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Melissa: Physical Medicine and Rehabilitation Patient Story

An avid runner, wife, mother, and elementary school teacher, 33-year-old Melissa never takes a day off from running. “I have run about 60 miles each week over the last year,” she says. So, when she began to experience fatigue that led to pain in her Achilles tendon, she worried she’d have to take some time off to have this addressed. Like many runners, Melissa’s mental health and wellbeing are directly related to her running, so she didn’t really consider time off as an option. Fortunately, Melissa wouldn’t have to make that decision. She was able to hit the pavement with only the minimum time off after her treatment.

Injury Following Fatigue

It was the summer of 2019 when Melissa began to experience increasingly concerning fatigue in her everyday life, and especially while running. Like many mothers to young children, she wrote this off for a few months. “When you’re a mom and not sleeping, you think that’s all it is, but my performance was really slipping. After running an Erie marathon in September, I felt so horrible and called Dr. Onishi immediately,” she says. Melissa expressed her gratitude for this connection, one she made through the incredible running community she is now a part of.

UPMC Physical Medicine and Rehabilitation (PM&R) physician Kentaro Onishi, DO, is a sub-three-hour marathon runner himself and a leading expert in treating endurance athletes and tendon injuries. Melissa ran on the relay team for Dr. Onishi’s ‘We Be Crazies’ running group in 2019, so she had his information; he was able to provide her immediate advice on that September call. “To my surprise, the first thing Dr. Onishi suggested I do is go get blood work, as the symptoms I was describing sounded a lot like anemia to him,” Melissa says. “He was right.” Her blood samples, showing extremely low levels of iron, prompted two iron infusions in October.

Within two weeks, Melissa was feeling more energetic, more like herself again. However, she was still dealing with her painful Achilles. “While I was unknowingly anemic, my stride was compromised because I was so tired. This is what led to the Achilles tendonitis/tendinopathy and bursitis of my heel,” she says. “I was hesitant to address it, because I need my daily run. I really do not take a day off—I ran six miles right before my son was born and started again only three weeks after my c-section.” Knowing that she didn’t plan to take a break, Dr. Onishi first prescribed several weeks of physical therapy. But, with no rest at all for her heel, PT wasn’t enough in this instance.

Same-Day Dreatment and Performance

During a follow-up visit in December 2019, Dr. Onishi saw that PT did not resolve Melissa’s Achilles tendinopathy as much as she had hoped, so he suggested mechanical tendon scraping for her Achilles tendon. “I was nervous when he said scraping, but it turned out to be a 5-minute procedure with local anesthetic, and I felt nothing,” Melissa says. “I know I was still a bit numb afterward, but when I ran that same evening, I could put pressure on my Achilles and did not feel the typical pain. It was amazing.”

Within a few weeks of the mechanical tendon scraping procedure, Melissa shares that she was running with absolutely no pain in her Achilles and heel. Today, she is able to train injury-free, and since January 2020, Melissa has run personal bests in every distance she has raced. This includes a two-minute improvement from a year prior in the 5k distance with a time of 19:06. She also qualified for the prestigious Boston Marathon in June with the best marathon time since having her son, finishing with 15 minutes to spare from the qualifying cut-off time.

Working Together to Reach New Heights

“The exact treatment Dr. Onishi chose for me just goes to show his expertise in the area. He discussed surgical treatments with me, but he also discussed innovative non-surgical treatments done using sports ultrasound that would allow for a safe and swift return to training. He can relate because he runs, can make the appropriate diagnosis because he listens, and can treat the injury in accordance with your lifestyle because he cares,” Melissa says. “It has always been hard for me to accept help as a strong-minded runner, but between Dr. Onishi and my physical therapists, I’ve made incredible progress. I trust them, I have so much respect for them, and now I see what can be done through their expertise.”

Melissa shares that she runs with her heart, that it’s like breathing to her, and that the stars truly aligned when the injury she sustained just so happened to be her fellow runner’s, and doctor’s, specialty. This experience has alleviated her fear that doctors will just sit you out of the game—that they don’t understand an athlete’s lifestyle. She says, “I don’t know where I’d be competitively had I not undergone this specific procedure. I just thank him over and over again. Running brings me so much joy. As a runner himself, Dr. Onishi understands the sentiment of competitive runners. Now I’m meeting new goals thanks to Dr. Onishi and UPMC.”