Alicias achilles tendonitis by fjwuxn

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									Achilles Tendonitis

Overview
Tendons are thick, fibrous tissues enclosed in a connective tissue sheath that connect muscles to bones.
The Achilles tendon is a combined tendon that connects three calf muscles (gastrocnemius, soleus, and
plantaris) to the heel bone. Achilles tendonitis is the inflammation of this tendon.                          Kim Husband 10/25/07 4:20 PM
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Signs of Achilles Tendonitis
People with Achilles tendonitis experience pain along the back of the ankle, heel, and lower calf
muscle. Typically, the first few steps in the morning are very painful. As the tendon and muscles loosen
up, the pain grows less intense. Increased pain following exercise and periods of prolonged sitting or        Kim Husband 10/25/07 4:21 PM
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when pushing off the toes when walking or running are also common features of Achilles tendonitis. If
you have flat feet or tight calf muscles, you are more likely to develop this condition. A change in          Kim Husband 10/25/07 4:21 PM
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footwear or exercise routines may also be a contributing factor.
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Diagnosing Achilles Tendonitis
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A primary care physician may be the first to evaluate your foot and ankle. He or she will look at
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motion, strength, and signs of swelling. The doctor may find point tenderness and warmth along the
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Achilles tendon, as well as pain with stretching and contracting the calf muscles.
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You may be referred to an orthopedic surgeon or podiatrist, who will further examine your ankle and
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foot and discuss treatment options with you.
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Visiting an Orthopedic Surgeon
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An orthopedic surgeon is a medical doctor who specializes in treating conditions of the bones and
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joints. Orthopedic surgeons provide special hands-on evaluation of your complaints and can develop a
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comprehensive plan that may include further diagnostic tests, prescribed medications, or invasive             Deleted: is commonly found
procedures such as injections or surgeries. A primary care doctor will often be able to recommend an          Kim Husband 10/25/07 4:23 PM
orthopedist who specializes in this type of injury.                                                           Deleted:
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Visiting a Podiatrist                                                                                         Deleted: the patients'
Podiatrists are specialty-care doctors whose training focused on problems associated with the ankle and       Kim Husband 10/25/07 4:23 PM
foot. Podiatrists can make a full and thorough assessment of your condition and offer comprehensive           Deleted: which
care plans. Podiatrists are also trained to perform surgical procedures to the ankle and foot.                Kim Husband 10/25/07 4:23 PM
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You may need a referral from your primary physician to see a podiatrist, so check with your health plan
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and providers before scheduling an appointment.                                                               Formatted: Indent: Left: 0"
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Treatment Options                                                                                             Deleted: modalities and
The treatment of Achilles tendonitis often includes oral anti-inflammatory medications in conjunction         Kim Husband 10/25/07 4:24 PM
with rest, ice, and elevation to decrease swelling. A physical therapist or athletic trainer has additional   Deleted:
treatments that can help reduce inflammation. Shoe inserts, massage, and frequent calf stretching may         Kim Husband 10/25/07 4:24 PM
also help alleviate symptoms of Achilles tendonitis.                                                          Deleted: that is appropriate
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Noninvasive Treatments                                                                                        Deleted: modalitie
After consulting with your primary physician, orthopedist, or podiatrist, you will formulate an               Kim Husband 10/25/07 4:25 PM
appropriate treatment plan together. Your doctor may prescribe pain or anti-inflammatory                      Deleted: the
medications. There are also supportive and therapeutic treatments available to help facilitate healing.       Kim Husband 10/25/07 4:25 PM
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When speaking with your doctor, ask some of these questions:
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   1. How long might it take for the condition to resolve?
   2. What can I do to help my ankle as it heals?
   3. What can I do to prevent this in the future?

Physical Therapy
Your doctor may refer you to a physical therapist (PT) who is specially trained to evaluate joints,
muscles, tendons, and ligaments. At your first appointment, your PT will evaluate your foot and ankle's    Kim Husband 10/25/07 7:27 PM
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range of motion, flexibility, strength, and swelling. He or she will also examine your walking and how
well you are able to balance.                                                                              Kim Husband 10/25/07 7:27 PM
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The initial treatments will focus on exercises and therapies such as ultrasound, electric muscle
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stimulation, and cold therapy to help decrease swelling and improve motion. The focus of your later
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rehabilitation will be on returning full strength and function.
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Your treatment will likely take place two to three times per week for several weeks, and you will be
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instructed on exercises to perform on your own to help speed your recovery.
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Most insurance companies reimburse for physical therapy services if you are referred by a doctor and
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see a therapist that participates in your health plan.
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Visiting a Chiropractor
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Chiropractors are doctors who specialize in conditions of bones, joints and the nervous system. Some
people find relief from visiting a chiropractor in conjunction with other forms of medical intervention.

Some chiropractors only treat problems in the areas of the back and neck, so call ahead to see if
yours treats complaints associated with Achilles tendonitis. If he does, ask these questions:

   1. Have you treated a problem like mine in the past?
   2. If so, how successful was the outcome of the complaint?                                              Kim Husband 10/25/07 4:30 PM
                                                                                                           Deleted: It is important for the patient to
   3. How many follow-up visits will I be required to attend?                                              contact the chiropractor’s office to see if they
                                                                                                           treat complaints associated with Achilles
Massage Therapy                                                                                            tendonitis. Some chiropractors only treat
Massage therapists use different massage techniques to treat muscles and soft tissues to improve           problems in the areas of the back and neck.
                                                                                                           Many times chiropractors require several
circulation, decrease muscle spasm or “knots,” reduce swelling, and improve mobility. Massage can          appointments a week over a fixed amount of
help as you recover from Achilles tendonitis by improving the circulation, tissue extensibility, and       time to treat ailments. If the chiropractor can
                                                                                                           treat your complaint, you may want to ask
flexibility of the Achilles tendon and calf muscles. Consult with your doctor to find out if massage       these questions:
therapy is indicated for your case.                                                                        Kim Husband 10/25/07 4:18 PM
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It is often necessary to pay out of pocket for massage therapy, but check with your insurance company
to see if they offer any discounts or partial reimbursement.

Invasive Treatments
Repeated injury or a one-time stress to the Achilles tendon can result in a tear or rupture of the
tendon. If the tendon is significantly torn or ruptured, an orthopedic surgeon or podiatrist will
surgically repair it. The surgeon will make an incision along the area of the Achilles tendon and
stitch the torn ends back together.
After surgery, you will use a walking cast and crutches to maintain the integrity of the tendon
and keep it positioned for proper healing. Extensive rehabilitation is required following this
procedure to restore normal tissue mobility, flexibility, strength, and function.

When visiting an orthopedic surgeon, you may want to begin by asking the surgeon the
following:

   1. What are the risks associated with the surgery?
   2. What is the success rate for this type of surgery?                                                     Kim Husband 10/25/07 4:19 PM
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   3. How long will my recovery time be after the surgery?

Supportive Products
Ice Packs
Ice works two ways. The cold helps to slow fluid accumulation in the joint and, in turn, relieve
swelling. Ice also acts as a pain reliever.
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                                                                                                             Deleted: A common treatment to reduce pain
Ice packs come in single- and multiple-use varieties. Single-use ice packs are filled with dry               and swelling associated with many different
chemicals you activate by squeezing the pack. These are often used by athletic trainers and first            injures is application of ice. When the Achilles
aid responders. Once squeezed, the pack stays cold for about an hour and is then discarded.                  tendon is injured, a signal is sent to the brain
                                                                                                             that your body needs help. The body sends
Multi-use packs are refillable with ice or are packaged with gel you can refreeze for repeated use.          extra fluids to the area to help speed up the
                                                                                                             healing process, but significant or prolonged
                                                                                                             swelling will decrease your range of motion
Orthotics                                                                                                    and strength and contribute to pain and muscle
Orthotics are types of shoe inserts you can wear to help reduce the strain on the joints. They help to       spasm. Ice works two-fold. The cold of the ice
cushion the feet, relieving stress on the foot, muscles, and tendons supporting them. Orthotics also help    helps to slow down how much fluid
to keep the foot and ankle in a proper anatomical position and help to reduce the chance of re-injury, or    accumulates in the tissues and, in turn, relieves
                                                                                                             swelling. Ice also acts as a pain reliever,
further injury, while maintaining proper biomechanical forces and alignment. Orthotics may be                helping to reduce or eliminate pain impulses to
recommended for individuals with flat feet or high arches. They can relieve irritation associated with       the brain. Ice packs come in single and
                                                                                                             multiple use varieties. Single-use ice packs are
Achilles tendonitis.                                                                                         filled with dry chemicals, activate when
                                                                                                             squeezed by the hand, and are often used by
Generic, off-the-shelf shoe inserts are an inexpensive way to determine if orthotics might be helpful.       athletic trainers and first aid responders. Once
Because everyone’s anatomy differs, custom-made orthotics are designed for comfortable wear and              the ice pack has been squeezed, it stays cold
                                                                                                             for about an hour and is then discarded. Multi-
maximum benefit to your anatomy.                                                                             use packs are refillable with ice or are
                                                                                                             packaged with gel that is able to be refrozen
                                                                                                             for continued use.
Night Splint
You can wear a special splint at night to help the Achilles tendon heal. It can be made of hard plastic      Kim Husband 10/25/07 4:33 PM
or come in the form of a “sock” splint, which is less cumbersome and more comfortable for some.              Deleted: that can be worn …thus
Night splints position the foot in a way that stretches the calf muscles and Achilles tendon while you       it…These …and                         ... [1]
sleep. This prolonged stretch can help reduce pain and swelling of the tendon.                               Kim Husband 10/25/07 4:35 PM
                                                                                                             Deleted: … …specific to the patient’s … for
Heel Lift                                                                                                    maximum benefit                       ... [2]
A heel lift is a wedge-shaped shoe insert you wear under your heel. It adjusts the angle of the rear foot,   Kim Husband 10/25/07 4:34 PM
which relieves pressure and stress on the arch of the foot and the Achilles tendon. Heels lifts              Deleted:
redistribute body weight, assist with mobility, and can stabilize your balance when you walk.                Kim Husband 10/25/07 4:36 PM
                                                                                                             Deleted: S…s…are made for use …These
                                                                                                             splints… …the individual…s…and t ... [3]
Air Heel Brace
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An air cast called an air heel brace can help reduce pressure on the heel and Achilles tendon during
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                                                                                                                                              ... [4]
weight-bearing activities. You wear this brace like a sock with an adjustable strap that allows you to
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secure it around your ankle and foot. It contains air cells under the heel and arch of the foot that
                                                                                                             Deleted: is available to… …T…is worn …it
provide gentle compression and support to the foot, relieving pain and inflammation.                         to be comfortably …secured …the    ... [5]
Lotions and Creams
Analgesic lotions and creams are formulated with medicines that help to relieve pain and swelling.
You apply them directly to the pained area. Some products cause a warming sensation when applied,            Kim Husband 10/25/07 4:39 PM
                                                                                                             Deleted: and lotions are
helping to relax the muscles and tissues in the pained area, relieving pain. Applying lotions with
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massaging strokes can also help reduce pain and swelling.
                                                                                                             Deleted: They are meant to be applied
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You generally apply creams up to six times a day. They are usually inexpensive, and you can use
                                                                                                             Deleted: are “heated” or
them in conjunction with oral medications or when you cannot tolerate taking anti-inflammatory
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medicines.
                                                                                                             Deleted: . This is beneficial to the injured
                                                                                                             area because the heat of the cream helps
Workout Suggestions                                                                                          Kim Husband 10/25/07 4:40 PM
Working closely with your doctor and a physical therapist will ensure that you perform the correct           Deleted: When lotions are applied
exercises at the various stages of healing. Frequent, gentle stretching of the calf muscles and Achilles     Kim Husband 10/25/07 4:40 PM
tendon throughout the day is very helpful for recovery. Non-weight-bearing exercises such as                 Deleted: , they
swimming and stationary bicycling may help restore motion and reduce pain at the ankle. Avoid any            Kim Husband 10/25/07 4:40 PM
activities that increase your pain, particularly high-impact activities that may aggravate this condition.   Deleted: be beneficial in reducing
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                                                                                                             Deleted: C
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