest is three months old and showing no sign of going away - the tiniest little twist on my planted foot, at anything remotely approaching normal speed, causes re-injury.And in all other respects my Achilles is fine & strong – I spent most of the last 20 years running half marathons on it, and indeed I power-walked a half marathon 15 months ago.I know a fair bit about Achilles treatments – rest and ice after each reinjury, and (being hooked on PubMed) I've had a Shockwave course, and I know about the possibility of PRP (Ultrasound-guided ideally!), But that is not what I'm asking - just, has anyone come across this particular way of (repeatedly) causing an Achilles injury, and had any success treating it?
Submitted: 4 months ago.
Category: Orthopedics
Expert:  Shantal-Mod replied 4 months ago.
Hello,
I'm Shantal and I'm a moderator for this topic.
I've been working hard to find a Professional to assist you with your question, but sometimes finding the right Professional can take a little longer than expected.
I was checking to see if you had already found your answer or if you still need assistance from one of the Professionals.
Please let me know if you wish to continue waiting or if you would like for us to close your question?
Thank you,
Shantal
Expert:  Dr. Thomas, MD replied 4 months ago.

Hello

Twisting motions cause a unique stress to the system.

Yes, I have seen this, and often these individuals have more than a problem in the achilles, including problems in the lower spine.

A full assessment by a structural medicine expert should be done.

In the UK, that is called a non invasive orthopedist.

A podiatrist should be consulted as well.

OK, so you might have more questions or want to give me more information: Please use reply to expert if you have further questions. Also, please click a positive rating [hopefully excellent—that’s how we are paid, per rating]. If you forgot something, just use reply and come back. I am here

http://www.justanswer.com/medical/expert-dr-thomas/

Customer: replied 4 months ago.
Sorry, but I am not after "advice" of the "go and see a specialist" kind. (I am already seeing two specialists, privately, via my GP, as it happens.) I was enquiring whether anybody had seen this particular thing, as described (in some detail), and what its cause and treatment might be.I appreciate that might be long odds, but I thought it wouldn't hurt to at least put the question in front of a few orthopaedic eyes.Forgive me, but it does sound like you haven't actually seen this particular situation as described, and diagnosed its cause and treatment.
Expert:  Dr. Thomas, MD replied 4 months ago.

I don't think you read my answer carefully

I will repeat it here and bold the parts you apparently missed....

Hang on.....

Twisting motions cause a unique stress to the system.

Yes, I have seen this, and often these individuals have more than a problem in the achilles, including problems in the lower spine.

A full assessment by a structural medicine expert should be done.

In the UK, that is called a non invasive orthopedist.

A podiatrist should be consulted as well.

The fact is that twisting motions overly affect a vulnerable structural pattern.

You need an expert trained in looking at the WHOLE structural pattern.

There are a number of choices: a PM&R doctor is but one.

There are others as well.

Let me know you have further questions.

please click a positive rating [hopefully excellent [5]—that’s how we are paid, per rating]. If you forgot something, come back. I am here http://www.justanswer.com/medical/expert-dr-thomas/

Customer: replied 4 months ago.
Apologies, but however much (or little) one believes in "structural medicine", the answer you gave could be given to practically ANY biomechanical problem asked:"often these individuals have more than a problem in the achilles/knee/hip/heel, including problems in the lower spine/core muscles/posture/neck/shoulders."And similarly"The fact is that twisting motions overly affect a vulnerable structural pattern."is just a general, generic appeal to "please come to this branch of medicine". (And as I made clear, my issue doesn't even require much of a push/twist – just everyday movements.)So I'm afraid that generic catch-all answer is of no use to my very specific request.Please, no further replies – thank you.
Expert:  Dr. SH replied 4 months ago.

Would you like me to help you out?

Please let me know.

Customer: replied 4 months ago.
Hi, and thank you for asking first – I'm actually going to close down this question as fast as I can, and (I expect) never use JustAnswer again.So, no further help required – again, thank you for asking first.
Expert:  Dr. SH replied 4 months ago.

You are most welcome.

I apologize that you had a bad experience here.

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