Achilles Tendonitis tennis elbow therapy exercises pdf be difficult to treat with no single approach being effective on its own. We outline a step by step approach to treatment and rehabilitation. Treatment for acute injuries includes rest and application of ice or cold therapy to reduce pain and inflammation. More chronic injuries may respond better to heat treatment with a strict 12 week heel drop exercise program which has been shown to be effective.
Decreasing pain and inflammation We recommend seeking professional advice before attempting any self help treatment. The aim of rehabilitation is to decrease the initial pain and inflammation, improve calf muscle flexibility and strength, re-establish joint co-ordination and gradually return to full fitness. The first stage of treatment for achilles tendonitis is to decrease pain and inflammation so normal daily activities such as walking can be done pain free. If acute Achilles tendonitis is allowed to become chronic it can be very very difficult to cure.
Cold therapy can be applied for 10 to 15 minutes at least three times a day. Every two hours if possible for the first day then gradually reduce the frequency as symptoms improve. Ice can be used in a wet tea towel or reusable hot and cold gel packs are ideal as they are much less messy and can be used for applying heat later in the rehabilitation process. Taping the Achilles tendon can help reduce the load on the tendon and relieve pain. Strips of elastic tape go from the top of the calf muscle and pass under the heel and can be beneficial in the early stages where the aim is to rest the tendon as much as possible as well as when returning running.
See video on achilles tendon taping. Place a heel lift or heel cup of about 1cm into both your shoes to raise the heel and help take the stress off the tendon. Do not leave it there forever though as the calf muscles may adaptively shorten over time and an increased strain will be placed on the Achilles tendon in the future. Anti-inflammatory medication such as ibuprofen can be taken under a Doctors advice. This may help in the short term to reduce inflammation and pain of acute Achilles tendonitis although there is no proof long term the medication can help and may even inhibit healing. Electrotherapy such as ultrasound applied by a professional therapist can also help reduce pain and inflammation and providing a micro massage effect to the tissues.
Sports massage can help mobilize the tissues of the tendon and relax the calf muscles. Identifying causes Identify the cause of the injury. Training too much too soon, training on hard surfaces, wearing the wrong shoes or shoes that are too old and not warming up are possible reasons for the injury occurring. Also, if you overpronate, the Achilles is twisted putting more strain on it. Training habits should also be looked at. Read more on causes and prevention. Improving flexibility Once you can perform daily activities pain-free, move on to this stage.
Concentrate on improving the flexibility of the calf muscles. This will help to reduce the strain on the Achilles tendon. Stretching exercises – two calf stretching exercises in particular are important, one with a straight leg for the gastrocnemius muscle and one with the leg bent to target the soleus muscle. Stretching should be done regularly, three times a day initially and should be maintained long after the injury has healed to prevent the injury returning.
The plantar fasciitis night splint is excellent for helping to stretching the calf muscles and Achilles tendon. It is worn over night and helps prevent the calf muscles from tightening up, something they are prone to do over night. The Achilles is likely to be a lot less sore the following morning. Sports massage applied directly to the tendon may help prevent adhesion’s forming within the tendon.
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