Posts Tagged ‘iontophoresis’


Tuesday is Steve day at PT.   Steve is a nice guy.  Very sympathetic.  We agree that ionto is not working.  He feels that if it were going to provide relief  it would have been evident by now.   Instead we just do ultrasound.  Steve tries to convince me I need stretching.  I listen to his theory and am not convinced it’s beneficial, but I also don’t think it’s going to hurt anything so he does a little light stretching of the tendon and calf muscles.  I tell him I think the exercise regimen is doing the most good.  But, it’s really hard to tell.  We discuss swimming, and I resolve to sign up for lessons.  No soreness in the evening and I’m able to do 2 sets of 15 reps eccentric heel drops.


I oversleep and have to run pretty fast 6 blocks to catch the train, without running shoes and without being warmed up.  This is the type of thing that is painful when the Achilles tendon is injured.  Later I walk over to Penn sports medicine and make an appointment with a non-surgical sports doc, just for the heck of it.  I want to discuss a glyceryl nitrate patch as an option.  I don’t really think anything helpful will come of it, but as long as I have embarked on this obsessive quest for relief, I figure I might as well try everything, just so I can say I’ve tried everything.  Well, maybe not everything.  I’ll probably draw the line somewhere.  Like, leeches for example.  I won’t try leeches.

After work I go to the gym and do 30 minutes on the stair climber with no pain.  Stair climbers seem to be pretty good for this..it’s possible to stay up on our toes the whole time so there is very little stress on the tendon.  Tomorrow will be a running day.


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So, I suppose it will be ironic if I finally have to filter the Pretzel City Sports race emails into my SPAM folder, not because of their sheer volume, not because of their borderline-offensive off-color jokes, but because it is just too depressing to get notifications of all the races I can’t run.   Or shouldn’t run.  Oh well.

Today’s events.

I run 4 miles in Mizunos and orthotics.   My running form has adapted to my injuries and re-adapted to the cushiony shoes.  I can’t be sure, but, I’m pretty sure I am running like Rocky.  Or like Dustin Hoffman in Marathon Man.  I’m using my upper body a lot, and breathing heavily.  I feel I should be wearing a Champion hoodie sweatshirt and baggy sweat pants instead of  lycra yoga pants and a girlie magenta fleece top. My knees hurt from the orthotics, but my ankle isn’t so bad.  Surprisingly, I am able to keep my heart rate at 121 for most of the run.  At the very end, I run through Pastorius Park (aka, the doggie park).  It is doggie rush hour,   the peak after-work dog-walking time.   A Bernese mountain dog woofs at me endearingly, and a hot dog in a little sweater sends the cute-o-meter into the red zone.  I feel energized by all the canine cuteness and accidentally speed up.  I check my heart rate, and it is 147.  All the dogs’ fault.  But I notice that my ankle hasn’t hurt for the last couple of miles.

After my run I go to PT.  Today is a Heather day.   I learn that Heather is a runner.  We discuss how much we hate ellipticals trainers.  We do ultrasound and iontophoresis.  This is my third visit and I can’t yet tell if it helping.  I will give it another week.




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MapMyRun is mocking me..it congratulated me on my “awesome workout”.  I logged a pitiful 4.5 miles on Saturday.  On flat ground.  Really, sloooowly.  Still having trouble keeping my heart rate stable in the target zone.  It jumps up to 130 when I start out, then settles down at 117-119.  It’s really hard to hit 121.

Back to the saga of the Achilles tendon.

Tuesday, Feb 19.  Unimproved but still hopeful, I arrive early at my PT appointment.  My PT today is Steve.  I learned my lesson and didn’t shave the ankle..and iontophoresis doesn’t burn at all this time.    We complete the iontophoresis, then move on to another modality, ultrasound.  That’s what the PT industry calls the stuff they do.  Modalities.  I figure, the more modalities the better.  Steve tells me I shouldn’t feel anything with the ultrasound.  Oddly, I do.   There is a certain spot where, when he touches it with the ultrasound thingy, I experience, err, ‘significant discomfort’ (I enjoy employing medical-type terminology.  It makes me feel like one of the “care team!”)  Anyway, this is interesting, and unexpected, apparently, so I am  hopeful that maybe those sound waves are penetrating the tendon and breaking up some sort of accumulated badness.  The PT asks if I’ve had an MRI.  He says I might have some tears in the tendon.  I ask if there would be any change in the treatment if that were the case.  He says no.  I say I’ll skip the MRI.    He asks if I have tried prolotherapy.  I haven’t.  I am excited because now I have something new to spend hours looking up on the Internet.  I leave, and stop and buy a bottle of Merlot before walking home.   Just another modality.  I’m pretty sure Merlot has holistic healing properties.

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My first session.

My PT is called Heather.  She examines my ankles and notes that my right tendon is thicker than the left and my right foot can only flex 90 degrees, whereas 8 degrees past 90 is normal,.  But my left can flex 9 degrees past 90.! I am proud of that extra 1 degree on the left, but sad when she suggests I should perform stretches on the right (bad) side.  I don’t believe in stretching.  But, I want to seem agreeable, so I agree to stretch.

She brings in the machine.  It’s just a little pod that interfaces with a stick-on electrode pad thingy that holds the dexamethasone.  She tells me it may feel prickly.  This is a euphemism.  It is actually more burny than prickly.  As if I have leaned my ankle on, say, the open oven door by accident.  I think I shouldn’t have shaved my legs before the appointment.  We agree to dial it up to the highest setting.   I listen to Vivaldi on my ipod and soon it’s over, but I am supposed to keep the pad on until bedtime because it is still delivering medication into my tendon fo a couple of hours.  Yay.

It takes 20 minutes to schedule my next appointment.  Apparently PTs are in great demand.  I am finally scheduled for next Tuesday.

I am hopeful.

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