Thursday, 18 December 2014

Treating Achilles Tendon Disorders

Achilles tendinitis, an injury of the Achilles due to overuse, is a common disorder which often occurs in people who usually participate in sports like gymnastics, running, football, baseball, softball, tennis, basketball and volleyball. If you are involved in any of these sports, you are at risk of suffering from this disorder. At times, even inactive people or recreational exercisers may suffer from this condition which triggers pain along the rear part of the leg, close to the heel.

Achilles tendinitis is caused when the tendon is subject to repetitive stress. Most people fall prey to this
disorder by pushing their bodies to do too much in very little time. However, other factors such as increasing the intensity/amount of exercise all of a sudden, using an aggressive exercise schedule when you have tight calf muscles (that strain the Achilles tendon), or bone spur can also increase the chance of developing tendinitis.

Most cases of this Achilles tendon disorder can be treated with nonsurgical treatment. Though these treatment options offer pain relief, the symptoms may take a few months to subside completely. Popular nonsurgical treatment for Achilles tendinitis includes:

  • Ample rest: The best way to heal yourself is to take adequate rest. Stay away from any activity that causes strain to your tendon. These include running or climbing the stairs as well as other high-impact exercises. Since you can't get involved in these activities, you can opt for easy, low-impact exercises that will put less stress on the Achilles tendon.
  • Apply ice packs: You can reduce the pain by applying ice packs on the affected area at any time, during the day. You may use these packs for up to 20 minutes but if your skin becomes numb, it’s advisable to stop it. 
  • Take NSAIDs: You can take some non-steroidal anti-inflammatory drugs (NSAIDs) that help reduce swelling and pain. However, you should remember that such medications won’t decrease the thickening of the degenerated tendon. You should also consult your podiatrist before continuing such medications beyond a month.
  • Exercise to stretch the calf muscles: One of the best ways to treat Achilles tendinitis is to do some stretching exercises that decrease stress on the Achilles tendon and strengthen your calf muscles. You may also do eccentric strengthening exercises under the supervision of an experienced physical therapist. 
  • Avoid having pain killers: Popping pain killers won’t be of much help in treating this Achilles tendon disorder. Since it is not an inflammation but a degenerative injury, the pain killing drugs will mask the problem temporarily, which will make the degeneration even worse.
  • Using orthotics and supportive shoes: Your podiatrist may suggest supportive shoes like those with heel lifts or the ones with a softer section at the back that offer pain relief. A silicone Achilles sleeve or a walking boot (albeit for a shorter time period) may also be advised by your foot doctor.

In case the nonsurgical treatment options fail to offer pain relief after 6 months, your podiatrist may consider surgery. Depending on the extent of tendon damage and location of the tendinitis, the specific type of surgery is determined.

Gastrocnemius recession to elongate the calf (gastrocnemius) muscles can help patients having difficulty in flexing their feet. D├ębridement (amputation of the damaged tissue) and repair operation is performed in cases where damage to the tendon is less than 50%. D├ębridement with an Achilles tendon transfer is done where the tendon damage is over 50%. Physical therapy is a significant part of post-surgery recovery and most patients usually need a year of rehabilitation before they can become pain-free.

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