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The Causes And Treatments Of Achilles Tendinitis Pains

RalphDominquez586949 2017.06.10 11:52 조회 수 : 9

Overview
Achilles TendinitisThe Achilles tendon is the largest tendon in the body. Tendons are long, tough cords of tissue that connect muscle to bone. The Achilles tendon is located in the back of the foot and connects your heel bone to your calf muscle. It helps you to walk, run and jump. The Achilles tendon is able to endure stress, but sometimes injury can occur to the tendon when overly stressed. Overuse of the Achilles tendon may cause the tendon to swell, become irritated, inflamed and cause pain. This is Achilles tendinitis. It is a common sports injury related to running, but can happen to anyone who puts a lot of stress on their feet (e.g.: basketball players and dancers). If you do not get treatment for Achilles tendinitis, the problem can become chronic and make it difficult for you to walk.

Causes
Excessive exercise is a common cause of Achilles tendonitis. This is particularly true for athletes. However, factors unrelated to exercise may also contribute to risk. Rheumatoid arthritis and infection are both correlated with tendonitis. In general, any repeated activity that strains the Achilles tendon can contribute to this problem. Here are a few possible causes, jumping into an exercise routine without a proper warm-up, straining calf muscles during repeated exercise or physical activity, playing sports such as tennis that require quick stops and changes of direction, wearing old or ill-fitting shoes, wearing high heels every day.

Symptoms
People with Achilles tendinitis may experience pain during and after exercising. Running and jumping activities become painful and difficult. Symptoms include stiffness and pain in the back of the ankle when pushing off the ball of the foot. For patients with chronic tendinitis (longer than six weeks), x-rays may reveal calcification (hardening of the tissue) in the tendon. Chronic tendinitis can result in a breakdown of the tendon, or tendinosis, which weakens the tendon and may cause a rupture.

Diagnosis
On examination, an inflamed or partially torn Achilles tendon is tender when squeezed between the fingers. Complete tears are differentiated by sudden, severe pain and inability to walk on the extremity. A palpable defect along the course of the tendon. A positive Thompson test (while the patient lies prone on the examination table, the examiner squeezes the calf muscle; this maneuver by the examiner does not cause the normally expected plantar flexion of the foot).

Nonsurgical Treatment
The first thing to do is to cut back your training. If you are working out twice a day, change to once a day and take one or two days off per week. If you are working out every day cut back to every other day and decrease your mileage. Training modification is essential to treatment of this potentially long lasting problem. You should also cut back on hill work and speed work. Post running ice may also help. Be sure to avoid excessive stretching. The first phase of healing should be accompanied by relative rest, which doesn't necessarily mean stopping running, but as I am emphasizing, a cut back in training. If this does not help quickly, consider the use of a 1/4 inch heel lift can also help. Do not start worrying if you will become dependent on this, concentrate on getting rid of the pain. Don't walk barefoot around your house, avoid excessively flat shoes, such as "sneakers", tennis shoes, cross trainers, etc. In office treatment would initially consist of the use of the physical therapy modalities of electrical stimulation, (HVGS, high voltage galvanic stimulation), and ultrasound. Your sports medicine physician should also carefully check your shoes. A heel lift can also be used and control of excessive pronation by taping can also be incorporated into a program of achilles tendonitis rehabilitation therapy. Orthotics with a small heel lift are often helpful.

Achilles Tendon

Surgical Treatment
Surgery for an acute Achilles tendon tear is seemingly straightforward. The ends of the torn tendon are surgically exposed and sutures are used to tie the ends together. The sutures used to tie together the torn tendon ends are thick and strong, and are woven into the Achilles both above and below the tear. While the concepts of surgery are straightforward, the execution is more complex. Care must be taken to ensure the tendon is repaired with the proper tension -- not too tight or too loose. The skin must be taken care of, as excessive handling of the soft tissues can cause severe problems including infection and skin necrosis. Nerves are located just adjacent to the tendon, and must be protected to prevent nerve injury. If surgery is decided upon, it is usually performed within days or weeks of the injury. The idea is to perform the repair before scar tissue has formed, which would make the repair more difficult. Some surgeons may recommend delaying surgery a few days from the initial injury to allow swelling to subside before proceeding with the repair.

Prevention
To prevent Achilles tendonitis or tendonosis from recurring after surgical or non-surgical treatment, the foot and ankle surgeon may recommend strengthening and stretching of the calf muscles through daily exercises. Wearing proper shoes for the foot type and activity is also important in preventing recurrence of the condition.
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