Preface: I am not a doctor, and I do not claim that this article can diagnose or treat tendon injuries. This is a collection of information based on my personal experiences, research, and talks with doctors. This is an informative article meant to assist someone in understanding a possible injury and offer information on how to treat said injuries. With that said I get a lot of questions about injuries which is why I started my Injuries posts in the first place. Well not I’m getting a lot of questions about recovery time and tricks so here is what I have for TOFP.
The biggest question in terms of recovery for TOFP is how long it will take to recover. However, this question cannot be answered without first asking other questions. It helps to determine if there are inflammatory cells present on the tendon (tendonitis). If there are no inflammatory cells present then the injury will be tendonosis. This is important because it determines the length and severity of the injury. The problem is that inflammatory cells can usually only be seen with a microscope, and that can only be done with surgery. Since the average person with tendon pain is not going to go under the knife to find out exactly what is causing the pain, diagnosing the injury can be a difficult task.
The majority of recent studies have shown that most injuries do not have an inflammatory process present, which means that TOFP is caused by tendonosis. However, it is still not common practice to just assume there are no inflammatory cells present and a general prognosis will be tendonitis.
If it is tendonitis (inflammation present) then the injury should respond quickly to anti-inflammatory meds and rest. A true case of tendonitis should and can be resolved within a few days to two weeks.
If the issue is tendonosis (no inflammation present) then what you are dealing with is a degeneration of tissue that must be rebuilt. The majority of barefoot runners with this injury will likely fall in this category because they are now putting strain on tissue that has not felt that strain in many years. The tendons of the foot have degenerated, and the sudden switch in loading has caused an injury. If this is the case then the affected person must avoid loading the muscles and tendons involved in the painful area. This can be done with bracing, taping, supportive shoes, and avoidance of exercise/stress. It takes time for tissue to heal and regenerate, and it is especially true for tendons so the recovery time will be much longer. The time it takes to recover from an uncomplicated form of tendonosis is 6 to 8 weeks, while chronic complicated tendonosis could take 3 to 6 months. The only way to determine which of these time frames applies is to rest and see.
You may be able to rest for 4-6 weeks with a tendonosis injury and then test the area with a short bout of exercise that will put stress on it. If the response is pain or an unusual amount of discomfort then continue resting. If there is no pain present then you may restart your normal routine with a few things in mind.
First you should consider all possible causes for the injury in the first place. This will mostly include form and level of exertion prior to the injury. Analyzing your footfall and making any necessary changes will be vital in the avoidance of a re-injury scenario. Second you should start extremely slow as you work your way back into a safe routine that will allow you to progress from the injury and not from the point where you left off in your training. Once you’ve suffered an injury, your new starting point will typically be far behind the last point you were training at, and that adjustment must be made in order to avoid future setbacks.