injuries poisoning
Achilles Tendinitis
Treatment of Achilles Tendinitis
Ice, nonsteroidal anti-inflammatory drugs (NSAIDs), and stretches Modification of activities Sometimes a heel lift Tendon inflammation should initially be treated with ice, gentle calf muscle stretching, and use of NSAIDs. A heel lift can be placed in the shoes to take tension off the tendon. Athletes should be instructed to avoid uphill and downhill running until the tendon is not painful and to engage in cross-training aerobic conditioning. Most clinicians treat complete tears of the Achilles tendon with surgical repair. However, recent studies ( Treatment references ) have shown that nonoperative management (including highly structured rehabilitation activities) gives long-term results similar to those of surgical repair in terms of ankle strength, range of motion in the ankle, rates of repeat tear of the tendon, and ability to do pre-injury activity. 1. Stand facing or next to wall with hands on the wall. 2. Bend knee on involved side to place top of involved foot down toward the floor with toes pointing down. 3. Bend knee on uninvolved side and slowly lower body until stretch is felt over the top of the foot and ankle. 4. Hold exercise for 30 second. 5. Perform 1 set of 4 repetitions, 3 times a day. 6. Special Instructions a. Perform plantarflexion stretching while either sitting or standing, whichever is most comfortable. Courtesy of Tomah Memorial Hospital, Department of Physical Therapy, Tomah, WI; Elizabeth C.K. Bender, MSPT, ATC, CSCS; and Whitney Gnewikow, DPT, ATC. 1. Sit in chair. 2. Bend knee on involved side to place top of involved foot down toward the floor with toes pointing down. 3. Slowly sit forward in the chair and push foot into plantarflexion until a stretch is felt over the top of the foot and ankle. 4. Hold exercise for 30 seconds. 5. Perform 1 set of 4 repetitions, 3 times a day. 6. Special Instructions a. Perform plantarflexion stretching while either sitting or standing, whichever is most comfortable. Courtesy of Tomah Memorial Hospital, Department of Physical Therapy, Tomah, WI; Elizabeth C.K. Bender, MSPT, ATC, CSCS; and Whitney Gnewikow, DPT, ATC. 1. Stand facing or next to wall with hands on the wall for support. 2. Place uninvolved leg forward. 3. Keep rear leg straight with knees and toes pointing toward the wall, keep rear heel on the floor. 4. Bend knee on uninvolved leg and lean hips toward the wall to feel a stretch along the calf of the rear leg. 5. Hold exercise for 30 seconds. 6. Perform 1 set of 4 repetitions, 3 times a day. (It is important to maintain a straight back posture with the heel firmly planted [not lifted] during the stretch.) Courtesy of Tomah Memorial Hospital, Department of Physical Therapy, Tomah, WI; Elizabeth C.K. Bender, MSPT, ATC, CSCS; and Whitney Gnewikow, DPT, ATC. 1. Stand facing or next to wall with hands on the wall for support. 2. Place uninvolved leg forward. 3. Keep heels on the floor and slowly bend both knees to feel stretch along the calf of the rear leg. 4. Hold exercise for 30 seconds. 5. Perform 1 set of 4 repetitions, 3 times a day. Courtesy of Tomah Memorial Hospital, Department of Physical Therapy, Tomah, WI; Elizabeth C.K. Bender, MSPT, ATC, CSCS; and Whitney Gnewikow, DPT, ATC. 1. Stand on balls of feet with heels off the floor. 2. Walk on balls of feet while keeping knees straight. 3. Walk as far as able during given time frame, stop at point of fatigue. 4. Perform 3 sets of 1 minute, 1 time a day. Courtesy of Tomah Memorial Hospital, Department of Physical Therapy, Tomah, WI; Elizabeth C.K. Bender, MSPT, ATC, CSCS; and Whitney Gnewikow, DPT, ATC. 1. Stand on heels with balls of feet off the floor. 2. Walk on heels while keeping knees straight. 3. Walk as far as able during given time frame, stop at point of fatigue. 4. Perform 3 sets of 1 minute, 1 time a day. Courtesy of Tomah Memorial Hospital, Department of Physical Therapy, Tomah, WI; Elizabeth C.K. Bender, MSPT, ATC, CSCS; and Whitney Gnewikow, DPT, ATC. 1. Stand with both feet on step with heels off edge of step. Hold on for support. 2. Raise up on balls of feet. 3. Focus on slowly lowering heels to below the height of the step. 4. Return to starting position and repeat. 5. Perform 3 sets of 10 repetitions, 1 time a day. Courtesy of Tomah Memorial Hospital, Department of Physical Therapy, Tomah, WI; Elizabeth C.K. Bender, MSPT, ATC, CSCS; and Whitney Gnewikow, DPT, ATC. 1.Lantto L, Heikkinen J, Flinkkila T, et al: A prospective randomized trial comparing surgical and nonsurgical treatments of acute Achilles tendon ruptures.Am J Sports Med44(9):2406-2414, 2016. doi: 10.1177/0363546516651060 2.Parisien RL, Dodson CC, Trofa DP, et al: Face off: Surgical versus nonsurgical treatment of acute Achilles tendon ruptures.AAOS NowJuly 2016, cover. 3.Myhrvold SB, Brouwer EF, Andresen TKM, et al: Nonoperative or surgical treatment of acute Achilles' tendon rupture.N Engl J Med386(15):1409-1420, 2022. doi: 10.1056/NEJMoa2108447 