Achilles Tendonitis Treatment Options

DIY Injury Rehabilitation

I will soon be producing a diyinjuryrehab.com Achilles Program that will deliver daily exercises to your Inbox for Achilles Tendonitis Treatment.

This will give you a varied but structured approach to your exercise program.

Take a look at the video opposite.
It show a very simple exercise that you should be doing for Achilles Tendonitis.

Please take the time to sign up for my Members Area – you will be notified as soon as it is released.

Physiotherapy or Sports Injury Specialist

You can expect to be thoroughly assessed.
They will look not just at your calf and leg but also your lower back, sacoiliac, hip, knee, ankle and foot joints.
They will assess muscle tone and balance for your legs and trunk.
You will be checked for shortened muscles and nerves.
They may use some manual techniques to loosen or mobilize tight structures.
Therapeutic Ultrasound, Laser or some other electrotherapy may be used to help settle inflammation if necessary.
A heel lift may be provided as a temporary measure to help with pain relief.
You can expect a combination of stretching and strengthening exercises to do at home.

Customised Orthotic Insoles

Specialized custom fitted insoles can be prescribed and made by a Podiatrist for Achilles Tendonitis treatment.
These insoles are made to exactly compensate for the structural or functional abnormalities in your foot and hindfoot.
A simple explanation would be that this helps to control any excessive pronation that may be taking place.

Investigations

ULTRASOUND SCAN
Ultrasound scanning has become very accurate recently in skilled hands.
It allows for quite accurate diagnosis of Achilles Tendinopathy.

MRI SCAN
MRI scanning may apparently finds it difficult to differentiate between symptomatic and non-symptomatic changes in the tendon. This is because there are differences in the normal anatomy of healthy tendons which the MRI picks up and may lead to possible problems. The advantages of an MRI are that they allow multiple views and sections through the tendon and allow the surgeon to build up a 3D view of the tendon before surgery which may be an Achilles Tendonitis treatment option (see below).

Injections

CORTICOSTEROID

Some Doctors still carry out injections of Corticosteroids around the paratenon as Achilles Tendonitis treatment.
There is a generally perceived risk that this may lead to further weakening the tendon and causing ruptures of the tendon.
So it depends who you see and what their particular experiences are.

SCLEROSING

Another type of injection for Achilles Tendonitis treatment is one which scleroses the new blood vessels and nerves associated with tendinopathy.
Sclerosis produces hardening and fibrosis of the tissues injected – it obliterates them.
The injections are carried out under the guidance of ultrasound for very accurate placement of the needle.
Sclerosing polidocanol injections have been shown to have good lasting effects in patients with chronic painful mid-portion Achilles tendinosis.

Shockwave Therapy

Extracorporeal Shockwave Therapy (ESWT) has been around for a while but it has been reformed over the past few years. Initially you needed local anaesthetic or more for the treatment but now it can be performed without anaesthesia. It works by producing shockwaves which exert a mechanical pressure and tension force on the afflicted tissue. This Achilles Tendonitis treatment breaks down scar tissue and promotes healing.
For a much clearer and more detailed explanation see this Canadian Site – click here

Surgery

If exercise does not help or the condition is longstanding (over 6 months) then you medical practitioner may offer you surgery as the ultimate Achilles Tendonitis treatment.
There are slightly different operations but your Achilles Tendon will be examined and any partial tears will be cleaned up and repaired.
If there is a thickened paratenon this will be removed.
If there is any bony protuberances they will be removed also.
The bursa (small fluid filled sac) may also be excised if this is inflamed.

This sort of surgery may be carried out through a small cut in the skin (keyhole) or by an open approach – longer scar depending on the surgeon and the nature of the problem.
Another type of surgery produces a series of small longitudinal cuts in the tendon to allow removal of damaged areas of the tendon.
If you want specific information about the different types of surgery then I have found and excellent French Website with lots of pictures and diagrams – click here

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