Still Fighting It

Another doctor's appointment, another update.  Dr. Nicola decided that we should do one more session of prolotherapy, as I still have some tenderness in the area of my Achilles.  I was able to discuss the injury with Dr. Nicola again to try to get a better handle on exactly what's happening, just for my own understanding more than anything else.

Basically, in a very specific, small area—where the initial impact from a bike pedal, which caused this injury, occurred—the tissue is stuck in chronic inflammation.  As Dr. Nicola explained, a normal inflammation process, essential to healing, goes through several stages.  Starting with acute inflammation, the body normally cycles through these stages, marked by different proteins /growth factors/ etc. in the blood, until the tissue matures and is normal again.  My problem is that I'm stuck somewhere in the middle.  

The idea behind the prolotherapy is to get me out of this chronic inflammation.  The diluted dextrose/lidocaine solution causes some cells near the site of the injection to burst, which releases some chemicals that initiate a new acute inflammatory process.  As I understand it (and, as always, this is just my lay understanding from our conversation), if the prolo works like it's supposed to, this new healing process will progress and complete like a normal inflammatory response, and in the process, bring the chronic inflammatory process to maturation as well.

So what that means for me right now, is that I've got about another 3+ weeks until my next appointment, with the following training/therapy protocol.  First, a day completely off (today).  Then I do 7 days of cycling for exercise, along with my normal GS/core work (including eccentric loading of the calf), ice 2x daily, and self massage.  Then I have 3 days of uphill treadmill walking, while continuing all those other things (including the bike).  Then I add running every other day, building up from 2 miles, adding a mile at a time.  So my next appointment is October 23, and I should be running 8 or 9 miles by then, and we'll have a good idea of where we stand then.