"That's got to be the first time a girl's ever said that to me," Jace mused.

Audrey Shindo

Achilles Tendon Rupture Non Operative Protocol | main |
Achilles Tendon Rupture Pain
Overview


Achilles TendonAchilles Tendonitis is an inflammation of the Achilles Tendon. This tendon attaches the muscles in the calf of the leg to the back of our heels. The Achilles Tendon is a long and thick tendon, which moves our foot down, so that the toes point to the ground (plantar flexion). This tendon can become inflamed due to the following causes. Over utilizing it, such as too much running, especially up or down hill. Trauma, such as a kick to the tendon. Shoe or boot pressure, especially at its attachment to the heel, or just above it. There are over 250,000 injuries to the Achilles Tendon annually. In fact, more Than 10% of all running injuries are to the Achilles tendon. Tendonitis may be classified as either acute or chronic. Acute Achilles Tendonitis comes on quickly, usually after a specific activity or event. It is characterized by an overstretching or tearing of some of the small fibers of the tendon, and causes pain or tenderness when walking or running. It can occur at the insertion (near the attachment to the heel bone, or further up the leg, about 4 or 5 inches above the heel. Acute tendonitis can also follow a specific injury, such as a kick to the tendon while playing soccer. Chronic Achilles Tendonitis develops gradually over time. Many times, you can feel an obvious thickening of the tendon that may be tender when squeezed, due to long standing scarring of the tendon. Pain is also present when walking or during other forms of activity, and feels better at rest.


Causes


Achilles tendinitis can be caused by any activity that puts stress on your Achilles tendon. Tendinitis can develop if you run or jump more than usual or exercise on a hard surface. Tendinitis can be caused by shoes that do not fit or support your foot and ankle. Tight tendons and muscles, You may have tight hamstring and calf muscles in your upper and lower leg. Your tendons also become stiffer and easier to injure as you get older. Arthritis, Bony growths caused by arthritis can irritate the Achilles tendon, especially around your heel.


Symptoms


Common symptoms of Achilles tendinitis include weakness in the leg, slight pain above the heel in the lower leg after activity, feeling of stiffness in the leg that usually appears in the morning and lessens throughout the day, bad pain the day after exercising, pain as you climb stairs or go uphill, swelling in the area of the Achilles tendon, creaking or cracking noise when you press on the Achilles tendon.


Diagnosis


A doctor examines the patient, checking for pain and swelling along the posterior of the leg. The doctor interviews the patient regarding the onset, history, and description of pain and weakness. The muscles, tissues, bones, and blood vessels may be evaluated with imaging studies, such as X-ray, ultrasound, or MRI.


Nonsurgical Treatment


Most cases of Achilles tendonitis can be treated at home. Here's what to do. Stop doing the activity that led to the injury. Avoid putting stress on your legs and feet, and give your tendon plenty of time to fully recover. Use the RICE formula. Don't exercise for a few days, or try an exercise that doesn't stress your feet, such as swimming. If necessary, your doctor may recommend that you use crutches or wear a walking boot to keep weight off your foot. Apply an ice pack wrapped in a towel or a cold compress to your tendon for 15 minutes or more after you exercise or if you feel pain in the tendon. Use tape or an athletic wrap to keep swelling down and help support and immobilize the tendon. Lie down and raise your foot above the level of your heart, and if possible, try to sleep with your foot elevated. This will help keep the swelling to a minimum. Take anti-inflammatory medications. Pain relievers like ibuprofen can help ease pain and reduce swelling in the affected area. Stretch and exercise your ankles and calf muscles while you recover. Keeping your muscles, tendons, and ligaments strong and flexible will aid in your recovery and help you keep from reinjuring your Achilles tendon. A doctor or a physical therapist can help you come up with a good exercise program. Try a pair of prescription orthotic inserts for your shoes if your doctor thinks it will help. Sometimes orthotics can be helpful. Talk to your doctor or someone trained in fitting orthotics to find out if they might work for you. Achilles tendon surgery is rarely needed. It's usually only done if the tendon breaks, and then only as a last resort after other methods of therapy have been tried. Most cases of Achilles tendonitis will get better on their own with rest and minor treatment.


Achilles Tendinitis


Surgical Treatment


The type of surgery you will have depends on the type of injury you are faced with. The longer you have waited to have surgery will also be a factor that determines what type of surgery is needed. With acute (recent) tearing the separation in your Achilles tendon is likely to be very minimal. If you have an acute tear you may qualify for less invasive surgery (such as a mini-open procedure). Surgeons will always choose a shorter, less invasive procedure if it is possible to do so. Most surgeons know that a less complicated procedure will have less trauma to the tendon and a much quicker rate of recovery after the surgery.


Prevention


Suggestions to reduce your risk of Achilles tendonitis include, icorporate stretching into your warm-up and cool-down routines. Maintaining an adequate level of fitness for your sport. Avoid dramatic increases in sports training. If you experience pain in your Achilles tendon, rest the area. Trying to ?work through? the pain will only make your injury worse. Wear good quality supportive shoes appropriate to your sport. If there is foot deformity or flattening, obtain orthoses. Avoid wearing high heels on a regular basis. Maintaining your foot in a ?tiptoe? position shortens your calf muscles and reduces the flexibility of your Achilles tendon. An inflexible Achilles tendon is more susceptible to injury. Maintain a normal healthy weight.
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Audrey Shindo

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