Achilles Tendonitis (2)

Symptoms of Achilles Tendonitis

The main problem with Achilles tendonitis, or Achilles tendonosis, is one of pain. This generally remains well localised to the problematic area of the tendon. Initially symptoms are intermittent and may just occur following periods of activity. The pain with Achilles tendonitis may initially occur just during or after activity. It may produce symptoms at rest or occasionally even at night. It is also possible that some patients with degenerative tendon problems (Achilles tendonosis) may have little in the way of symptoms initially.

Causes of Achilles Tendonitis

Achilles tendons, like all musculo-skeletal tissue, are exposed to multiple episodes of minor trauma during their activity. All tendons are constructed very much for strength and have relatively little in the way of blood vessels associated with them .This means they are slow to repair themselves. Over a period of time, if the Achilles tendons’ capacity for repair is continually exceeded, structural changes will occur. These symptoms and structural changes, may take longer to manifest themselves as in the case of Achilles tendonosis. Not all people are equally susceptible to these type of soft tissue problems. Some people’s Achilles genes are just better than others.

Treatments for Achilles Tendonitis

Both operative and non-operative managements are available for Achilles tendonitis. Generally, one would be advised to try non-operative management first though dependent upon length and severity of symptoms this is open to discussion of course. There are two, seemingly diametrically opposed, ways of managing Achilles tendonitis non-operatively. On the one hand one may go down the route of splinting用夹板托着, immobilisation and resting of the Achilles tendonitis. On the other hand one may go down the route of physiotherapy, supervised massage, stretches and strengthening type exercises for Achilles tendonitis. Both routes seem to work with equal likelihood. It is not possible to know who would benefit from one route and who would benefit from another.

Physiotherapy for Achilles Tendonitis

In the acute phases ultrasound, restriction of activity and rest for the Achilles tendon are likely to be advised. Later deep friction massage of the tendon will be started and exercises to stretch the Achilles tendon will be taught. Non-steroidal anti-inflammatory tablets such as Brufen may be useful if these are not contra-indicated.

Orthotic 矫正术for Achilles Tendonitis

The minimum is to try a heel raise. This is a wedge of material which raises the heel relatively to the foot, thus removing some of the tension from the Achilles tendon.You may feel easier wearing high heels, though for men this probably should be limited just to Friday or Saturday nights (and when your wife is out). An alternative form of treatment of Achilles tendonitis is to wear an Achilles Aircast walking boot. This should be used for all weight bearing activity and the back part of the boot should be rested in bed at night. Short periods of driving during treatment for Achilles tendonitis are possible. Full weight bearing in the Aircast boot is also possible during treatment for Achilles tendonitis.

How Soon Should Non-Operative Treatment of Achilles Tendonitis Improve Symptoms

Some symptoms from the Achilles tendon should improve soon, perhaps within days or weeks. Lasting improvement however takes longer and it may be up to 3-6 months before significant inroads are made into the symptoms. If the symptoms of Achilles tendonitis have failed to improve much by this stage, then they are unlikely to do so with further conservative treatment. All told, success rate in the region of 50-75% can be expected with conservative management of the Achilles tendonitis.