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Achilles Tendon problems and IBD (reminder for all you middle aged weekend warriors)

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Ulcerative Colitis
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Posted 7/17/2011 8:36 PM (GMT 0)
Hi all,

Since I see a few questions about tendon problems on the site, I thought I would share my story. In April 2011 I was in remission (ie no antibiotics or pred at that time) and started to play indoor soccer with colleagues (bad idea). The second time out playing, I completely ruptured my achilles tendon. Had my achilles tendon been weakened by the multiple short courses of steroids for UC or antibiotics that I had taken for other illnesses or was it just age or lack of soccer fitness?

I decided on the standard treatment which is surgery putting the tendon back in place which involves 3 weeks of immobilization and 3-4 weeks of partial weight bearing. I stayed home during this time, was very sedentary, took pain killers (codeine) and blood thinners (heparin) because the tendon/ankle is very painful after surgery.

Unfortunately at the end of the 7 week period I had a bad flareup which required pred starting at 40mg. I only have flareups like this once every 3-4 years now. I can never explain why I have flareups and this one was no exception.

Hobbling with crutches to the restroom was awful. The pred worked as always but I was mindful of the warnings about pred on tendon weakness, and collagen creation which is what the achilles is made out of. Sure enough, I had an ultrasound last week - about 3 months after surgery - and the achilles tendon has not properly healed. It is too thin and has a cavity in it at the rupture zone. Apparently it is a rare result. My physical therapist expects that I will have to undergo further surgery, and I am seeing a couple of surgeons to have plenty of advice. Hopefully by the time of the next surgery and/or recovery period, I won't be taking prednisone or at least my body will heal better.


Age 42 (male)
UC since 1992
Asacol 2 800 mg x 3
1 VSL#3, omega 3, imodium (as needed), acetaminophen/paracetamol (as needed)
Pred 5 mg, hydrocortisone 10 mg (tapering)
Posted 7/17/2011 11:44 PM (GMT 0)
ahnadlass1,

Wow, I am so sorry. I've heard ACL tear is soooo painful.

Might I suggest you try LDN - low dose naltrexone?

I have an aunt who had a terribly painful trigger finger that was immobile and since she started on LDN (for her arthritis pains), she had NO problems with it anymore.

I, myself, have been taking LDN for my Ulcerative Colitis. But since it is an immune system booster of sorts, it is capable of doing all sorts of great things in the body.

Anyway, I hope your next surgery/recovery will be easier on you.

Good luck to you.

Posted 9/18/2011 8:27 PM (GMT 0)
Hi all,

Just wanted to give an update on my orthopedic surgeries and UC. Last week I had my second surgery on my Achilles tendon. My UC had been fine before the surgery, and I had been successful in completely weaning off the pred and hydrocortisone. Frankly I think that the VSL#3 had helped me to recover quickly. My colon held on for about 24 hours after the surgery. I imagine that the morphine, general anesthesia, and local anesthesia helped keep the colon quiet. After about 24 hours as the surgical pain and meds started to diminish, the UC symptoms returned - fever, night-sweats and mild diarrhea (4-5 times a day). Even though that type of diarrhea is not bad for a mobile UC patient, when you are non-weight-bearing using 2 crutches, with IV and blood drain tubes trailing you to the restroom, it gets very tricky to get there in one piece. Now I am back at home without the tubes so it is much easier, but I still can't figure out what set my colon off. Morphine, codeine, tramadol, anesthesia, etc should not upset the colon. They did not give me any antibiotics because of the known side-effects with tendons. Maybe it was just the stress?

Hopefully for the next 3 months I will stay off the prednisone, and my Achilles will heal normally.

Good health to all.

Age 42 (male)
UC since 1992
Asacol 2 800 mg x 3
1-2 packets VSL#3, omega 3, imodium (as needed), acetaminophen/paracetamol (as needed)
Codeine/tramadol/heparin - post-op recurring meds

Post Edited (ahnadlass1) : 9/18/2011 2:40:03 PM (GMT-6)

Posted 9/18/2011 11:17 PM (GMT 0)
Strained mine 4 years ago, while on a high dose of pred and it has never been right since.
Posted 9/19/2011 5:12 PM (GMT 0)
I don't think you necessarily have to be on pred in order for tendon issues to become worse (or not completely heal). Because I've been exercising regularly with weights and such for many yrs now, my son used to get me to arm-wrestle his friends (he couldn't beat me until he was almost 17 yrs old) so he thought it was pretty cool that he has such a "strong" mom...well of course I beat all of his friends but one, he was in better shape then the rest of them and I have to say my right elbow has never been the same...after about 15 minutes we called it a draw (my son seemed so disapointed at that time but hey, it is what it is). I wasn't on pred at that time and to this day my elbow is still a little messed up.

I have a little moral to this story as well, after beating his friends arm wrestling, my son and his buddies decided to start lifting weights so at least I was ble to promote some healthy life-style into their lives...afterall what kid likes to be made fun of cuz someones (42 yr old mom) kicked their butts arm wrestling LOL!
Posted 9/19/2011 6:00 PM (GMT 0)
Flaring while on crutches. that's got to be one of the worst punishments on earth. Probably the only way to make it worst is flaring while on crutches in the winter.
I destroyed my ankle a few years a go, three fractures which required surgery, 1 plate and 14 screws later things were back in place. Wasn't allowed to put any weight on it for 3 months. I count myself very fortunate my UC stayed in remission until after I completed all the physical therapy.
Will be praying that you don't encounter any more flaring after the second surgery, or for many years for that matter.
Posted 9/23/2011 9:57 AM (GMT 0)
Just a note about the heparin I am taking - Lovenox 1 syringe daily 4000 IU: Although it may help certain people with their UC, it doesn't seem to be helping me as my UC is still causing me problems. I also think it is increasing rectal bleeding a bit.

Age 42 (male)
UC (pancolitis) since 1992
Asacol 2 800 mg x 3
1-2 packets VSL#3, omega 3, imodium (as needed), acetaminophen/paracetamol (as needed)
Codeine/tramadol/heparin - post-op recurring meds
Posted 11/3/2011 5:31 PM (GMT 0)
Just another update - this disease can be vicious.

As a recap, I am trying to recover from a second surgery on my Achilles tendon and at the same time trying to get over a mild UC flare. I finally went to get some rectal meds from my GI doctor a few weeks ago when I stopped the heparin (Lovenox). I think in the end that the heparin (Lovenox) may have helped me because once I went off it my UC symptoms got worse.

Unfortunately even 2 weeks of steroidal rectal enemas and 4 packets a day of VSL#3 have not helped much - the night diarrhea, rectal bleeding, urgency and pain continues. I live in France, and the rectal enemas that my doctor prescribes includes as a base - 4-ASA (4-aminosalicylic acid) which is similar to 5-ASA. It is called Quadrasa in France. It does not seem to be used in other places, but in the past it has helped me. There are some old studies on 4-ASA like this one:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1379410/?tool=pmcentrez

At night is when it is toughest - I keep my orthopedic boot on and my crutches and head lamp (to see the way better) nearby so that I can try to make it to the toilet in time. I am determined to stay off the oral prednisone for another month so that my tendon can properly heal this time.
Posted 12/6/2014 9:27 PM (GMT 0)
Some antibiotics (the fluorquinolones) are associated with Achilles tendon problems. e.g. Cipro is a bad one. I am having Achilles tendonitis. It started after I took it about 6 months ago.
Posted 12/6/2014 11:15 PM (GMT 0)
Exactly. Go over your medical history and see if you were ever on fluorquinolones (cipro, levaquin, avelox, etc). You could take the antibiotic once in your lifetime and still rupture your tendon 10 years after taking it.

Because of the permanent ramifications it has on not just our microbes, but also on the joints and tendons, I would not recommend taking the antibiotic unless your life is in question. It's notorious for causing neuropathy and other permanent changes to the genetic code. There was a recent study published in the journal of neurology about it inducing neuropathy in a relatively high percentage of patients long after they discontinued the drug.

Any doctor who prescribes it without explanation of the risks needs to have their license revoked - plain and simple it's a violation of the Hippocratic oath they swore to uphold when practicing medicine. Sorry, but they really need to be educated on serious matters like these. You can't just play around with someone's life like that and not suffer the consequences.

Post Edited (Guardian7) : 12/6/2014 4:18:25 PM (GMT-7)

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