http://www.rehime.com.ar/bases/paginasdecine/index.php?title=Dealing_With_Achilles_Tendinitis&feed=atom&action=historyDealing With Achilles Tendinitis - Historial de revisiones2024-03-29T06:22:39ZHistorial de revisiones para esta página en el wikiMediaWiki 1.24.1http://www.rehime.com.ar/bases/paginasdecine/index.php?title=Dealing_With_Achilles_Tendinitis&diff=12212&oldid=prevMichealY29 en 00:23 12 jun 20172017-06-12T00:23:50Z<p></p>
<table class='diff diff-contentalign-left'>
<col class='diff-marker' />
<col class='diff-content' />
<col class='diff-marker' />
<col class='diff-content' />
<tr style='vertical-align: top;'>
<td colspan='2' style="background-color: white; color:black; text-align: center;">← Revisión anterior</td>
<td colspan='2' style="background-color: white; color:black; text-align: center;">Revisión de 00:23 12 jun 2017</td>
</tr><tr><td colspan="2" class="diff-lineno">Línea 1:</td>
<td colspan="2" class="diff-lineno">Línea 1:</td></tr>
<tr><td class='diff-marker'>−</td><td style="color:black; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>Overview<br>Achilles tendinitis occurs when the <del class="diffchange diffchange-inline">band </del>of <del class="diffchange diffchange-inline">tissue that connects </del>the calf muscles at the back of <del class="diffchange diffchange-inline">the </del>lower leg <del class="diffchange diffchange-inline">to </del>the <del class="diffchange diffchange-inline">heel bone, the Achilles </del>tendon, <del class="diffchange diffchange-inline">becomes inflamed</del>. <del class="diffchange diffchange-inline">This condition </del>is <del class="diffchange diffchange-inline">a </del>result of <del class="diffchange diffchange-inline">overuse from intense </del>exercise, <del class="diffchange diffchange-inline">jumping, </del>running, <del class="diffchange diffchange-inline">and other activities that strain </del>the tendon and <del class="diffchange diffchange-inline">calf muscles</del>.<br><br>Causes<br><del class="diffchange diffchange-inline">Short of a trauma, the primary cause of </del>Achilles tendonitis is <del class="diffchange diffchange-inline">when the calf muscle is so tight </del>that <del class="diffchange diffchange-inline">the heel </del>is <del class="diffchange diffchange-inline">unable </del>to <del class="diffchange diffchange-inline">come down </del>to the <del class="diffchange diffchange-inline">ground placing extreme stress on the Achilles tendon at the insertion. Keep </del>in <del class="diffchange diffchange-inline">mind </del>that the <del class="diffchange diffchange-inline">calf muscle is designed to contract up, lifting </del>the <del class="diffchange diffchange-inline">heel bone off the ground, propelling you forwards </del>to the <del class="diffchange diffchange-inline">front of the foot for push off. When the calf is so tight that the heel is prevented </del>from <del class="diffchange diffchange-inline">coming down on the ground there will be stress on the </del>tendon <del class="diffchange diffchange-inline">and </del>the <del class="diffchange diffchange-inline">foot will </del>over <del class="diffchange diffchange-inline">pronate causing the Achilles tendon to twist</del>, <del class="diffchange diffchange-inline">adding </del>to <del class="diffchange diffchange-inline">the stress on the insertion</del>. <del class="diffchange diffchange-inline">Improper treatment may lead </del>to a <del class="diffchange diffchange-inline">more severe </del>injury, <del class="diffchange diffchange-inline">such as a rupture </del>or <del class="diffchange diffchange-inline">chronic weakening</del>, <del class="diffchange diffchange-inline">which may require surgery</del>.<br><br>Symptoms<br><del class="diffchange diffchange-inline">If you have </del>Achilles tendinitis <del class="diffchange diffchange-inline">or Achilles enthesopathy, you are likely to </del>experience <del class="diffchange diffchange-inline">the following symptoms</del>. <del class="diffchange diffchange-inline">Pain</del>. <del class="diffchange diffchange-inline">You may notice aching, burning, or tearing pains at </del>the back of <del class="diffchange diffchange-inline">your heel or above </del>the ankle<del class="diffchange diffchange-inline">. The pain can range from mild to very severe and disabling. It is most noticeable in </del>the <del class="diffchange diffchange-inline">following circumstances. After resting. Many people report that pain increases when they first get out </del>of <del class="diffchange diffchange-inline">bed in </del>the <del class="diffchange diffchange-inline">morning or after sitting for a period of time</del>. <del class="diffchange diffchange-inline">After exercise. Pain </del>may <del class="diffchange diffchange-inline">increase if you exercise or stand for a period </del>of <del class="diffchange diffchange-inline">time</del>. <del class="diffchange diffchange-inline">A lump. In some cases, </del>a <del class="diffchange diffchange-inline">tender lump can develop at the site </del>of the <del class="diffchange diffchange-inline">injured </del>tendon <del class="diffchange diffchange-inline">(</del>tendinosis<del class="diffchange diffchange-inline">). Bone spurs. When the injury occurs at the point where </del>the tendon <del class="diffchange diffchange-inline">attaches to the foot, </del>a <del class="diffchange diffchange-inline">bone spur may develop on the heel</del>.<br><br>Diagnosis<br>A podiatrist can usually make the diagnosis by clinical history and physical examination alone. Pain with touching or stretching the tendon is typical. There may also be a visible swelling to the tendon. The patient frequently has difficulty plantarflexing (pushing down the ball of the foot and toes, like one would press on a gas pedal), particularly against resistance. In most cases X-rays don't show much, as they tend to show bone more than soft tissues. But X-rays may show associated degeneration of the heel bone that is common with Achilles Tendon problems. For example, [<del class="diffchange diffchange-inline">https</del>://<del class="diffchange diffchange-inline">marlinejaquish</del>.<del class="diffchange diffchange-inline">wordpress</del>.com/<del class="diffchange diffchange-inline">category</del>/<del class="diffchange diffchange-inline">hammer-toes </del>heel spurs], calcification within the tendon, avulsion fractures, periostitis (a bruising of the outer covering of the bone) may all be seen on X-ray. In cases where we are uncertain as to the extent of the damage to the tendon, though, an MRI scan may be necessary, which images the soft tissues better than X-rays. When the tendon is simply inflamed and not severely damaged, the problem may or may not be visible on MRI. It depends upon the severity of the condition.<br><br>Nonsurgical Treatment<br><del class="diffchange diffchange-inline">Proper footwear </del>with a <del class="diffchange diffchange-inline">strong and secure counter (</del>the <del class="diffchange diffchange-inline">heel circumference) may help to encourage heeling </del>of the <del class="diffchange diffchange-inline">tendon</del>. <del class="diffchange diffchange-inline">A tendinitis will occasionally resolve on it?s own, with rest, ice, </del>and <del class="diffchange diffchange-inline">gentle stretching</del>. <del class="diffchange diffchange-inline">If symptoms persist for more than 2 weeks, consult </del>your <del class="diffchange diffchange-inline">physician</del>. <del class="diffchange diffchange-inline">Your physician </del>may <del class="diffchange diffchange-inline">suggest physiotherapy </del>and <del class="diffchange diffchange-inline">custom </del>orthotics<del class="diffchange diffchange-inline">. Physiotherapy </del>can <del class="diffchange diffchange-inline">suggest appropriate exercises </del>and <del class="diffchange diffchange-inline">modalities </del>to <del class="diffchange diffchange-inline">aid in </del>the <del class="diffchange diffchange-inline">healing process</del>. <del class="diffchange diffchange-inline">Custom orthotics can be very successful in treating </del>the <del class="diffchange diffchange-inline">problem</del>, <del class="diffchange diffchange-inline">as </del>the <del class="diffchange diffchange-inline">original cause may be due to an improper alignment </del>of the foot and heel. <del class="diffchange diffchange-inline">Re-aligning </del>the foot to <del class="diffchange diffchange-inline">a neutral position may provide an optimal</del>, <del class="diffchange diffchange-inline">biomechanically sound environment for healing </del>to <del class="diffchange diffchange-inline">occur</del>.<br><br><br>Surgical Treatment<br><del class="diffchange diffchange-inline">Treating this surgically, there are numerous methods </del>to repair <del class="diffchange diffchange-inline">the </del>tendon. <del class="diffchange diffchange-inline"> Most commonly, Achilles </del>tendon is <del class="diffchange diffchange-inline">exposed through </del>an <del class="diffchange diffchange-inline">incision at the back </del>of the <del class="diffchange diffchange-inline">ankle</del>. <del class="diffchange diffchange-inline"> After identifying both ends of ruptured tendon</del>, <del class="diffchange diffchange-inline">the edges got trimmed and then both ends were sutured together with optimal tension.  To get </del>a <del class="diffchange diffchange-inline">better outcome with fixation</del>, <del class="diffchange diffchange-inline">an anchor may have to </del>be <del class="diffchange diffchange-inline">in place in calcaneus, provided the rupture is very low</del>. <del class="diffchange diffchange-inline"> Care must </del>be <del class="diffchange diffchange-inline">taken </del>to <del class="diffchange diffchange-inline">avoid injuries </del>to the <del class="diffchange diffchange-inline">nerves located adjacent </del>to the tendon.<br><br>Prevention<br><del class="diffchange diffchange-inline">A 2014 study looked at the effect of using foot orthotics on the Achilles tendon. The researchers found that running </del>with <del class="diffchange diffchange-inline">foot orthotics resulted in a significant decrease in Achilles tendon load compared </del>to running <del class="diffchange diffchange-inline">without orthotics. This study indicates that foot orthoses may act to reduce the incidence of chronic Achilles tendon pathologies in runners </del>by <del class="diffchange diffchange-inline">reducing stress on the Achilles tendon1</del>. <del class="diffchange diffchange-inline">Orthotics seem to reduce load on the Achilles tendon by reducing excessive pronation</del>,</div></td><td class='diff-marker'>+</td><td style="color:black; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>Overview<br>Achilles tendinitis <ins class="diffchange diffchange-inline">(tendonitis) or Achilles tendon inflammation </ins>occurs when the <ins class="diffchange diffchange-inline">Achilles tendon becomes inflamed, as a result, </ins>of <ins class="diffchange diffchange-inline">the Achilles tendon being put under too much strain. The Achilles tendon joins </ins>the calf muscles <ins class="diffchange diffchange-inline">to the heel bone, and is found </ins>at the back of <ins class="diffchange diffchange-inline">a person's </ins>lower leg<ins class="diffchange diffchange-inline">. It is </ins>the <ins class="diffchange diffchange-inline">largest </ins>tendon <ins class="diffchange diffchange-inline">in the body and can endure great force</ins>, <ins class="diffchange diffchange-inline">but is still susceptible to injury</ins>. <ins class="diffchange diffchange-inline">Achilles tendinitis </ins>is <ins class="diffchange diffchange-inline">usually the </ins>result of <ins class="diffchange diffchange-inline">strenuous, high impact </ins>exercise, <ins class="diffchange diffchange-inline">such as </ins>running<ins class="diffchange diffchange-inline">. If ignored</ins>, <ins class="diffchange diffchange-inline">Achilles tendinitis can lead to </ins>the tendon <ins class="diffchange diffchange-inline">tearing or rupturing, </ins>and <ins class="diffchange diffchange-inline">therefore it is important to seek the necessary treatment. Sometimes, treatment can be as simple as getting rest or changing an exercise routine. However, in more severe cases, surgery may be required</ins>.<br><br>Causes<br>Achilles tendonitis is <ins class="diffchange diffchange-inline">an overuse injury </ins>that is <ins class="diffchange diffchange-inline">common especially </ins>to <ins class="diffchange diffchange-inline">joggers and jumpers, due </ins>to the <ins class="diffchange diffchange-inline">repetitive action and so may occur </ins>in <ins class="diffchange diffchange-inline">other activities </ins>that <ins class="diffchange diffchange-inline">requires </ins>the <ins class="diffchange diffchange-inline">same repetitive action. Most tendon injuries are </ins>the <ins class="diffchange diffchange-inline">result of gradual wear and tear </ins>to the <ins class="diffchange diffchange-inline">tendon </ins>from <ins class="diffchange diffchange-inline">overuse or ageing. Anyone can have a </ins>tendon <ins class="diffchange diffchange-inline">injury, but people who make </ins>the <ins class="diffchange diffchange-inline">same motions </ins>over <ins class="diffchange diffchange-inline">and over in their jobs</ins>, <ins class="diffchange diffchange-inline">sports, or daily activities are more likely </ins>to <ins class="diffchange diffchange-inline">damage a tendon</ins>. <ins class="diffchange diffchange-inline">A tendon injury can happen suddenly or little by little. You are more likely </ins>to <ins class="diffchange diffchange-inline">have </ins>a <ins class="diffchange diffchange-inline">sudden </ins>injury <ins class="diffchange diffchange-inline">if the tendon has been weakened over time. Common causes of Achilles tendonitis include</ins>, <ins class="diffchange diffchange-inline">over-training </ins>or <ins class="diffchange diffchange-inline">unaccustomed use</ins>,<ins class="diffchange diffchange-inline">?too much too soon?. Sudden change in training surface e.g. grass to bitumen. Flat (over-pronated) feet, High foot arch with tight Achilles tendon. tight hamstring (back of thigh) and calf muscles, toe walking (or constantly wearing high heels). Poorly supportive footwear, hill running. Poor eccentric strength</ins>.<br><br>Symptoms<br><ins class="diffchange diffchange-inline">People with </ins>Achilles tendinitis <ins class="diffchange diffchange-inline">may </ins>experience <ins class="diffchange diffchange-inline">pain during and after exercising</ins>. <ins class="diffchange diffchange-inline">Running and jumping activities become painful and difficult</ins>. <ins class="diffchange diffchange-inline">Symptoms include stiffness and pain in </ins>the back of the ankle <ins class="diffchange diffchange-inline">when pushing off </ins>the <ins class="diffchange diffchange-inline">ball </ins>of the <ins class="diffchange diffchange-inline">foot</ins>. <ins class="diffchange diffchange-inline">For patients with chronic tendinitis (longer than six weeks), x-rays </ins>may <ins class="diffchange diffchange-inline">reveal calcification (hardening </ins>of <ins class="diffchange diffchange-inline">the tissue) in the tendon</ins>. <ins class="diffchange diffchange-inline">Chronic tendinitis can result in </ins>a <ins class="diffchange diffchange-inline">breakdown </ins>of the tendon<ins class="diffchange diffchange-inline">, or </ins>tendinosis<ins class="diffchange diffchange-inline">, which weakens </ins>the tendon <ins class="diffchange diffchange-inline">and may cause </ins>a <ins class="diffchange diffchange-inline">rupture</ins>.<br><br>Diagnosis<br>A podiatrist can usually make the diagnosis by clinical history and physical examination alone. Pain with touching or stretching the tendon is typical. There may also be a visible swelling to the tendon. The patient frequently has difficulty plantarflexing (pushing down the ball of the foot and toes, like one would press on a gas pedal), particularly against resistance. In most cases X-rays don't show much, as they tend to show bone more than soft tissues. But X-rays may show associated degeneration of the heel bone that is common with Achilles Tendon problems. For example, [<ins class="diffchange diffchange-inline">http</ins>://<ins class="diffchange diffchange-inline">crystaneuenschwande</ins>.<ins class="diffchange diffchange-inline">hatenablog</ins>.com/<ins class="diffchange diffchange-inline">entries</ins>/<ins class="diffchange diffchange-inline">2015/03/25 </ins>heel spurs], calcification within the tendon, avulsion fractures, periostitis (a bruising of the outer covering of the bone) may all be seen on X-ray. In cases where we are uncertain as to the extent of the damage to the tendon, though, an MRI scan may be necessary, which images the soft tissues better than X-rays. When the tendon is simply inflamed and not severely damaged, the problem may or may not be visible on MRI. It depends upon the severity of the condition.<br><br>Nonsurgical Treatment<br><ins class="diffchange diffchange-inline">Wear shoes </ins>with a <ins class="diffchange diffchange-inline">low half-inch to one-inch heel that are somewhat flexible through </ins>the <ins class="diffchange diffchange-inline">ball </ins>of the <ins class="diffchange diffchange-inline">foot</ins>. <ins class="diffchange diffchange-inline">Avoid flat footwear such as slippers or sandals </ins>and <ins class="diffchange diffchange-inline">stiff shoes</ins>. <ins class="diffchange diffchange-inline">Add a heel lift in </ins>your <ins class="diffchange diffchange-inline">shoe</ins>. <ins class="diffchange diffchange-inline">You </ins>may <ins class="diffchange diffchange-inline">also use arch support inserts or orthotic insoles. Heel lifts </ins>and orthotics can <ins class="diffchange diffchange-inline">be purchased at many of our pharmacies </ins>and <ins class="diffchange diffchange-inline">Podiatry departments. Avoid standing or walking barefoot. Perform calf-stretching exercises for 30 </ins>to <ins class="diffchange diffchange-inline">60 seconds on each leg at least 2 times a day. Stand an arm?s length away from a wall, facing </ins>the <ins class="diffchange diffchange-inline">wall</ins>. <ins class="diffchange diffchange-inline">Lean into </ins>the <ins class="diffchange diffchange-inline">wall</ins>, <ins class="diffchange diffchange-inline">stepping forward with one leg, leaving </ins>the <ins class="diffchange diffchange-inline">other stretched behind you. The leg behind you is the one being stretched. Keep this leg straight (locked) and the toes pointed straight at the wall. Stretch forward until you feel tightness in the calf </ins>of <ins class="diffchange diffchange-inline">your back leg. Hold this position without bouncing for 30 to 60 seconds. Repeat for </ins>the <ins class="diffchange diffchange-inline">opposite leg. Do stair exercises every day. Stand facing the stairs with the ball of your </ins>foot <ins class="diffchange diffchange-inline">on a stair </ins>and <ins class="diffchange diffchange-inline">your </ins>heel <ins class="diffchange diffchange-inline">hanging off</ins>. <ins class="diffchange diffchange-inline">Balance on one foot at a time while holding onto </ins>the <ins class="diffchange diffchange-inline">rail. Slowly lower your heel as low as it will drop down and then slowly raise it up as high as you can lift it. Repeat this exercise slowly several times on each </ins>foot<ins class="diffchange diffchange-inline">. Perform this exercise every other day, gradually increasing the number of repetitions over time as tolerated. If you are overweight, talk </ins>to <ins class="diffchange diffchange-inline">your personal physician about resources that can help you lose weight. Carrying excess weight places additional pressure on your feet. Decrease the time that you stand</ins>, <ins class="diffchange diffchange-inline">walk, or engage in exercises that put a load on your feet. Switch </ins>to <ins class="diffchange diffchange-inline">a nonimpact form of exercise until your tendon heals, such as swimming, pool running, and using an elliptical trainer</ins>.<br><br><br>Surgical Treatment<br><ins class="diffchange diffchange-inline">Chronic Achilles tendon tears can be more complicated </ins>to repair<ins class="diffchange diffchange-inline">. A </ins>tendon <ins class="diffchange diffchange-inline">that has torn and retracted (pulled back) into the leg will scar in the shortened position over time</ins>. <ins class="diffchange diffchange-inline">Restoring normal </ins>tendon <ins class="diffchange diffchange-inline">length </ins>is <ins class="diffchange diffchange-inline">usually not </ins>an <ins class="diffchange diffchange-inline">issue when surgery is performed within a few weeks </ins>of the <ins class="diffchange diffchange-inline">injury</ins>. <ins class="diffchange diffchange-inline">However</ins>, <ins class="diffchange diffchange-inline">when there has been </ins>a <ins class="diffchange diffchange-inline">delay of months or longer</ins>, <ins class="diffchange diffchange-inline">the treatment can </ins>be <ins class="diffchange diffchange-inline">more complicated</ins>. <ins class="diffchange diffchange-inline">Several procedures can </ins>be <ins class="diffchange diffchange-inline">used </ins>to <ins class="diffchange diffchange-inline">add length </ins>to <ins class="diffchange diffchange-inline">a chronic Achilles tear. A turndown procedure uses tissue folded down from </ins>the <ins class="diffchange diffchange-inline">top of the calf to add length </ins>to the <ins class="diffchange diffchange-inline">Achilles </ins>tendon<ins class="diffchange diffchange-inline">. Tendon transfers from other tendons of the ankle can also be performed to help restore function of the Achilles. The results of surgery in a chronic situation are seldom as good as an acute repair. However, in some patients, these procedures can help restore function of a chronically damaged Achilles</ins>.<br><br>Prevention<br><ins class="diffchange diffchange-inline">If you're just getting started </ins>with <ins class="diffchange diffchange-inline">your training, be sure </ins>to <ins class="diffchange diffchange-inline">stretch after </ins>running<ins class="diffchange diffchange-inline">, and start slowly, increasing your mileage </ins>by <ins class="diffchange diffchange-inline">no more than 10% per week</ins>. <ins class="diffchange diffchange-inline">Strengthen your calf muscles with exercises such as toe raises. Work low-impact cross-training activities</ins>, <ins class="diffchange diffchange-inline">such as cycling and swimming, into your training.</ins></div></td></tr>
</table>MichealY29http://www.rehime.com.ar/bases/paginasdecine/index.php?title=Dealing_With_Achilles_Tendinitis&diff=11307&oldid=prevJesse8897988 en 20:39 11 jun 20172017-06-11T20:39:47Z<p></p>
<table class='diff diff-contentalign-left'>
<col class='diff-marker' />
<col class='diff-content' />
<col class='diff-marker' />
<col class='diff-content' />
<tr style='vertical-align: top;'>
<td colspan='2' style="background-color: white; color:black; text-align: center;">← Revisión anterior</td>
<td colspan='2' style="background-color: white; color:black; text-align: center;">Revisión de 20:39 11 jun 2017</td>
</tr><tr><td colspan="2" class="diff-lineno">Línea 1:</td>
<td colspan="2" class="diff-lineno">Línea 1:</td></tr>
<tr><td class='diff-marker'>−</td><td style="color:black; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>Overview<br>Achilles tendinitis <del class="diffchange diffchange-inline">is an inflammation (swelling) </del>of the tendon, <del class="diffchange diffchange-inline">which usually occurs as </del>a result of overuse <del class="diffchange diffchange-inline">injury. Basketball players are the most susceptible to Achilles tendinitis because of the frequent </del>jumping<del class="diffchange diffchange-inline">. Any activity requiring a constant pushing off the foot</del>, <del class="diffchange diffchange-inline">such as </del>running <del class="diffchange diffchange-inline">or dancing</del>, <del class="diffchange diffchange-inline">may result in swelling of </del>the tendon.<br><br>Causes<br><del class="diffchange diffchange-inline">When you place </del>a <del class="diffchange diffchange-inline">large amount </del>of stress on <del class="diffchange diffchange-inline">your </del>Achilles tendon <del class="diffchange diffchange-inline">too quickly, it can become inflamed from tiny tears that occur during </del>the <del class="diffchange diffchange-inline">activity</del>. <del class="diffchange diffchange-inline">Achilles tendonitis </del>is <del class="diffchange diffchange-inline">often a result of overtraining</del>, <del class="diffchange diffchange-inline">or doing too much too soon. Excessive hill running can contribute </del>to <del class="diffchange diffchange-inline">it. Flattening of </del>the <del class="diffchange diffchange-inline">arch </del>of <del class="diffchange diffchange-inline">your </del>foot <del class="diffchange diffchange-inline">can place you at increased risk of developing Achilles tendonitis because of </del>the <del class="diffchange diffchange-inline">extra </del>stress <del class="diffchange diffchange-inline">placed </del>on <del class="diffchange diffchange-inline">your </del>Achilles tendon <del class="diffchange diffchange-inline">when walking </del>or <del class="diffchange diffchange-inline">running</del>.<br><br>Symptoms<br><del class="diffchange diffchange-inline">Symptoms of </del>Achilles <del class="diffchange diffchange-inline">Tendinitis include </del>the following. Pain <del class="diffchange diffchange-inline">and stiffness along the Achilles tendon in the morning</del>. <del class="diffchange diffchange-inline">Pain along the tendon </del>or back of <del class="diffchange diffchange-inline">the </del>heel <del class="diffchange diffchange-inline">that worsens with activity</del>. <del class="diffchange diffchange-inline">Severe </del>pain <del class="diffchange diffchange-inline">the day after exercising</del>. <del class="diffchange diffchange-inline">Thickening of </del>the <del class="diffchange diffchange-inline">tendon</del>. <del class="diffchange diffchange-inline">Bone spur (insertional tendinitis)</del>. <del class="diffchange diffchange-inline">Swelling </del>that <del class="diffchange diffchange-inline">is present all </del>the time <del class="diffchange diffchange-inline">and gets worse throughout the day with activity</del>. <del class="diffchange diffchange-inline">If </del>you <del class="diffchange diffchange-inline">have an Achilles tendon rupture, you might feel a pop </del>or <del class="diffchange diffchange-inline">snap</del>, <del class="diffchange diffchange-inline">accompanied by </del>a <del class="diffchange diffchange-inline">sharp pain behind your ankle</del>. <del class="diffchange diffchange-inline">You are likely to have difficulty walking properly</del>. <del class="diffchange diffchange-inline">If you have ruptured your Achilles </del>tendon <del class="diffchange diffchange-inline">then surgery is likely </del>to <del class="diffchange diffchange-inline">be </del>the <del class="diffchange diffchange-inline">best treatment option</del>.<br><br>Diagnosis<br>A podiatrist can usually make the diagnosis by clinical history and physical examination alone. Pain with touching or stretching the tendon is typical. There may also be a visible swelling to the tendon. The patient frequently has difficulty plantarflexing (pushing down the ball of the foot and toes, like one would press on a gas pedal), particularly against resistance. In most cases X-rays don't show much, as they tend to show bone more than soft tissues. But X-rays may show associated degeneration of the heel bone that is common with Achilles Tendon problems. For example, [https://<del class="diffchange diffchange-inline">terrikrein</del>.wordpress.com/<del class="diffchange diffchange-inline">2015</del>/<del class="diffchange diffchange-inline">06/22/help</del>-<del class="diffchange diffchange-inline">for-hammertoes-treatment </del>heel spurs], calcification within the tendon, avulsion fractures, periostitis (a bruising of the outer covering of the bone) may all be seen on X-ray. In cases where we are uncertain as to the extent of the damage to the tendon, though, an MRI scan may be necessary, which images the soft tissues better than X-rays. When the tendon is simply inflamed and not severely damaged, the problem may or may not be visible on MRI. It depends upon the severity of the condition.<br><br>Nonsurgical Treatment<br><del class="diffchange diffchange-inline">The recommended treatment for Achilles tendinitis consists </del>of <del class="diffchange diffchange-inline">icing</del>, gentle stretching, and <del class="diffchange diffchange-inline">modifying or limiting activity</del>. <del class="diffchange diffchange-inline">Nonsteroidal anti-inflammatory medications (NSAIDs), such as ibuprofen or naprosyn, </del>can <del class="diffchange diffchange-inline">reduce pain and swelling. Physical therapy </del>and the <del class="diffchange diffchange-inline">use of an orthosis (heel lift) </del>can <del class="diffchange diffchange-inline">also </del>be <del class="diffchange diffchange-inline">helpful. For chronic cases where tendinosis is evident and other methods of treatment have failed</del>, <del class="diffchange diffchange-inline">surgery </del>may be <del class="diffchange diffchange-inline">recommended </del>to <del class="diffchange diffchange-inline">remove </del>and <del class="diffchange diffchange-inline">repair </del>the <del class="diffchange diffchange-inline">damaged tissue</del>.<del class="diffchange diffchange-inline"><br></del><br><br><br>Surgical Treatment<br><del class="diffchange diffchange-inline">Surgery is considered when non-operative measures fail</del>. <del class="diffchange diffchange-inline">Patient compliance and postoperative management </del>is an <del class="diffchange diffchange-inline">important aspect of </del>the <del class="diffchange diffchange-inline">operative management to prevent ankle stiffness or recurrence </del>of the <del class="diffchange diffchange-inline">symptoms</del>. <del class="diffchange diffchange-inline">Surgery usually requires a removal </del>of <del class="diffchange diffchange-inline">the damaged tissue (debridement) and meticulous repair of the </del>tendon<del class="diffchange diffchange-inline">. Post-operative immobilization is required</del>, <del class="diffchange diffchange-inline"> followed by gradual range of motion </del>and <del class="diffchange diffchange-inline">strengthening exercises start</del>. <del class="diffchange diffchange-inline">It </del>may <del class="diffchange diffchange-inline">require 6 months for </del>the <del class="diffchange diffchange-inline">full recovery</del>. <del class="diffchange diffchange-inline">Some known complication are recurrence, stiffness of </del>the <del class="diffchange diffchange-inline">ankle and deep vein thrombosis</del>.<br><br>Prevention<br><del class="diffchange diffchange-inline">Suggestions to reduce your risk </del>of Achilles <del class="diffchange diffchange-inline">tendonitis include, incorporate stretching into your warm-up and cool-down routines, maintain an adequate level of fitness for your sport, avoid dramatic increases </del>in <del class="diffchange diffchange-inline">sports training, if you experience pain </del>in <del class="diffchange diffchange-inline">your </del>Achilles tendon<del class="diffchange diffchange-inline">, rest the area. Trying </del>to <del class="diffchange diffchange-inline">?work through? the pain will only make your injury worse, wear good quality supportive shoes appropriate to your sport</del>. <del class="diffchange diffchange-inline">If there is </del>foot <del class="diffchange diffchange-inline">deformity or flattening, obtain </del>orthoses<del class="diffchange diffchange-inline">, avoid wearing high heels on a regular basis. Maintaining your foot in a ?tiptoe? position shortens your calf muscles and reduces </del>the <del class="diffchange diffchange-inline">flexibility </del>of <del class="diffchange diffchange-inline">your </del>Achilles tendon. <del class="diffchange diffchange-inline">An inflexible </del>Achilles tendon <del class="diffchange diffchange-inline">is more susceptible to injury</del>, <del class="diffchange diffchange-inline">maintain a normal healthy weight.</del></div></td><td class='diff-marker'>+</td><td style="color:black; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>Overview<br>Achilles tendinitis <ins class="diffchange diffchange-inline">occurs when the band </ins>of <ins class="diffchange diffchange-inline">tissue that connects </ins>the <ins class="diffchange diffchange-inline">calf muscles at the back of the lower leg to the heel bone, the Achilles </ins>tendon, <ins class="diffchange diffchange-inline">becomes inflamed. This condition is </ins>a result of overuse <ins class="diffchange diffchange-inline">from intense exercise, </ins>jumping, running, <ins class="diffchange diffchange-inline">and other activities that strain </ins>the tendon <ins class="diffchange diffchange-inline">and calf muscles</ins>.<br><br>Causes<br><ins class="diffchange diffchange-inline">Short of </ins>a <ins class="diffchange diffchange-inline">trauma, the primary cause </ins>of <ins class="diffchange diffchange-inline">Achilles tendonitis is when the calf muscle is so tight that the heel is unable to come down to the ground placing extreme </ins>stress on <ins class="diffchange diffchange-inline">the </ins>Achilles tendon <ins class="diffchange diffchange-inline">at </ins>the <ins class="diffchange diffchange-inline">insertion</ins>. <ins class="diffchange diffchange-inline">Keep in mind that the calf muscle </ins>is <ins class="diffchange diffchange-inline">designed to contract up</ins>, <ins class="diffchange diffchange-inline">lifting the heel bone off the ground, propelling you forwards </ins>to the <ins class="diffchange diffchange-inline">front </ins>of <ins class="diffchange diffchange-inline">the </ins>foot <ins class="diffchange diffchange-inline">for push off. When </ins>the <ins class="diffchange diffchange-inline">calf is so tight that the heel is prevented from coming down on the ground there will be </ins>stress on <ins class="diffchange diffchange-inline">the tendon and the foot will over pronate causing the </ins>Achilles tendon <ins class="diffchange diffchange-inline">to twist, adding to the stress on the insertion. Improper treatment may lead to a more severe injury, such as a rupture </ins>or <ins class="diffchange diffchange-inline">chronic weakening, which may require surgery</ins>.<br><br>Symptoms<br><ins class="diffchange diffchange-inline">If you have </ins>Achilles <ins class="diffchange diffchange-inline">tendinitis or Achilles enthesopathy, you are likely to experience </ins>the following <ins class="diffchange diffchange-inline">symptoms</ins>. Pain. <ins class="diffchange diffchange-inline">You may notice aching, burning, </ins>or <ins class="diffchange diffchange-inline">tearing pains at the </ins>back of <ins class="diffchange diffchange-inline">your </ins>heel <ins class="diffchange diffchange-inline">or above the ankle</ins>. <ins class="diffchange diffchange-inline">The </ins>pain <ins class="diffchange diffchange-inline">can range from mild to very severe and disabling</ins>. <ins class="diffchange diffchange-inline">It is most noticeable in </ins>the <ins class="diffchange diffchange-inline">following circumstances</ins>. <ins class="diffchange diffchange-inline">After resting</ins>. <ins class="diffchange diffchange-inline">Many people report </ins>that <ins class="diffchange diffchange-inline">pain increases when they first get out of bed in </ins>the <ins class="diffchange diffchange-inline">morning or after sitting for a period of </ins>time. <ins class="diffchange diffchange-inline">After exercise. Pain may increase if </ins>you <ins class="diffchange diffchange-inline">exercise </ins>or <ins class="diffchange diffchange-inline">stand for a period of time. A lump. In some cases</ins>, a <ins class="diffchange diffchange-inline">tender lump can develop at the site of the injured tendon (tendinosis)</ins>. <ins class="diffchange diffchange-inline">Bone spurs</ins>. <ins class="diffchange diffchange-inline">When the injury occurs at the point where the </ins>tendon <ins class="diffchange diffchange-inline">attaches </ins>to the <ins class="diffchange diffchange-inline">foot, a bone spur may develop on the heel</ins>.<br><br>Diagnosis<br>A podiatrist can usually make the diagnosis by clinical history and physical examination alone. Pain with touching or stretching the tendon is typical. There may also be a visible swelling to the tendon. The patient frequently has difficulty plantarflexing (pushing down the ball of the foot and toes, like one would press on a gas pedal), particularly against resistance. In most cases X-rays don't show much, as they tend to show bone more than soft tissues. But X-rays may show associated degeneration of the heel bone that is common with Achilles Tendon problems. For example, [https://<ins class="diffchange diffchange-inline">marlinejaquish</ins>.wordpress.com/<ins class="diffchange diffchange-inline">category</ins>/<ins class="diffchange diffchange-inline">hammer</ins>-<ins class="diffchange diffchange-inline">toes </ins>heel spurs], calcification within the tendon, avulsion fractures, periostitis (a bruising of the outer covering of the bone) may all be seen on X-ray. In cases where we are uncertain as to the extent of the damage to the tendon, though, an MRI scan may be necessary, which images the soft tissues better than X-rays. When the tendon is simply inflamed and not severely damaged, the problem may or may not be visible on MRI. It depends upon the severity of the condition.<br><br>Nonsurgical Treatment<br><ins class="diffchange diffchange-inline">Proper footwear with a strong and secure counter (the heel circumference) may help to encourage heeling </ins>of <ins class="diffchange diffchange-inline">the tendon. A tendinitis will occasionally resolve on it?s own</ins>, <ins class="diffchange diffchange-inline">with rest, ice, and </ins>gentle stretching<ins class="diffchange diffchange-inline">. If symptoms persist for more than 2 weeks</ins>, <ins class="diffchange diffchange-inline">consult your physician. Your physician may suggest physiotherapy </ins>and <ins class="diffchange diffchange-inline">custom orthotics</ins>. <ins class="diffchange diffchange-inline">Physiotherapy </ins>can <ins class="diffchange diffchange-inline">suggest appropriate exercises </ins>and <ins class="diffchange diffchange-inline">modalities to aid in </ins>the <ins class="diffchange diffchange-inline">healing process. Custom orthotics </ins>can be <ins class="diffchange diffchange-inline">very successful in treating the problem</ins>, <ins class="diffchange diffchange-inline">as the original cause </ins>may be <ins class="diffchange diffchange-inline">due </ins>to <ins class="diffchange diffchange-inline">an improper alignment of the foot </ins>and <ins class="diffchange diffchange-inline">heel. Re-aligning </ins>the <ins class="diffchange diffchange-inline">foot to a neutral position may provide an optimal, biomechanically sound environment for healing to occur</ins>.<br><br><br>Surgical Treatment<br><ins class="diffchange diffchange-inline">Treating this surgically, there are numerous methods to repair the tendon</ins>. <ins class="diffchange diffchange-inline"> Most commonly, Achilles tendon </ins>is <ins class="diffchange diffchange-inline">exposed through </ins>an <ins class="diffchange diffchange-inline">incision at </ins>the <ins class="diffchange diffchange-inline">back </ins>of the <ins class="diffchange diffchange-inline">ankle</ins>. <ins class="diffchange diffchange-inline"> After identifying both ends </ins>of <ins class="diffchange diffchange-inline">ruptured </ins>tendon, <ins class="diffchange diffchange-inline">the edges got trimmed </ins>and <ins class="diffchange diffchange-inline">then both ends were sutured together with optimal tension</ins>. <ins class="diffchange diffchange-inline"> To get a better outcome with fixation, an anchor </ins>may <ins class="diffchange diffchange-inline">have to be in place in calcaneus, provided </ins>the <ins class="diffchange diffchange-inline">rupture is very low</ins>. <ins class="diffchange diffchange-inline"> Care must be taken to avoid injuries to </ins>the <ins class="diffchange diffchange-inline">nerves located adjacent to the tendon</ins>.<br><br>Prevention<br><ins class="diffchange diffchange-inline">A 2014 study looked at the effect </ins>of <ins class="diffchange diffchange-inline">using foot orthotics on the </ins>Achilles <ins class="diffchange diffchange-inline">tendon. The researchers found that running with foot orthotics resulted </ins>in <ins class="diffchange diffchange-inline">a significant decrease </ins>in Achilles tendon <ins class="diffchange diffchange-inline">load compared </ins>to <ins class="diffchange diffchange-inline">running without orthotics</ins>. <ins class="diffchange diffchange-inline">This study indicates that </ins>foot orthoses <ins class="diffchange diffchange-inline">may act to reduce </ins>the <ins class="diffchange diffchange-inline">incidence </ins>of <ins class="diffchange diffchange-inline">chronic </ins>Achilles tendon <ins class="diffchange diffchange-inline">pathologies in runners by reducing stress on the Achilles tendon1</ins>. <ins class="diffchange diffchange-inline">Orthotics seem to reduce load on the </ins>Achilles tendon <ins class="diffchange diffchange-inline">by reducing excessive pronation</ins>,</div></td></tr>
</table>Jesse8897988http://www.rehime.com.ar/bases/paginasdecine/index.php?title=Dealing_With_Achilles_Tendinitis&diff=10659&oldid=prevNikiUpchurch597 en 17:44 11 jun 20172017-06-11T17:44:52Z<p></p>
<table class='diff diff-contentalign-left'>
<col class='diff-marker' />
<col class='diff-content' />
<col class='diff-marker' />
<col class='diff-content' />
<tr style='vertical-align: top;'>
<td colspan='2' style="background-color: white; color:black; text-align: center;">← Revisión anterior</td>
<td colspan='2' style="background-color: white; color:black; text-align: center;">Revisión de 17:44 11 jun 2017</td>
</tr><tr><td colspan="2" class="diff-lineno">Línea 1:</td>
<td colspan="2" class="diff-lineno">Línea 1:</td></tr>
<tr><td class='diff-marker'>−</td><td style="color:black; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div><del class="diffchange diffchange-inline">Overview<br>Achilles tendinitis is an inflammation (swelling) of the tendon, which usually occurs as a result of overuse injury. Basketball players are the most susceptible to Achilles tendinitis because of the frequent jumping. Any activity requiring a constant pushing off the foot, such as running or dancing, may result in swelling of the tendon.<br><br>Causes<br>The Achilles tendon is a strong band of connective tissue that attaches the calf muscle to the heel bone. When the muscle contracts, the tendon transmits the power of this contraction to the heel, producing movement. The Achilles tendon moves through a protective sheath and is made up of thousands of tiny fibres. It is thought that Achilles tendonitis develops when overuse of the tendon causes the tiny fibres that make up the tendon to tear. This causes inflammation, pain and swelling. As the tendon swells it can begin to rub against the sheath surrounding it, irritating the sheath and causing it too to become inflamed and swollen. It has a poor blood supply, which can make it susceptible to injury and can make recovery from injury slow. Factors that can lead to the development of Achilles tendonitis include, tight or weak calf muscles, rapidly increasing the amount or intensity of exercise. Hill climbing or stair climbing exercises. Changes in footwear, particularly changing from wearing high-heeled shoes to wearing flat shoes. Wearing inadequate or inappropriate shoes for the sporting activity being undertaken. Not adequately warming up and stretching prior to exercise. A sudden sharp movement that causes the calf muscles to contract and the stress on the Achilles tendon to be increased. This can cause the tendon fibres to tear.<br><br>Symptoms<br>There are several types of Achilles tendinitis symptoms, but all of them are closely related. People who suffer from Achilles tendon pain typically have swelling in the Achilles tendon, and that pain can be chronic as the microscopic tears in the area become more prevalent over time. The most intense pain is typically located just a few centimeters above the area where the tendon meets the heel. This area is called the watershed zone, and the amount of blood moving through it is what gives it the highest potential for injury, especially for athletes. Most of the Achilles tendinitis symptoms in people with the condition will happen immediately after they have been inactive for a fairly significant amount of time. That means that the most pain will generally be felt after sitting or lying down for an extended period, or right after waking up in the morning and getting moving. If you aren?t positive that you are suffering specifically from Achilles tendinitis symptoms, consult a doctor to make sure.<br><br>Diagnosis<br>A podiatrist can usually make the diagnosis by clinical history and physical examination alone. Pain with touching or stretching the tendon is typical. There may also be a visible swelling to the tendon. The patient frequently has difficulty plantarflexing (pushing down the ball of the foot and toes, like one would press on a gas pedal), particularly against resistance. In most cases X-rays don't show much, as they tend to show bone more than soft tissues. But X-rays may show associated degeneration of the heel bone that is common with Achilles Tendon problems. For example, heel spurs, calcification within the tendon, avulsion fractures, periostitis (a bruising of the outer covering of the bone) may all be seen on X-ray. In cases where we are uncertain as to the extent of the damage to the tendon, though, an MRI scan may be necessary, which images the soft tissues better than X-rays. When the tendon is simply inflamed and not severely damaged, the problem may or may not be visible on MRI. It depends upon the severity of the condition.<br><br>Nonsurgical Treatment<br>Make sure that the tendon is not torn through and through. If it is severed, you must see a doctor immediately so that the tendon can be repaired. Severe injuries can sever a tendon, without a skin laceration being present. Testing involves moving the toes and foot to see if the tendon moves. If the tendon does not appear to move, it may be severed (comparing the injured tendon and its movement to the same tendon on the uninjured foot may help). Very sharp pain, a sudden pop, or an obvious gap in the structure of the tendon are all signs of a rupture, and should be seen by a doctor as soon as possible. If there is extreme swelling of the leg, and pain (out of proportion to the amount of trauma received), you may have sustained a vascular injury. A doctor must see this type of injury immediately. If you are not sure, see a doctor. If you have multiple injured areas see a doctor immediately, in order to prevent excessive swelling and pain. If the above exam is negative, then you may proceed with self-treatment. (However, if you are not sure of the extent of your injury, you should consult your doctor immediately). The sooner you begin to treat your injury by following "R.I.C.E.", the better you will feel. Rest is very important. Take off your shoe, get off your feet, and relax. Ice should be applied as soon as possible. Never apply ice directly on the injured area, as the cold may make the pain worse. Ice should be applied close to the injured site, between the heart and the injury, so that as the blood flows under the ice, it will be cooled. This cool blood flowing into the injured area will help to reduce the swelling and pain. Apply the ice, wrapped in a cloth or over an elastic bandage, to the foot for 15 minutes, every 1-2 hours, for up to 3 days after an injury. If the ice is uncomfortable, or causes increased pain, do not continue to use it, and see a doctor. If you have poor circulation do not use ice, as this may cause a serious problem. c. Compression is used to limit swelling, and to give support to the injured area. Compression should be applied to the entire foot, starting first at the toes and working back to the ankle. If it is applied just to the injured area, increased swelling will occur in front and behind the wrapping. Compression should be applied with a 3-inch elastic bandage, beginning around the base of all the toes, and then going around the foot and ankle. Continue over the calf muscle when possible. Compression reduces motion in the injured area and foot, and this decreases the pain, and allows for quicker healing. The bandage should not be so tight that it causes increased pain or throbbing in the toes or foot. It should be comfortable! Do not remove the elastic bandage for the first 12 hours, unless it becomes too tight, or the pain increases, or the toes become pale, blue, or cool. If any of these things happen, immediately remove all bandages, and leave them off for several hours. The normal color and temperature of the toes should return immediately. If not, see a doctor immediately! Continue until the swelling and pain subsides; it could take from several days to several weeks. d. Elevation of the leg will aid in reducing swelling and pain. Blood rushes to an injured area to bring increased blood cells, that aid in healing. Gravity will also force blood to the injured area. Too many cells and too much fluid will apply pressure to the injured nerves and tissues, and cause increased pain and delayed healing. Keep your foot elevated so that it is at least parallel to the ground, or higher if it is comfortable. Do this for at least 48 hours, or until the throbbing subsides, when you lower the leg.<br><br><br><br>Surgical Treatment<br>For paratenonitis, a technique called brisement is an option. Local anesthetic is injected into the space between the tendon and its surrounding sheath to break up scar tissue. This can be beneficial in earlier stages of the problem 30 to 50 percent of the time, but may need to be repeated two to three times. Surgery consists of cutting out the surrounding thickened and scarred sheath. The tendon itself is also explored and any split tears within the tendon are repaired. Motion is started almost immediately to prevent repeat scarring of the tendon to the sheath and overlying soft tissue, and weight-bearing should follow as soon as pain and swelling permit, usually less than one to two weeks. Return to competitive activity takes three to six months. Since tendinosis involves changes in the substance of the tendon, brisement is of no benefit. Surgery consists of cutting out scar tissue and calcification deposits within the tendon. Abnormal tissue is excised until tissue with normal appearance appears. The tendon is then repaired with suture. In older patients or when more than 50 percent of the tendon is removed, one of the other tendons at the back of the ankle is transferred to the heel bone to assist the Achilles tendon with strength as well as provide better blood supply to this area.<br><br>Prevention<br>So what are some of the things you can do to help prevent Achilles Tendinitis? Warm Up properly: A good warm up is essential in getting the body ready for any activity. A well structured warm up will prepare your heart, lungs, muscles, joints and your mind for strenuous activity. Balancing Exercises, Any activity that challenges your ability to balance, and keep your balance, will help what's called proprioception, your body's ability to know where its limbs are at any given time. Plyometric Training, Plyometric drills include jumping, skipping, bounding, and hopping type activities. These explosive types of exercises help to condition and prepare the muscles, tendons and ligaments in the lower leg and ankle joint. Footwear, Be aware of the importance of good footwear. A good pair of shoes will help to keep your ankles stable, provide adequate cushioning, and support your foot and lower leg during the running or walking motion. Cool Down properly, Just as important as warming up, a proper cool down will not only help speed recovery, but gives your body time to make the transition from exercise to rest. Rest, as most cases of Achilles tendinitis are caused by overuse, rest is probably the single biggest factor in preventing Achilles injury. Avoid over training, get plenty of rest; and prevent Achilles tendinitis.</del></div></td><td class='diff-marker'>+</td><td style="color:black; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins class="diffchange diffchange-inline">Overview<br>Achilles tendinitis is an inflammation (swelling) of the tendon, which usually occurs as a result of overuse injury. Basketball players are the most susceptible to Achilles tendinitis because of the frequent jumping. Any activity requiring a constant pushing off the foot, such as running or dancing, may result in swelling of the tendon.<br><br>Causes<br>When you place a large amount of stress on your Achilles tendon too quickly, it can become inflamed from tiny tears that occur during the activity. Achilles tendonitis is often a result of overtraining, or doing too much too soon. Excessive hill running can contribute to it. Flattening of the arch of your foot can place you at increased risk of developing Achilles tendonitis because of the extra stress placed on your Achilles tendon when walking or running.<br><br>Symptoms<br>Symptoms of Achilles Tendinitis include the following. Pain and stiffness along the Achilles tendon in the morning. Pain along the tendon or back of the heel that worsens with activity. Severe pain the day after exercising. Thickening of the tendon. Bone spur (insertional tendinitis). Swelling that is present all the time and gets worse throughout the day with activity. If you have an Achilles tendon rupture, you might feel a pop or snap, accompanied by a sharp pain behind your ankle. You are likely to have difficulty walking properly. If you have ruptured your Achilles tendon then surgery is likely to be the best treatment option.<br><br>Diagnosis<br>A podiatrist can usually make the diagnosis by clinical history and physical examination alone. Pain with touching or stretching the tendon is typical. There may also be a visible swelling to the tendon. The patient frequently has difficulty plantarflexing (pushing down the ball of the foot and toes, like one would press on a gas pedal), particularly against resistance. In most cases X-rays don't show much, as they tend to show bone more than soft tissues. But X-rays may show associated degeneration of the heel bone that is common with Achilles Tendon problems. For example, [https://terrikrein.wordpress.com/2015/06/22/help-for-hammertoes-treatment heel spurs], calcification within the tendon, avulsion fractures, periostitis (a bruising of the outer covering of the bone) may all be seen on X-ray. In cases where we are uncertain as to the extent of the damage to the tendon, though, an MRI scan may be necessary, which images the soft tissues better than X-rays. When the tendon is simply inflamed and not severely damaged, the problem may or may not be visible on MRI. It depends upon the severity of the condition.<br><br>Nonsurgical Treatment<br>The recommended treatment for Achilles tendinitis consists of icing, gentle stretching, and modifying or limiting activity. Nonsteroidal anti-inflammatory medications (NSAIDs), such as ibuprofen or naprosyn, can reduce pain and swelling. Physical therapy and the use of an orthosis (heel lift) can also be helpful. For chronic cases where tendinosis is evident and other methods of treatment have failed, surgery may be recommended to remove and repair the damaged tissue.<br><br><br><br>Surgical Treatment<br>Surgery is considered when non-operative measures fail. Patient compliance and postoperative management is an important aspect of the operative management to prevent ankle stiffness or recurrence of the symptoms. Surgery usually requires a removal of the damaged tissue (debridement) and meticulous repair of the tendon. Post-operative immobilization is required,  followed by gradual range of motion and strengthening exercises start. It may require 6 months for the full recovery. Some known complication are recurrence, stiffness of the ankle and deep vein thrombosis.<br><br>Prevention<br>Suggestions to reduce your risk of Achilles tendonitis include, incorporate stretching into your warm-up and cool-down routines, maintain an adequate level of fitness for your sport, avoid dramatic increases in sports training, if you experience pain in your Achilles tendon, rest the area. Trying to ?work through? the pain will only make your injury worse, wear good quality supportive shoes appropriate to your sport. If there is foot deformity or flattening, obtain orthoses, avoid wearing high heels on a regular basis. Maintaining your foot in a ?tiptoe? position shortens your calf muscles and reduces the flexibility of your Achilles tendon. An inflexible Achilles tendon is more susceptible to injury, maintain a normal healthy weight.</ins></div></td></tr>
</table>NikiUpchurch597http://www.rehime.com.ar/bases/paginasdecine/index.php?title=Dealing_With_Achilles_Tendinitis&diff=3152&oldid=prevKandiceKwt: Página creada con «Overview<br>Achilles tendinitis is an inflammation (swelling) of the tendon, which usually occurs as a result of overuse injury. Basketball players are the most susceptible...»2017-06-09T11:42:58Z<p>Página creada con «Overview<br>Achilles tendinitis is an inflammation (swelling) of the tendon, which usually occurs as a result of overuse injury. Basketball players are the most susceptible...»</p>
<p><b>Página nueva</b></p><div>Overview<br>Achilles tendinitis is an inflammation (swelling) of the tendon, which usually occurs as a result of overuse injury. Basketball players are the most susceptible to Achilles tendinitis because of the frequent jumping. Any activity requiring a constant pushing off the foot, such as running or dancing, may result in swelling of the tendon.<br><br>Causes<br>The Achilles tendon is a strong band of connective tissue that attaches the calf muscle to the heel bone. When the muscle contracts, the tendon transmits the power of this contraction to the heel, producing movement. The Achilles tendon moves through a protective sheath and is made up of thousands of tiny fibres. It is thought that Achilles tendonitis develops when overuse of the tendon causes the tiny fibres that make up the tendon to tear. This causes inflammation, pain and swelling. As the tendon swells it can begin to rub against the sheath surrounding it, irritating the sheath and causing it too to become inflamed and swollen. It has a poor blood supply, which can make it susceptible to injury and can make recovery from injury slow. Factors that can lead to the development of Achilles tendonitis include, tight or weak calf muscles, rapidly increasing the amount or intensity of exercise. Hill climbing or stair climbing exercises. Changes in footwear, particularly changing from wearing high-heeled shoes to wearing flat shoes. Wearing inadequate or inappropriate shoes for the sporting activity being undertaken. Not adequately warming up and stretching prior to exercise. A sudden sharp movement that causes the calf muscles to contract and the stress on the Achilles tendon to be increased. This can cause the tendon fibres to tear.<br><br>Symptoms<br>There are several types of Achilles tendinitis symptoms, but all of them are closely related. People who suffer from Achilles tendon pain typically have swelling in the Achilles tendon, and that pain can be chronic as the microscopic tears in the area become more prevalent over time. The most intense pain is typically located just a few centimeters above the area where the tendon meets the heel. This area is called the watershed zone, and the amount of blood moving through it is what gives it the highest potential for injury, especially for athletes. Most of the Achilles tendinitis symptoms in people with the condition will happen immediately after they have been inactive for a fairly significant amount of time. That means that the most pain will generally be felt after sitting or lying down for an extended period, or right after waking up in the morning and getting moving. If you aren?t positive that you are suffering specifically from Achilles tendinitis symptoms, consult a doctor to make sure.<br><br>Diagnosis<br>A podiatrist can usually make the diagnosis by clinical history and physical examination alone. Pain with touching or stretching the tendon is typical. There may also be a visible swelling to the tendon. The patient frequently has difficulty plantarflexing (pushing down the ball of the foot and toes, like one would press on a gas pedal), particularly against resistance. In most cases X-rays don't show much, as they tend to show bone more than soft tissues. But X-rays may show associated degeneration of the heel bone that is common with Achilles Tendon problems. For example, heel spurs, calcification within the tendon, avulsion fractures, periostitis (a bruising of the outer covering of the bone) may all be seen on X-ray. In cases where we are uncertain as to the extent of the damage to the tendon, though, an MRI scan may be necessary, which images the soft tissues better than X-rays. When the tendon is simply inflamed and not severely damaged, the problem may or may not be visible on MRI. It depends upon the severity of the condition.<br><br>Nonsurgical Treatment<br>Make sure that the tendon is not torn through and through. If it is severed, you must see a doctor immediately so that the tendon can be repaired. Severe injuries can sever a tendon, without a skin laceration being present. Testing involves moving the toes and foot to see if the tendon moves. If the tendon does not appear to move, it may be severed (comparing the injured tendon and its movement to the same tendon on the uninjured foot may help). Very sharp pain, a sudden pop, or an obvious gap in the structure of the tendon are all signs of a rupture, and should be seen by a doctor as soon as possible. If there is extreme swelling of the leg, and pain (out of proportion to the amount of trauma received), you may have sustained a vascular injury. A doctor must see this type of injury immediately. If you are not sure, see a doctor. If you have multiple injured areas see a doctor immediately, in order to prevent excessive swelling and pain. If the above exam is negative, then you may proceed with self-treatment. (However, if you are not sure of the extent of your injury, you should consult your doctor immediately). The sooner you begin to treat your injury by following "R.I.C.E.", the better you will feel. Rest is very important. Take off your shoe, get off your feet, and relax. Ice should be applied as soon as possible. Never apply ice directly on the injured area, as the cold may make the pain worse. Ice should be applied close to the injured site, between the heart and the injury, so that as the blood flows under the ice, it will be cooled. This cool blood flowing into the injured area will help to reduce the swelling and pain. Apply the ice, wrapped in a cloth or over an elastic bandage, to the foot for 15 minutes, every 1-2 hours, for up to 3 days after an injury. If the ice is uncomfortable, or causes increased pain, do not continue to use it, and see a doctor. If you have poor circulation do not use ice, as this may cause a serious problem. c. Compression is used to limit swelling, and to give support to the injured area. Compression should be applied to the entire foot, starting first at the toes and working back to the ankle. If it is applied just to the injured area, increased swelling will occur in front and behind the wrapping. Compression should be applied with a 3-inch elastic bandage, beginning around the base of all the toes, and then going around the foot and ankle. Continue over the calf muscle when possible. Compression reduces motion in the injured area and foot, and this decreases the pain, and allows for quicker healing. The bandage should not be so tight that it causes increased pain or throbbing in the toes or foot. It should be comfortable! Do not remove the elastic bandage for the first 12 hours, unless it becomes too tight, or the pain increases, or the toes become pale, blue, or cool. If any of these things happen, immediately remove all bandages, and leave them off for several hours. The normal color and temperature of the toes should return immediately. If not, see a doctor immediately! Continue until the swelling and pain subsides; it could take from several days to several weeks. d. Elevation of the leg will aid in reducing swelling and pain. Blood rushes to an injured area to bring increased blood cells, that aid in healing. Gravity will also force blood to the injured area. Too many cells and too much fluid will apply pressure to the injured nerves and tissues, and cause increased pain and delayed healing. Keep your foot elevated so that it is at least parallel to the ground, or higher if it is comfortable. Do this for at least 48 hours, or until the throbbing subsides, when you lower the leg.<br><br><br><br>Surgical Treatment<br>For paratenonitis, a technique called brisement is an option. Local anesthetic is injected into the space between the tendon and its surrounding sheath to break up scar tissue. This can be beneficial in earlier stages of the problem 30 to 50 percent of the time, but may need to be repeated two to three times. Surgery consists of cutting out the surrounding thickened and scarred sheath. The tendon itself is also explored and any split tears within the tendon are repaired. Motion is started almost immediately to prevent repeat scarring of the tendon to the sheath and overlying soft tissue, and weight-bearing should follow as soon as pain and swelling permit, usually less than one to two weeks. Return to competitive activity takes three to six months. Since tendinosis involves changes in the substance of the tendon, brisement is of no benefit. Surgery consists of cutting out scar tissue and calcification deposits within the tendon. Abnormal tissue is excised until tissue with normal appearance appears. The tendon is then repaired with suture. In older patients or when more than 50 percent of the tendon is removed, one of the other tendons at the back of the ankle is transferred to the heel bone to assist the Achilles tendon with strength as well as provide better blood supply to this area.<br><br>Prevention<br>So what are some of the things you can do to help prevent Achilles Tendinitis? Warm Up properly: A good warm up is essential in getting the body ready for any activity. A well structured warm up will prepare your heart, lungs, muscles, joints and your mind for strenuous activity. Balancing Exercises, Any activity that challenges your ability to balance, and keep your balance, will help what's called proprioception, your body's ability to know where its limbs are at any given time. Plyometric Training, Plyometric drills include jumping, skipping, bounding, and hopping type activities. These explosive types of exercises help to condition and prepare the muscles, tendons and ligaments in the lower leg and ankle joint. Footwear, Be aware of the importance of good footwear. A good pair of shoes will help to keep your ankles stable, provide adequate cushioning, and support your foot and lower leg during the running or walking motion. Cool Down properly, Just as important as warming up, a proper cool down will not only help speed recovery, but gives your body time to make the transition from exercise to rest. Rest, as most cases of Achilles tendinitis are caused by overuse, rest is probably the single biggest factor in preventing Achilles injury. Avoid over training, get plenty of rest; and prevent Achilles tendinitis.</div>KandiceKwt