posted by slow_healer_sam 18d ago

Doing everything right for months and still not healing, what am I missing

I need someone to tell me what I'm missing here. Hamstring and patellar tendon issues for going on two years now, but the last five months I've been doing this properly. Eccentrics three times a week, BPC-157 for 8 weeks earlier this year, sleeping fine, protein is dialed in, I stretch, I foam roll, I do the boring PT homework every single time. Still get that same deep ache after any run over two miles and stairs are still a problem going down. I'm starting to think my tissue just doesn't heal like other people's. Anyone else hit this wall where you're doing everything and nothing moves the needle? How long is too long before I should be worried something else is going on.

Still here. Still slow.

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Dr_Rehab_RayCleveland, OH9 points18d ago

When you say eccentrics three times a week, what's the actual load look like. A lot of people plateau because the exercise stopped being hard months ago and nobody increased it. Also worth asking, has anyone actually confirmed this is tendinopathy and not something else mimicking it, like a partial tear or nerve referral from the back. Two years of intermittent issues without imaging is a gap I'd want closed before assuming the loading protocol is the problem.

Load is the drug with the best data.

CoachTerrellAtlanta, GA10 points18d ago

This is the pattern I see constantly. People call it eccentrics but they're doing bodyweight slow lowers that stopped being a stimulus a long time ago. Tendon wants heavy and progressive, not comfortable and consistent. If you can do your current sets without any effort on the last rep you're not loading the tendon anymore, you're just maintaining a habit.

You cannot inject your way out of a bad program.

tendon_tinkerAustin, TX6 points18d ago

I track load progression in a spreadsheet because I don't trust my own memory on this stuff, and looking back at year one of my elbow rehab I was doing the same weight for four months straight and calling it progressive. It wasn't. Once I actually added load every 1-2 weeks things started moving. Also check if you skip days when life gets busy, inconsistent loading resets a lot of the adaptation.

Measure it or it did not happen.

AchillesAnnaPortland, OR4 points18d ago

My insertional Achilles took almost a year before I felt like myself running hills again. Reactive stuff can turn around fast but if this has been going on two years it's probably degenerative changes at this point and those timelines are just longer, sometimes over a year. I had months where I swore nothing was working and then week whatever it just started feeling different. Try not to judge it week to week.

Slow is smooth. Smooth is 5k pace eventually.

LabRatLouisBoston, MA6 points18d ago

Worth asking the boring questions too. Are you on a statin or have you had a course of fluoroquinolone antibiotics recently. Thyroid function fine. Any undiagnosed metabolic stuff. People want the answer to be the loading program because that's the part they control, but sometimes it's a systemic factor working against you the whole time and no amount of perfect eccentrics fixes that.

Preclinical is not a promise.

rotator_cuff_rickNaperville, IL2 points18d ago

Two years is a long time to not have real imaging done. I know it's not fun to hear but get the MRI before you keep tweaking the exercise program. Tendinitis and tendinopathy get treated differently and if you've been resting through flare ups thinking it's inflammation this whole time that could be half your problem right there.

Two years of patience beat six months of panic.

slow_healer_samBoise, ID6 points18d ago

Fair, I don't think I've actually progressed the load in months, just kept doing the same sets because they still hurt a little the next day so I assumed that meant it was enough. Never got imaging either, just went off what one PT said early on. Guess I have two things to fix before I complain again.

Still here. Still slow.