Tuesday, August 20, 2013

Pain in Achilles Tendon: How To Treat

Symptoms of Achilles Tendinitis:

1. Pain in the Achilles tendon.
2. Pain with walking when you first wake up in the morning.
3. Pain with aggravating activities or sports, especially if they involve running.
4. May progress to pain even with usual daily activities, such as walking.
5. Decreased pain when you are resting.

Causes of Achilles Tendinitis:

1. Repeated impact on the leg, such as jogging or sports.
2. Improper sports/exercise training, such as increasing pace, distance or intensity too soon.
3. "Running on uneven or loose terrain." (1)
4. Overpronation of the foot.
5. Tight calf muscles.
6. Incorrect shoewear.

Modifying Your Exercise To Decrease Achilles Tendinitis:

1. Rest from aggravating exercises. Replace with pain-free exercises, such as swimming or biking.
2. Eliminate running or greatly reduce your running. Do not jog on hills. Avoid jogging on roads/sidewalks.
3. Modify your shoewear or get fitted for orthotics.
4. Eliminate intervals.
5. Increase calf stretching, and perform prior to and after exercising.
6. Use ice or ice massage to the Achilles tendon, especially after your sport.
7. Consider seeing a physical therapist and/or a certified prosthetist/orthotist.
8. Ask your primary doctor for a referral to an orthopedic foot/ankle specialist.
9. Return to your sport at a slow, pain-free pace.
10. Incorporate eccentric calf strengthening (if they can be done pain-free). For example, stand and do a calf raise with both legs. At the top of the calf raise, release the good leg so that you are standing only on the affected leg. Use the affected leg to lower yourself back down. Repeat 3 sets of 10-15 reps.


Specific Reference: 
(1). Brotzman SB, Wilk KE. Clinical Orthopaedic Rehabilitation, 2nd ed. 2003: Mosby. Page 405.

General Reference:
Greenberg RC, Saltzman C. "Achilles Tendon Dysfunction," in Brotzman SB, Wilk KE. Clinical Orthopaedic Rehabilitation, 2nd ed. 2003: Mosby. Pages 405-410. 

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