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weatherman
USA
184 Posts |
 Posted - 11/28/2006 : 12:18:18
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I talked to the new TMS doc in Seattle, to discuss whether an in-person visit would be worthwhile - since he is actually within a day's drive for me. He was very helpful over the phone, though didn't necessarily tell me what I was hoping to hear. Regarding the whole achilles issue, he definitely recommended going conventional as the first approach on the chance that there is really something physical, and that his advice would be the same in person. He said the downside to tearing one is just too huge, and that it's reasonable to go through a course of rest (my most despised 4-letter word) and physical therapy - then, if it's still there after 6 weeks or whatever to consider the TMS approach. So, reluctantly that is where I will head. I'm still extremely suspicious about it for several reasons, but it's a case where being wrong one way is a lot worse than being wrong the other way.
He spent 3 months training with Sarno last year, and said that 95% of the people show up because of back issues. I'm guessing the achilles thing is somewhat uncharted territory, as far as routinely advising people that it's TMS right off the bat.
My offer of a trade for a sore back still stands, any takers?
Weatherman (speaking of weather we're getting around 25 below tonight) |
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Littlebird
USA
391 Posts |
Posted - 11/28/2006 : 17:21:23
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Hi Weatherman,
Often doctors in general seem to feel that it's best to test for (or recommend treatment such as rest for) every possible problem that might cause a symptom, partly because if they don't check for each potential problem and one of the problems not checked for later turns out to be the source of the symptom, then the patient might sue them. Since there is a great downside to a tear, he may feel that he can't risk telling you to consider it TMS without first having you go through conventional treatment, just in case.
Perhaps a doctor who's been familiar with TMS for a longer period of time would be comfortable with considering TMS first, but then again, maybe not. Sorry to hear you have to go through a course of rest when you'd rather not. |
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armchairlinguist
USA
1397 Posts |
Posted - 11/28/2006 : 21:06:53
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Obviously I am not a doctor, but, that said, I find what he says curious. Why is there such a downside to tearing an Achilles tendon, compared to anything else? Isn't that somewhat contrary to Sarno's view that our bodies are extremely efficient at healing themselves?
I have to wonder if the allegedly terrible consequences of Achilles overuse/injury/tears are really nocebos/TMS.
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Wherever you go, there you are. |
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weatherman
USA
184 Posts |
Posted - 11/29/2006 : 08:12:24
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I can relate to both of the above comments, it has been a true mental quandry as to how to view this whole thing. But one thing I must point out, an achilles tear really sucks! I know a couple of guys that have had them. The post surgery/rehab is the most miserable thing imaginable, it's at least 6 months before you can resume ANY kind of activity. Once torn, it can be repaired but it's never the same - witness Dan Marino and Lawrence Taylor. One of the guys who tore one wasn't a person you would describe as "full of sweetness and light", and said he wouldn't wish one on his worst enemy. It makes an ACL tear look like a Sunday stroll.
The dilemma is that many people who get tears ignored a sustained period of pain beforehand. Pain - like the old commercial used to say, is it real or is it Memorex? Then again, some tear them with no warning at all. I guess those cases are just part of the fortunes of war, which you can't worry about. On the other hand, I've had minor flareups that I've pushed through and been fine with.
Littlebird, I have to chuckle at your comment on liability. My sister is an ER doc and you are right on the mark. She's told me many times about the unnecessary tests etc. they give people just to insulate themselves against the liability lottery. Her liability insurance runs somewhere around 60K per year - and guess who pays it? Not the doctors!
I am getting the impression that TMS docs come in many flavors. Some are more purist than others, some have an orthopedic background and others don't. All of these things would factor into a TMS doc's advice. I did have a brief e-mail conversation with another TMS doc at one point who said that most achilles "strains" etc. were TMS. I guess the keyword is MOST.
It doesn't help that I have lots of OCD personality, not that I've ever been formally diagnosed. Starting with my first TMS type injury in 1979, I can recite from memory every period in my life - to the month - that I've missed out on playing outside because of such things. This looks like another chapter, I guess I'll play along for a short period and if the pain sticks around, then I can say it's TMS. Maddening, for sure.
Weatherman
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tennis tom
USA
4749 Posts |
Posted - 11/29/2006 : 10:13:56
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Hi Weatherman,
I might as well throw my 2 cents in. You may have to become one of the world experts on the achilles tendon to figure out what you should do. As you know a legitimate achilles tendon tear is one of the worst sports injuries and can be a career ender. In the old days I heard they stapled it back together, but it was always shorter. The last one I heard about they are using better surgical methods and the outcome was improved but this is all anecdotal.
It's a body part I wouldn't want to do persoanl research on or "push hard through". Since your sister is an ER doctor she knows the "blood and guts" of the human body. Out of curiostity, what does she think about TMS/Sarno? In the ER, I would imagine she is seeing the obverse of the TMS ratio, 80% legitimate injuries vs 20% psychosomatic, but just a guess-timate on my part.
I think your're doing what I would be doing, trying to learn as much as I could and get as many opinions as possible and then do what seems reasonable, a conservative approach. Have you had any imaging, x-ray/mri and do they show anyting?--bareing im mind normal anomalies.
I would see as many orhtos or trainer types until you've heard every opinion and possiblity that can occur to the achilles and then make your decision on "knowledge" which goes along with the TMS paradigm.
This is a potential injury I would not want to brute force my way through, the downside could be too great. How 'bout cross-training to get rid of the excess energy until all the facts are in?
Good Luck.
tt |
Edited by - tennis tom on 11/29/2006 10:22:45 |
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armchairlinguist
USA
1397 Posts |
Posted - 11/29/2006 : 11:08:54
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Another suggestion -- while you are out of the game for a bit, do some thinking about why you are so attached to your training and so hate every period out.
I understand that you love your activity and I think that's awesome. But you seem to have such strong negative feelings about any time out that it would be an easy place for TMS to come in and distract you, since the distraction obviously works so well.
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Wherever you go, there you are. |
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weatherman
USA
184 Posts |
Posted - 11/30/2006 : 10:28:02
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Armchairliguist
The answer to your last comment is easy, I'm sure that I am addicted to the endorphin rush that comes at the end of a period of hard exercise. It's the same thing as "runner's high", except I get it by doing uphill hiking/skiing/cycling. I am at least borderline depressive - always have been - and that is the one thing that wipes all that out.
A dilemma about the whole TMS thing is that real overuse injuries certainly can occur, though they are in the small minority. The bad thing is that, at their outset, they act exactly like TMS-type pain. To use an analogy, I've read that when you're far out at sea, a tidal wave is indistinguishable from a normal wave. The tidal wave is much longer than a normal wave, but no taller; most of it is beneath the surface. When it comes onshore, the energy is forced upward as the wave enters the shallows - resulting in a tidal wave.
If I stopped activity every time I felt a twinge, pull etc., I would have settled into a rocking chair about 27 years ago. You can push through 98% of these things with no problems. The issue is knowing when you're into the other 2%. I still don't have an answer for that one.
Weatherman |
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Texasrunner
USA
60 Posts |
Posted - 02/09/2007 : 07:18:10
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Weatherman- you did not state you exact symptoms, but I'm guessing chronic Achillies pain. As a longtime marathoner, I have dealt with Achillies problems from time to time. I think if it was torn, you would be unable even walk.
I have found that the real problem with Achillies is adeqaute blood supply, and this is documented. Hence, it is a perfect site for TMS. Althought Dr. Sarno radically opposes any physical therapy, my experience has been that if I "jump-start" the helaing process by say, icing and then warm soaks, (to enhance the blood flow) I can then follow up with TMS practice successfully. You also might try cross-friction massage. Again, these are counter to Sarno's teachings, but the mind/body is a complex thing and repsonds to many stimuli. |
Edited by - Texasrunner on 02/09/2007 07:18:33 |
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momtoone
18 Posts |
Posted - 02/09/2007 : 12:23:26
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| Weatherman, I sympathize with you totally. I have fibro (severe TMS I now call it) but achillies tendonitis (chronic daily) is my worst symptom and it is in BOTH legs. It was so bad for months before Sarno I did not think I could take it any more. I really would have rather died, it would start about 15 minutes after I got out of the bed and mind you I have small child to take care of so I have to get up. I have to say that with the Sarno work, it has gotten better. They still hurt on a daily basis but nothing !!! like it was. I have only been at this a few weeks so I am hoping for improvement with each week. Good luck to you, I know how bad that pain can be. |
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shawnsmith
Czech Republic
2048 Posts |
Posted - 02/09/2007 : 12:38:45
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quote:
Originally posted by momtoone
I have small child to take care of
Hmmm, something tells me that deep down inside you resent having to get up in the morning and take care of these kids. You would rahter pamper yourself instead of pampering them. Of course you will not consciously be aware of harbouring such feelings as they would be considered shameful and embarassing by society's standards. You may also be resentful in being trapped into a situation you cannot, no matter how hard you wish to, get out of. |
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momtoone
18 Posts |
Posted - 02/09/2007 : 17:43:29
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Shawn,
Very good deduction you are an "armchair" therapist..HAHA.. This is actually one of my biggest "hangups" that I have encountered while doing the TMS work. You would have to know the whole long story but my son did not come easy for us. Thus, it has been very difficult for me to acknowledge that sometimes I am resentful that I can not lay in bed and just rest without feeling loads of guilt. This is something that I am struggling with a great deal right now. I also have the Supermom syndrome so that is not helping either. However, I will continue with my journaling and continue with telling myself it is o.k. and that these feelings are ok and the inner child in me needs taken care of as well. Excellent insight from that small post I wrote. Good job Thanks and good health to you..
Mom |
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art
1903 Posts |
Posted - 02/11/2007 : 13:42:57
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Originally posted by armchairlinguist[/i]
quote:
Obviously I am not a doctor, but, that said, I find what he says curious. Why is there such a downside to tearing an Achilles tendon, compared to anything else? Isn't that somewhat contrary to Sarno's view that our bodies are extremely efficient at healing themselves?
I have to wonder if the allegedly terrible consequences of Achilles overuse/injury/tears are really nocebos/TMS.
A torn Achilles is a bad thing. Athletes, runners, skaters, dancers, live in fear of such injuries. They can easily ruin a career. As a runner, I'm very respectful of Achilles pain. |
Edited by - art on 02/11/2007 13:44:06 |
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weatherman
USA
184 Posts |
Posted - 02/12/2007 : 01:14:10
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I was a bit surprised to see this thread pop back up, it's actually a good time for an update. I did do the 6 weeks of decreased activity, and have undertaken some exercises on my own to strengthen the achilles area - for about 3 months now. As several people have noted, a tear is a big deal, and I see no harm in some strengthening from that standpoint. It's feeling considerably better, and I'm slowly closing in on my former activity levels.
I'm still unsure as to whether the original "injury" was really TMS - my gut instinct is yes. But I've had a TMS type thing lately - on a couple of recent outings the achilles that bothered me originally was fine, but the other one was hurting. I knew it was absolutely TMS, and I pushed through it successfully.
The following may run contrary to pure TMS theory, but I'm quite impressed with the strengthening exercises - they're called Alfredson Eccentric exercises, and can be found on the internet, along with some encouraging clinical results. (I'm not offering medical advice, and would definitely run it by a doc or PT before undertaking them, as one could actually tear one doing the exercises). If nothing else, my achilles area is noticeably stronger, and I'm living in less fear of tearing it. I guess my solution has been a combination of the physical coupled with some TMS awareness. Achilles tears are real, they do happen, and any physical thing one can do to prevent them seems like a good idea to me.
Weatherman |
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tennis tom
USA
4749 Posts |
Posted - 02/12/2007 : 06:54:51
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Hi Weatherman,
Sounds like a reasonable approach to me. Good Luck. |
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Seattle TMS doc - achilles advice
