Treatment Achilles Tendon

Injury Management - Hot or Cold
As massage therapists a question we are commonly asked is whether you should apply heat or cold to an injury or sore/tight area. The general consensus is that you should use cold on acute injuries and heat may be more appropriate for chronic injuries.

Acute injuries are sudden injuries and usually the result of an impact, a fall or a sprain. The cause of an acute injury is normally fairly clearly (or at least the time the injury occurs is apparent). The common signs of an acute injury generally include pain, swelling, tenderness at injury site and heat/redness.

A chronic injury tends to be slower to develop with no one single event triggering the injury. The injury is longstanding although may come and go. Typically it is the result of long term overuse but can also be the end result of an inadequately treated acute injury.

Hot or Cold?

Quite simply, acute injuries need to be treated with ice as it reduces inflammation at the injury site. When combined with compression, cold therapy initially constricts the blood vessels and reduces the amount of blood that can reach the injured area. This also has the outcome of limiting any bleeding at the site of the injury. Another benefit of cold therapy is that cold can decrease muscle spasm, reducing sensitivity to stretching.

The reduced swelling from using cold therapy allows greater movement in the injured muscle/joint and so reduces the functional loss related to the injury. The swelling associated with the inflammatory response may also produce an increased pressure in the tissue, leading to the area becoming more painful. This pain is believe to be intensified by chemicals that are released into the blood when tissue is damaged and so vasoconstriction from applying ice also decreases pain.

Normal procedure is to apply ice, wrapped in a towel or something similar (ice should not be left directly applied to the skin) for around 10-15 minutes at a time. The temperature at the injury site is then permitted to return to normal and then the ice is reapplied. This ice-on ice-off procedure can be repeated, for up to a couple of days for particularly nasty acute injuries. A form of ice that adapts to the shape of the injured area works best (hence the common suggestion of a packet of frozen peas wrapped in a tea towel). Leaving the ice on for too long can result in ice burns/frostbite and the Hunting Response may result.

Application of ice is also useful in dealing with chronic injuries in athletes who are in training. For example, an athlete with a condition such as mild Achilles tendonitis who chooses to continue exercise may wish to ice the area after training (same 10-15 minutes on /off protocol applies).

Conversely heat is generally indicated in the treatment of chronic injuries. The application of superficial heat to an injured area can increase the flexibility of muscles, tendons and ligaments and also reduce any muscle spasms. The exact mechanism by which heat can reduce pain is not entirely clear although hypotheses are that heat inactivates nerve fibres or that heat may induce the release of endorphins.

Heat seems to work best for untightening muscles and improving flexibility. Blood flow increases in the heated areas of the body because the heat can relax the walls of the blood vessels. It is for this reason that it is generally not recommended to apply heat to an area that is already inflamed.

Moist heat is normally best and can be as simple as taking a bath or shower. Wet towels can also be used (but please ensure that the temperature is not too high as to cause burns). Never fall asleep when using any form of heat therapy.

As with any injury management, if excessive pain and discomfort persists after around 48 hours, then please consult your health professional.

Frequently Asked Questions

  1. QUESTION:
    Achilles tendon treatment?
    surgical via conservative treatment

    • ANSWER:
      I tore my achilles playing basketball & had surgery at the end of April '06. I began physical therapy 3 months after the surgery. I am still recovering, but played a little football in November, so I am doing fairly well. The type of treatment depends on what you want to do. Surgery is painful for about 2 weeks, but there is less of a chance that you will re-injure yourself. If you want to be active surgery is the way to go because it provides more reinforcement, that is if you had a tear. I am glad I did it, but I had a cast put on after the surgery... there are other options where you do not have a cast put on, but need to be really really careful not to retear it. It's a tough call.. good luck

  2. QUESTION:
    What is the treatment for achilles tendons that have become thickened?
    I have been having problems with both of the achilles tendons for a while now. Can hardly walk at times. They are thck and lumpy. Went to the doctor she told me to stop wearing high heels......I wish.
    Anyone had similar problems. No silly answers please.
    Can i clarify that i don't wear high heels...i usually wear flats.

    • ANSWER:
      Comfrey oil (symphytum officinale) is excellent for tendon problems and speeds healing. You can buy the infused oil in most health food stores, it should be a green colour. Rub into the ankles twice a day and you should experience relief within a couple of weeks. Try and stretch the feet and ankles for 10mins each day too, just rotate the ankles as far as possible in all directions.

      Best wishes.

  3. QUESTION:
    What is the best treatment for short achilles tendons in a 22 month old?
    My 22 month old daughter has congenitally short achilles tendons. Is this a mild form of clubfeet? What is the best treatment for this condition? I have heard of physiotherapy, night splints and plaster castings.

    • ANSWER:
      Plaster casting workd very well, it has 3 or 4 casting phases by slowly stretching the tendons, then they might put some orthopedic braces on for a while, last resort is the actuall surgery of extending the cord or of clipping it to reduce strain, but they wouldnt recommend that till the child is much older. my son was born premature and went through the same things, he is now 14 and walks almost perfect its a long ride but worth it. and lots of physical therapy and learning how you can do the stretches on his leg that he needs, I truely hope this helps.

  4. QUESTION:
    best treatment for a torn achilles tendon and sprained foot?
    my right foot is sprained and the achilles tendon is tore badly enough that the DR said its threatening to rupture. what are good treatment measures to reduce pain and speed healing??
    i dont run or jog or play sports(i wish), im a stay at home mother, and where they said stay off it and only walk with crutches, i just cant, i have a 3 and a 1 yr old, crutches and toddlers dont mix.

    • ANSWER:
      With a torn achilles, speed healing simply isn't an option. I know it's tempting, but DO NOT run on it or you could put yourself out of sports (or just about anything involving moving) for anywhere from 6 weeks to a year. The achilles tendon can end up being a very serious (although non-life threatening of course) injury. There honestly isn't much you can do to speed the healing and block out pain aside from Ibuprofen, which is more for pain than anything.

      EDIT: Oh, I was assuming it was a running injury, since that's how practically all achilles tendons are injured. I wouldn't know anything in that case.

  5. QUESTION:
    What are the symptoms and treatment for achilles tendon partial tear?
    I am a fifteen year old athlete who plays lacrosse and gymnastics. Two weeks ago i landed on the front of my foot while doing a backflip. It didn't hurt but it felt weird. Two days later i ran a mile. The next morning i could not walk without pain in the back of my ankle and heel. I still cannot run or walk without pain or rise up on my toes. I have been continuing to run and play lacrosse since i hurt it. Do i need to see a doctor and/or stop playing? Options that don't include sitting out would be the best.

    • ANSWER:
      im recovering from a fully ruptured achilles. its not fun its been 5 months and i got a few more before im 100% again. you should really see a doctor and hope that its just a sprain.

  6. QUESTION:
    Without surgical treatment, could I have torn my achilles tendon further since the MRI?
    I tore my achilles tendon about a month and a half ago. It really hurts. I've been going to a podiatrist and he said that I didn't need surgical treatment. I've been in a walking boot since then and the pain hasn't eased a bit! The Dr. did a MRI of it and said it was just a little tear and the "fibers" around the tendon were completely torn. Could I have torn my achilles tendon further? What should I do? All the treatments aren't helping and I'm tired of taking pain medication.....Thank you!

    • ANSWER:
      If on MRI, it was just a little tear as you say, it should have healed in 6 weeks. However, you should not have walked on it with that boot cast. Conservative treatment of torn TA's will consist of putting you in a long leg cast with your ankle in a tiptoe position to allow the fibers to heal. You need to stay in the cast for at least 6 weeks followed by supervised physiotherapy until your TA is fully healed and functional. You should have seen an orthopedic surgeon who is in a better position to treat you rather than a foot "expert".

  7. QUESTION:
    what treatment should I use for a sprained achilles tendon?

    • ANSWER:
      Rest, Ice, Compression, Elevation is recommended for almost all injuries. Ice the are for 20 minutes on and 20 minutes off for about the next hour or 2. This should help keep the swelling down. Stay off the foot. You do not want to tear the achilles tendon. That is very painful. However, I do believe that you should go see a doctor. It's important to know what grade sprain you have, so you can treat it in the best possible way.

  8. QUESTION:
    I have a swollen achilles tendon w/ no pain but the swelling wont go down?
    I have swelling around the achilles tendon but no pain. IT has been swollen for months but doctors have no answer or treatment. Ive iced it as much as I can and used support while any activity but the swelling wont go down....... im not sure what to do? the problem is there is no pain just swelling but the swelling fluctuates. so im not sure what to do.... any suggestions?

    • ANSWER:

  9. QUESTION:
    Achilles Tendon that has been going on for a while?
    7 years ago I hurt my Achilles Tendon. I don't know if I actually tore it, but I limped constantly for about 15 months and have had problems (on and off) ever since. Does anyone know what the treatment for this is? I know 7 years is a long time for it to be going on, but I have always made excuses as to why I could not see a doctor. But I don't think I can make anymore excuses - it hurts!

    • ANSWER:
      this is a difficult one to answer without seeing you but there is the obvious answer just to go to the doctor and have them check this out. Then there is another answer that might help you if you give it a chance. It is called the 180. This number stands for the number of repetitions that have to be done between the two legs for a specific exercise for the tendon. You do not start off doing all of this number but just one set of fifteen per leg. Stand on the edge of a step or 2x4 board with the ball of the feet near the edge. Rise up on both toes as high as possible and starting with the non-injured leg do this movement. The heels are raised up as high as possible and you take the injured foot off the step and slowly lower the remaining heel down as far as it will go. Now to return to the starting point use the other leg to elevate the feet to the starting position. Do that fifteen times and then do it one more set on the good leg. Now reverse the positions of the feet so that the injured foot is now in the work position. Slowly lower it down and have the good leg return the feet to the starting position. Attempt to get to fifteen and stop there for the day. Then the next day try it again and as it becomes easier for the injured leg add another set until you have are doing six sets per leg. The tendon at that point will be strong enough to handle most activities. For a specific examination if there are any questions see a doctor, orthopedist, or podiatrist about this problem.

  10. QUESTION:
    how long does tendinitis....pulled Achilles tendon..take to heel? the best treatment? can it b chronic prob?
    im a waitress and i pulled mine in august. just recently went to the doctor...a generalist...he gave me something for the pain and a gel for the imflammation. would like to get back to running but it still hurts. after work i wind up limping.....desperate as i need to run for my mental sanity.

    • ANSWER:
      Since you have had the injury since August it is more of a tendonitis than a strained tendon. I'd stay on the meds you were given and try to warm it up first with something nonimpact (bike or eliptical runner) for 5 minutes or so. Then start some long slow painfree stretching. Like five to ten stretches with each held for at least 30 seconds. Don't make it hurt. If you do it will just stay inflamed. Many people use heat before exercise and ice afterwards with some success. One important factor to remember is that you have two muscles that run through your achilles tendon. Your Gastroc and your Soleus. Your Gastoc attaches above your knee and is best stretched with your knee straight. Your soleus attaches below your knee and needs to be stretched with your knee bent. 10 PAINFREE stretches (5 each) per hour you are awake. If you aren't stretching enough to bug you then you aren't stretching enough. Another good test is to sit on the floor with your legs straight out infront of you. Using only your legs muscles pull your toes back towards you are far as you can without increasing your pain. They should be even. If not, keep stretching. This can be a chronic problem if not addressed.

  11. QUESTION:
    I pulled my Achilles awhile ago now im playing basketball but it really hurts any treatment suggestions?
    I sprained both my ankles last year and pulled my achilles tendon and have tendinitis. The suicide drills really hurt, so do some defense drills. I don't know if I should even be doing some of it. please,any help?

    • ANSWER:
      you should not be playing until you see an orthopedic surgeon. if you tear a tendon, it,s gonna be painful, and a long recovery. i had a torn meniscus. before i got to the doc, i had to use crutches. i wish i was clever enough to go before a total melt down. oh, well. that,s how we learn. the ortho doc was a blessing.

  12. QUESTION:
    Is there any self-treatment for tendinitis in my achilles?
    I'm a dancer and I'm not sure but I might have tendinitis in my Achilles tendons. They are very uncomfortable especially when I don't warm up my ankles a lot before I go on pointe and sometimes they hurt even when I just pointe my foot. Im trying to heat and ice them but is there anything else I can do?
    what sort of band?

    • ANSWER:

  13. QUESTION:
    Untreated Achilles Tendon Rupture in Cat?
    My cat has a full achilles tendon rupture, but the vet refuses to operate on her because of her age. The leg is now lame, but doesn't seem to be causing her any pain. The vet essentially said that my cat ought to be dying soon, (she's 18 years old). Even though she is incredibly healthy and does not seem to have any other problems.

    What should I do? Seek alternate treatment, or leave her as is? Does it hurt her?

    • ANSWER:
      That is an unusually response from your vet, some cats live a lot longer than 18 years so some treatment would seem worthwhile. I guess the question might be whether the vet thinks the operation would be successful, if not the vet probably doesn't want to put the cat through the risk of an operation. If the cat isn't in pain but can still get around okay the vets advice might be reasonable. If it was me I'd take the cat to another vet for a second opinion, just to make sure.

  14. QUESTION:
    Achilles Tendon - been going on for a while?
    7 years ago I hurt my Achilles Tendon. I don't know if I actually tore it, but I limped constantly for about 15 months and have had problems (on and off) ever since. Does anyone know what the treatment for this is? I know 7 years is a long time for it to be going on, but I have always made excuses as to why I could not see a doctor. But I don't think I can make anymore excuses - it hurts!

    • ANSWER:
      You sound as if you have a detached achilles tendon. This means the tendon has become detached from the bone and can be reattached with a simple surgery. You would be in a cast for around 6 weeks but no more pain or limping. Go see the Doc.

  15. QUESTION:
    Achilles tendon and walking boot?
    I was put in a walking boot for super delayed (6 months) treatment of a Lisfranc sprain on my right foot. I started using the boot today, and my foot felt fine. However, the right back side of my ankle, where I'm guessing in the Achilles tendon, is starting to feel very sore.

    Is this because I'm not used to the boot? Or has anyone else ever experienced this?

    • ANSWER:
      I recently had surgery on my Achilles tendon and big toe (both on the right foot) and spent some time in the walking boot. I had no problems with my boot because my doctor gave me a boot one size bigger than I would wear for my shoe.

      The pain in your Achilles tendon could possibly related to trying to adjust to the walking boot, but it's also possible that they may need to change the size of the boot.

      It is also possible that the Achilles tendon is reacting to the time of the delayed treatment of the Lisfranc fracture (an example only).

      I would recommend getting back in touch with the surgeon to let them know what's going on.

  16. QUESTION:
    Achilles tendonitis treatment?
    Over the last 2 weeks, i have had a small swelling on the back of my achilles tendon which seems to be over a firm small lump on the tendon itself, it has also been making creaking noises when i move my foot.
    I am aiming to run a half marathon end of march, so this is very frustrating. Although i can run without too much discomfort, it gets stiff and slightly sore after running, so i have almost completely stopped running to allow it to heal, but with little change.
    I have read that achilles tendonitis can become a permanent problem if not treated properly.
    Can i keep running? and how can i get rid of the problem fast?

    • ANSWER:
      no way to get rid of it fast, consider therapy and possibly extracorporeal shock wave

  17. QUESTION:
    Pain in my achilles tendon?
    I have pain in my achilles tendon, but i didn't do anything wrong to it. I jumped off the stairs because i was falling but i felt ok. But when i walk i get pain in the achilles area. I found that i get a shock of pain when i curl my toes (like scrunch them) the pain shocks to the achilles area. What could be wrong? And what could be the treatment?

    • ANSWER:
      you might want to go get your feet checked out by a doctor-- it sounds like a tendon/ligament thing(since your toes affect it) and your arch might be messed up and it might help to get orthotics or something

  18. QUESTION:
    Achilles tendon rupture, please help?
    I ruptured my achilles tendon last week and I am currently in a cast, waiting for an MRI. Im weighing the options between normal casting for treatment or opting for surgery. Does anyone know how long the surgery lasts for and how long the hospital stay is? Thank you in advance

    • ANSWER:
      surgery takes about an hour and is an outpatient procedure

  19. QUESTION:
    My achilles tendon hurts...?
    Hello, i am an active runner and i have noticed that my achilles tendon has started hurting a pretty good bit. I can deal with it when running on flat terrain, but walking down stairs SUCKS, and running up/down hills makes it hurt. Our team takes ice baths every tuesday and thursday, in pretty frigid water, but it doesn't seem to be doing much. Any ideas of what it is and what i should do for treatment?

    • ANSWER:
      You have to give it rest and time to self heal. You can't allow weight bearing activities, as this only aggravates the condition and delays recovery.

      Ice only keeps the swelling down, but does not play a signfiicant role in rehab

      Good luck.

  20. QUESTION:
    After casts have been removed what other rehabilitation treatments are used for a ruptured Achilles tendon?
    I am a 65 year old Diabetic and two weeks ago I ruptured my Achilles tendon in a fall. Fortunately, I was able to see an orthopedic specialist within and hour-and-a-half after the accident. After viewing
    x-rays he set my leg in a cast (which extends from my foot to my thigh). Due to my age and medical condition (possibility of an infection) he felt that surgery wasn't a good idea. I am to remain in this cast for four weeks when it will be removed and replaced with a cast from knee to foot. Two weeks later that cast will be removed and replaced with a walking cast. So after two months I will
    be " cast free". What is the next step - he said something about a boot? My concern is that I was due to go on a vacation in Canada five days after the last cast is removed. All the doctor said is that
    I won't be too mobile. If you can let me know about the rehabilitation process it will allow me to make a more intelligent decision as to whether I should go on the trip and use a walker.
    I understand that each patient is different,

    • ANSWER:
      I will tell you that achilles are NO easy rehab;; your doc is truly going the right way;; even if you didn't have diabetes (but I guess you can say that he knows the extent of the tear more than I);; you have a better chance of this coming out 'real' if you heal yourself rather than surgery..but ya gotta do it the right way & trust me, your doc knows how;; the problem here is that you don't;; best piece of advice I can give you is to follow your doc's orders to the tee; not a bad idea to write down questions & ask @ the follow up, or even give the office a call every 2 wks for an update if no follow ups;; the tissues need to heal;; tissues take ~ 6wks if everything goes welll; your doc is gonna be a little conservative with you BECAUSE of your level of diabetes;; take that cast off before it's time & you will not heal properly;; any time you move your leg, your achilles is involved..so that is why he is going with these different castings..they limit movement during the stages of healing that will apply to how the adhesions are building @ this injury site;; & yes, when all's said & done, he will give you a 'boot' (looks like an astronaut boot)...it's actually yet another bracing device but allows you to weight bear without too much agitation to the ankle;; re-hab..well, that's where YOU are gonna be doing all the work..the toughest part;; remember that these adhesions (or scar tissue, like a 'scab') is building up over time to repair you;; they get tougher & tougher as time goes on;; since you do not heal normally (diabetic), these adhesions will not be played with until you start rehab (under doc's orders when you actually start);; the idea behind this is to defray some of the excess scar tissue that has built up in the area of injury so you can actually move the part @ that time;; painful & timely;; THAT, you'll have to be home for cuz you'll have appts 2-3 x's/wk for PT;; you also may want to be thinking more crutches by the time you get to the boot...& you can even now build your upper extremities & upper trunk muscles to get you around easier;; I would schedule the trip to canada either sooner or about 1-2 months later to actually enjoy it..good luck, hope this isn't too long..but you have an experience when that last boot comes off..again, that is where the hard work for you really beings...

  21. QUESTION:
    Achilles tendon injury running xc? Should I be worried?
    I started running cross country this year and about a week into it I sprained my right hip. It's not been about 6 weeks since the injury and it's not getting any better. I have been seeing the athletic trainer who has been giving me ultra sound treatment and some sort of electrode treatment. That hasn't been working either so now I'm going to physical therapy for a steroid treatment on top of it. Also, about a week ago the left side of my hip started hurting. The trainer said that's just because I was favoring my left side. I was told I could run as much as I wanted as long as I could tolerate the pain because I wasn't doing any damage. The problem is, now all the sudden, starting a few days ago, the achilles tendon in my left leg is sore. Is this something I should bring up with the trainer and/or physical therapist? I have about 3 weeks left of the season. Would it be bad to run until its over?
    Thanks.

    • ANSWER:
      One thing that I can tell you for sure, is that it really could be a bad thing for you to finish the last 3 weeks of the season. I can't say that it WOULD be bad, but let me tell you something... YOU DO NOT WANT TO END UP WITH A SERIOUS PROBLEM WITH YOUR ACHILLES!!!! Tendons once they develop a problem, can really turn into something that can be really hard to get rid of. Especially the achilles tendon, it has to bear so much strain by design. In order to use it properly, you have to put enormous amounts of stress on it and it really does have to be in top notch shape if you are planning on doing ANYTHING athletic with it.
      Let me tell you, it's not worth a measly 3 weeks of a running season to screw up your achilles. It'd be one of the worst mistakes of your life if you kept on running and ended up causing a problem that could last a long, long time. The achilles isn't like pulling a hamstring, or something in the belly of a muscle. You can keep going through those injurys and they usually end up being just fine even if you abuse them some before they heal. But take my word for it, I speak from experience... You don't want to mess around with that tendon. Achilles' are notorious for not healing and once they get bad, they can stay that way. And even if a once chronically injured achilles does heal, it won't be 100% and will always be more susceptible to re-injury when pushed hard and there's just too many things that you'll have to use that tendon for. I've had problems with my achilles' for 3 years now and if I had known what I know now back then, I would have treated my initial achilles injury like a LIFE OR DEATH SITUATION, no joke!
      If that injury is giving you problems, even if they are small problems, then I would back out of the last part of the season. Don't worry about a few weeks, worry about the rest of your life. Good luck.

  22. QUESTION:
    Achilles tendon bruise?
    I was wearing a pair of heels to a job interview, and they turned out to be pretty uncomfortable. There is a strip that curves around the ankle that is made of a hard material, and it was a little tight. When I was walking, I think the strap was repeatedly chaffing across the skin.

    Last night I found that I had a dark pink sore spot on the bank of my ankle, and this morning it has been really hurting. It is hard to walk on it, and the pain is pretty sharp. I was wondering what this might be, and it looks like it's a bruise on the achilles tendon, from my online searches.

    Does anyone have any information about this? How bad is it? Could this happen from wearing heels? How long does it take to recover? Treatment? Any advice would be great. Thanks a lot, this has been the worst.

    • ANSWER:
      Hello,

      First of all I am sorry that you have this pain, it must be extremely frustrating.

      However, from your description it is very hard to determine exactly what is wrong with your heel/Achilles. It sounds like a bruise/blister.

      Here is what you should do:

      1) In general you should be completely resting your injured foot - Don't wear a show with a back and keep the injury clean

      2) Ice your heel at least 4 times a day, either by applying ice directly or by rolling a frozen bottle under/behind your heel when you sit down.

      3) If you can massage it, then do so lightly to help with healing.

      Now, In order to understand your condition better and to give you a better diagnosis please answer these questions:

      1) Is it sensitive to the touch/press on it?
      2) Where exactly is the pain located in your Achilles (insertion point to the heel bone)?
      3) Do you have high or low arches in your feet?
      4) Is the pain just as bad as when you were "injured" or there is some improvement after resting?
      5) Is there any swelling or bruising visible?
      6) Is there a visible lump/bump on the back of your heel?

      Again, if you can answer these then I will be able to help.
      You can write to me directly if you prefer, my email is itaiw@yahoo.com

      Good luck and feel better.

  23. QUESTION:
    Tore achilles tendon?
    I was at wrestling practice today and i kind of rolled my ankle to the outside and i hear a loud pop or crack. immedietely i was in extreme pain and couldnt put any weight on that foot. the trainer came and looked at it and gave me crutches and i went to see a friend thats a doctor and she said that i may have partially or fully tore my achilles tendon or sprained something very bad. Has anybody had any experience with this type of injury? like how long will it take until its healed because im a very active person and will it require surgery? another thing is there any kind of treatment i can do until i go to see the doctor?

    • ANSWER:

  24. QUESTION:
    achilles tendon hurts?
    I twisted my ankle about two months ago and had a really bad bruise. My ankle looks and feels okay but I still feel discomfort on my Achilles tendon when I run or jump. Any ideas? treatments?

    • ANSWER:
      You may have developed Achilles tendonitis. The standard treatment is to rest it and immobilize it. Check here for more information.

      http://orthopedics.about.com/cs/ankleproblems/a/achilles_2.htm

  25. QUESTION:
    a doctor in new york city that uses botox to treat tight achilles tendon?
    I am 28 y.o and I have really tight achilles tendon...I go to physical therapy and I do my stretching exercise and I have seen a lot of progress. But I really feels as if botox in conjunction with the stretching exercise would really loosen up the achilles tendons. problem is I was told that only one doctor in new york city performs this treatment and he doesn't accept my insurance. I was told he was the only one, by his secretary...so i don't believe it..but when i looked it up I don't see any other doctors listed as performing this procedure.....help me ...please.
    clara nelson you suck...using my question to spam

    • ANSWER:
      Botox? Can't say I've heard of this either for this condition...rather, the up and coming treatment for tendon problems that has failed PT is Platelet Rich Plasma Therapy. I still don't know a whole lot about it, but there are definitely physicians in NYC that do this...

  26. QUESTION:
    Achilles pain that worsens with stretching?
    I have occasional pain in my achilles tendons, sometimes but not always associated with running. I've read that many people suggest stretching. I've found that when I stretch, it makes the pain much worse. I am an overpronator. I ice them and that alleviates the pain somewhat not always. Any suggestions for other methods of treatment?

    • ANSWER:
      Get orthotics- the overpronating stretched the tendon more than it normally should be, and this causes pain. Needless to say, stretching even more would make it worse.

  27. QUESTION:
    Achilles tendon pain?
    My boyfriend ruptured his achilles tendon over a year ago and he constantly feels pain in that area. He says it feel like it is really tight and it aches. So far I am not aware of any treatments (except stretching) that can help his pain. He stretches it all the time and it helps but not alot. Pains meds don't help either. I was curious if anyone has heard or used any methods of relieving the pain. Any advice would be appreciated. Thanks.

    • ANSWER:
      sadly, stretching. i hurt my achilles when i broke my ankle over a month ago. and i hurt it when i was a lot younger. but all you can do is stretch it, lots. he should go to physical therapy if he isn't already going.

  28. QUESTION:
    what is best treatment for Achilles tendonitis?
    I am a 64 year old "runner" - 6 since 2003 and likely will do no more. I have had left Achilles tendonitis for 3 months now and I am told cold treatment is only good for reducing swelling and pain and should only be used for first couple of days. Because it restricts the healing effect of what small blood supply there is to the tendon. I am now 3 months with this condition and my left (back) ankle is twice as thick as my right side and I am right handed/footed. I now have orthotics for to help prevent future injuries (I have very high arches). I have gotten mixed advice re cold treatment and about excercise and stretching. I have seen my Dr., physio, chiro and orthotics. Most treatement has been laser and manipulation to help break down adhesions. It is no better now than 3 months ago. Is there any professional or patient with specific experience with Achilles tendonitis, precise treatment and length of recovery?
    I am taking oral and topical anti-inflammatories. But can topical (voltarene gel) reach the tendon given the layers or skin it has to be absorbed through before reaching the Achilles tendon?

    • ANSWER:

  29. QUESTION:
    achilles tendon surgery?
    might have to have surgery, have been diagnosed with achilles tendonitis, in a plaster cast, it has been a month today since i started to feel any pain, my doctor gave me a list of treatment options surgery being the last resort, but i am currently on my last option before surgery, but as it has only been a month i dont think my doc will recomend surgery. my next appt is in the middle of october and that will inly have been 2.5 months, surgery is the only option but i dont know WHEN i will have surgery. how much does it cost? how long til my doc will actually schedule surgery? thx
    said that stretching/rehab/strengthening/ect will only make it worse until its fully healed
    the doctor that i am going to is my schools sports injuries/podiatrist

    said that any type of rehab before its fully healed will only make it worse

    he would be proforming the surgery(dr mark moriarty)

    said it was so bad that he was surprised that i didnt feel the tears when they actually happened

    was vague about them being micro tears or a partial rupture

    surgery is my last option

    • ANSWER:

  30. QUESTION:
    Achilles Tendon -surgery, cost and where to treat? ?
    My father in Bangladesh, over 60, has suffered AT rupture and needs surgery. Since I am working in UK, I was thinking to bring him over here for treatment. However I have no idea, where to treat him and how much it will cost. Can anyone who has gone through the surgery(or has a relative with similar experience) advise me regarding this? I also have heard that this is treated best in australia but dont know how much it cost there.

    I have a rough idea of how much it costs in India but not very confident of the quality of treatment there.

    • ANSWER:
      I've had both of mine knee replaced and I am very pleased with the results (it's been 1 yr). I had total knee replacement surgery performed by an orthopedic surgeon of Fly2india4health Consultants in India. I could hardly walk by the time surgery day rolled around, I'm now walking pain- and limp-free now but I'd be in a wheelchair if I hadn't had the replacements. My world got smaller & smaller. Now I can walk miles, need no walking aids, and take no pain meds. With the assistance of Fly2india4health Consultants I chose to have my surgery in India with a surgeon they knew well and trusted. Before deciding on this physician, I did some checking on the cost of having the surgery done in the states and learned that I would have to pay in the neighborhood of ,000 for my surgery, hospital stay, rehab and follow ups some 400% more than what I wound up paying in India. This did not include my flight and hotels or any incidentals that I had to pick up while staying in India. If u need any orthopaedic care I will certainly advice you to go to Fly2india4health Consultants!

      Source:
      http://www.fly2india4health.com

  31. QUESTION:
    Good ways to deal with different types of foot and ankle tendinosis?
    I have chronic tendinosis in my feet and ankles. I have it running across the top of my left foot, both sides of either ankle, and in my right achilles tendon. Are there any treatments I could do at home to help myself or any products that may help? Also, does anyone know the names of the tendons on the sides of the ankles and across the top of the feet? Thanks!

    • ANSWER:

  32. QUESTION:
    No treatment at all for ruptured gastrocnemius?
    Yesterday I was chasing after my two-year old, and as I went to run, I heard a distinctive ripping sound and felt a very disconcerting sensation in my right calf. I'm unable to put my heel flat on the floor unless my knee is bent, and of course then I can't straighten my leg. My calf hurts to touch on the meaty, inside/back part, although when I'm sitting, it doesn't hurt at all really (twinges a bit). Any swelling is minimal (it's now almost 24 hours later) and I have no bruising yet, although I woke up with a pale reddish oblong mark on my leg this morning where it's sore. I went to the walk-in clinic (hobble-in?) at the hospital and had it checked out. The Dr told me that on examination, she is sure that I have a complete rupture of the gastrocnemius tendon. She was certain it wasn't my achilles tendon (I can still move my foot). For treatment, she suggested icing my calf, but that's it. She said it should heal in a few weeks, and that I can't do any further damage.

    Is there anything else I can do? I have three children - five, four and two-and-a-half - and it's just about impossible for me to stay still when I have a house, kids and husband to look after. Would wrapping it help it feel more stable? When I'm 'walking', I often step funny and my calf HURTS and feels like something is...not where it should be. The Dr described the rupture as a blind snapping up (blargh!). I live in a two-story house, and going down the stairs is very precarious. I guess I'm also wondering if it's true that I can't do any more damage to my calf? I want to just suck it up and plow through this injury, but I want to make sure I don't make things worse.

    Any thoughts would be appreciated!

    • ANSWER:
      Well, you DO have something that is not where it should be, the muscle and tendon are all balled up now.

      From what I understand, the soleus muscle will take some of the extra strain on that leg now, so try to take it a little easy... because if you tear that one before it is conditioned to the extra work, you'll have worse than whatever limp you probably will always have as it is now. I'd say the biggest immediate risk is from falling while trying to do something with a weakened and painful leg. This injury won't heal, but it will quit hurting and you will adapt to not having that muscle to use.

      I don't know if reattaching the tendon with surgeries is even an option on this one, but I do know that unless medical technology has advanced on such things a lot, it may not be as good of an option as just letting it be.

  33. QUESTION:
    Achilles and/or Peroneal Tendonitis?
    I think I have achilles and peroneal tendonitis. I started noticing that it was difficulty to bend my ankle up because of pain and tightness in my Achilles tendon. But then I started having pain on the outside of my lower leg where the peroneals are. I'm noticing that I can't bend my ankle as well as the other (when I'm squatting). Its always stiff after I sit for a long time or when waking up in the morning but it usually stretches out after a few steps or a quick 20sec stretch. I have been using heat and ice (both feel good), taking Aleve, resting, doing some stretches for the calves, and am breaking in new orthotics (only wearing 3 hours per day) for my pronated feet. What I was wondering was: (1) is it possible to have both achilles and peroneal tendonitis? (2) I was told to do eccentric heel raises - but won't this aggravate it? (3) is there anything else I'm missing for treatment?

    Its not completely horrible so I don't want to go to a doctor yet.

    • ANSWER:
      You could be missing the right kind of massage work to treat what you have:

      http://www.a-body-for-living.com/massage-for-heel-pain.html

      This may give you some ideas to help you treatment locally in your area.

  34. QUESTION:
    do i have achilles tendonitis?
    so all of the sudden i was walking to my math class on monday and my heel like around the achilles tendon started hurting and i could barely walk and its been like this for 3 days now. I've been limping around and i could barely make it to my bus stop this morning cuz its such a long walk. is this achilles tendonitis? should i go to the doctor? what is the treatment for it? would they give me crutches or a walking boot?
    1) Do you have high or low arches in your feet? I don't know.
    2) Do you have "extra" pain when you first get up in the morning and take a few steps? No it hurts after I walk some but not like right when I get out of bed.
    3) What kind of shoes do you usually wear? I wear sperrys and toms.
    4) Did you start any sports activity lately? I'm playing soccer but I've been playing for a long time.
    5) Where exactly is the pain located in your heel? It's like where the bone is and then like a little above that so where the Achilles tendon is.
    6) Is there any redness or swelling visible? it's a little red and a little swollen.
    7) Is it painful to the touch? Only if I like push down on it.

    • ANSWER:
      Hello,

      First of all I am sorry that you have this pain which prevents you from walking normally.

      It is difficult to say exactly what it is based on the info you provided. I would say though that it's either Achilles Tendinitis ot a condition called Plantar Fasciitis.

      In order to get a good diagnosis please answer these questions:

      1) Do you have high or low arches in your feet?
      2) Do you have "extra" pain when you first get up in the morning and take a few steps?
      3) What kind of shoes do you usually wear?
      4) Did you start any sports activity lately?
      5) Where exactly is the pain located in your heel?
      6) Is there any redness or swelling visible?
      7) Is it painful to the touch?

      Here are a few things you can do right now:

      1) In general you should be completely resting your foot - try to take a couple days without activity and see if there is some improvement.

      2) Ice your heel at least 4 times a day, either by applying ice directly or by rolling a frozen bottle under your heel and arch when you sit down.

      3) Massage the area to speed up healing.

      Again, if you can answer my questions I would be happy to assist you further.
      You can write to me directly if you prefer, my email is in my Yahoo profile or itaiw@yahoo.com

      Feel Better!

      **********************************
      Thanks for the additional info!
      The location of your pain may indicate Achilles Tendinitis or even Haglund's Deformity.

      I would appreciate it if you can send me an email - it will make it easier for me to help you out further.

      Cheers,

  35. QUESTION:
    Achilles Tendonitis Question?
    I've been training for a half marathon. 2 weeks ago I did my long run of 8 miles with no pain. A few days later I was doing a 5 mile run and this pain slowly built up in the back of my leg. it was a stabbing pain. It was higher than my ankle and and almost right below my calf. Yet, when I walked I could walk with no limp.

    Even now when I walk there is no pain. I can pinch my Achilles tendon with no pain. When I stretch my my calf and achilles there is no pain.
    Yet, when I run, the pain begins right there just past the base of my calf. It's almost dead center of the leg. When it first occurred it was like a stabbing pain.

    I rested a week and a half with no running. Then yesterday I went for a 5.5 mile jog. It was a bit sore at first. Not stabbing, but more of an ache. Any time I came to a hill, I walked up the hill and commenced to running once at the top. After about 2 miles the pain was gone. When I finished the run I was doing a quarter mile cool down/walk. On the cool down the pain started back a little bit in the same place. Not a stabbing pain, but more of the dull ache.

    After the run I took an ice batch followed by an ice pack treatment on the spot. Today I have been keeping it elevated and using ice treatment.

    I am thinking of taking another 1.5 week to 2 weeks off. I have my half marathon on March 1st. I thought it was an achilles tendinitis, but it seems to high. I don't think it's compartment syndrome. Any ideas as to what it is and what I should do?

    • ANSWER:
      See a PT or Podiatrist as it sounds as if you are rolling one of your feet while running. It could also be your running shoes, how old are they, you might need a different brand and so on. As it is higher than the achilles tendon, I am thinking you are out of alignment, foot, ankle, knee or hip, so see a PT and they might be able to help. Best of Luck

  36. QUESTION:
    How bad is my achilles tendonitis?
    My Chiropractor said that I have achilles tendinitis in my right foot. I think that part of the reason I have it is because about two years ago I sprained it. Ever since then I have had this painful popping sound when I walk or rotate it. Another reason that I have it is that I have some really bad flat feet. I'm NOT overweight and I am 14. It hurts all the time, even when I sit. She had me go to an orthopedic doctor to get personalized foot supports, hoping that it would decrease the pressure on the achilles tendon. It's been about two weeks now that I have been wearing them, and my foot has slowly gotten worse too the point that I'm on cructches. I can walk on it, but if i walk normally I feel a lot of pain my calf. So I was wondering how bad it is, should I go to a doctor, and what should I do to make it feel better? I have the R.I.C.E. treatment and it still really hurts, but I have only done it for two days. How long should I be on crutches?
    -Note- My ankle is ALLWAYS popping! It gets cramped and then it pops. It really hurts
    sorry, I noticed that I allready included that note that I put above

    • ANSWER:
      Wow, I’m really sorry to hear about what you are going through. That’s really a lot to be dealing with at such a young age. I also have severe Achilles problems so I do understand the heartache that I’m sure you’re experiencing.

      I also strained my Achilles tendon about 2 years ago and I kept walking on it without any kind of treatment which I know now was a big mistake. I’m sure that you did the same thing or else you probably wouldn’t be having any problems right now. The key to healing an Achilles injury I believe is to give it the proper rest and treatment immediately following the injury because that is the crucial time that it needs to be treated properly in order to heal properly. After that period and especially if you continue to walk on it over time (like I continued to do) the injury seems to get worse and it’s ability to heal becomes less. Now, I’m dealing with a very severe and chronic case of tendonitis and my Achilles is so weak that I can’t even stretch it. I wear about ¾ of an inch of heel lifts just so I can walk. I slowly increased the amount of heel lift because I believed it would take more and more stress off of the Achilles so that it would have an easier ability to heal which I don’t really recommend doing by the way. I think that using so much heel lift has shortened up my calf muscles more than they should’ve been and now I can’t even stand flat footed without my shoes and heel lifts or it will do damage to the very weak tendon. I actually have both of my tendons injured, I hurt the other one about 6 months after the first and it’s in just as of bad condition now. I’m not too sure about how well heel lifts work and especially in the long run but they do take stress off of the tendon for sure. The only problem is that they reduce flexibility.

      These Achilles injuries are somewhat of a mystery on how they get healed. I think that once they become chronic or long term, they are really difficult to clear up and need just the right types of treatment and conditions if they are going to have a chance. The key for you (and for me) I believe is to somehow get them to heal to the point to where they are strong enough to be stretched out (mine right now are too weak to stretch) and at that point, stretch them very gently and slowly over time to increase the flexibility which in turn will take a lot of the stress off of them that comes from walking. To stretch them, I would recommend trying to sit on the floor with your leg straight and place a rope around the bottom of your foot and hold each end in each hand. Pull back gently to stretch the calf muscle. Don’t stretch too hard or too much at once or you will do damage. Stretching with your leg straightened will stretch the calf muscle but it’s also important to stretch with the knee bent which will stretch the soleus muscle which is underneath the calf. You could do this by sitting on your butt and putting your knee on your chest and pulling your foot towards you with your hands to stretch.

      At this point, I think that crutches are a good idea to give some needed rest to your Achilles so that they will have a chance to heal some. Hopefully this will help them recover to the point to where they gain some strength and enough strength to where you can begin to stretch them like I said and bring some flexibility back to your calf. Eventually you will able to SAFELY put more and more use into the Achilles which will strengthen it and eventually you will be able to walk without crutches and eventually walk normally. When it starts to get stronger, you can slowly put more and more weight on the injured Achilles and support the rest of the weight with the crutches to begin to strengthen it. Don’t be too hasty to do too much too soon, have some patience. I kept trying to stretch too hard and too early and I kept doing damage and now my tendons have degraded and degraded to where I’m at now, which is pretty much the worst they have ever been.

      Again, it’s just a matter of using the right treatments to slowly get them back to strength and to health and at that point it’s a matter of increasing flexibility and a slow and steady recovery from there. Scar tissue that has formed in the tendon also has to grow a strong blood supply before it will heal well. This takes time and is another reason not to keep abusing the tendon and preventing the present level of scar tissue from maturing and improving. You should be taking a daily vitamin and also an additional vitamin c supplement that also contains bioflavoniods. Vitamin c helps in collagen production which is what tendons use to rebuild themselves and bioflavonoids help in the effectiveness of the vitamin c in the body. Ice at this point could be counter productive, I read someone else’s statements about how they quit icing a chronic Achilles injury and they were better off and I tried it too. It seems to have been a good choice, the ice wasn’t helping all that muc

  37. QUESTION:
    Is it normal for orthopedic surgeons to operate without ever seeing the patient prior to the day of surgery?
    I was scheduled for achilles tendon surgery this Friday with a specialist that I am currently seeing. Out of the blue, he recommends that I go to this other guy for the surgery as he has more experience. OK, fine. However, when I call the new surgeon, his people schedule the surgery without even asking me what my problem is, previous medical treatment, etc. I asked if they needed to see me before the surgery to talk things over and they said no. Is this normal!?

    • ANSWER:
      It might very well be completely normal if your normal doctor has sent him over your file along with the x-rays he has taken. The one thing that would set your mind at ease is in checking out his qualifications beforehand and briefly talking with him prior to the procedure. If you still feel uneasy......let them know that you would like to reschedule and get a consult from this doctor BEFORE anything is done. Good luck to you!

  38. QUESTION:
    Why is the NHS so CRAP? The poor treatment is RUINING MY LIFE!?
    6 years ago I developed such severe leg and achilles tendon pain that i was put in a plaster cast for a few weeks and I couldn't walk at all for months afterwards. They keep referring me to different people - I was referred to an orthopaedic surgeon. It took months to get the appointment, but he decided I'd be better off with a physio. It took months to get a physio appointment and the physio said I'd be better off with a podiatrist. It took months to get a podiatrist appointment, and the podiatrist said I should go back to the orthapaedic surgeon. The orthapaedic surgeon did a scan and said the pain in my lower legs is compartment syndrome, and he put me on the waiting list for an operation. I've been waiting over a year and still no operation date. And still no-one has done anything about the achilles tendon pain. This started when I was 20 years old, I am about to turn 27 and I have been virtually crippled this whole time! I can barely walk, I can't work, I have no job as I am virtually crippled. The crap NHS is ruining my life! I hate this F%^&*NG country! I can't afford private medical treatment.
    Mr A - how do you suggest I get a job when I can't even walk out of the house without help? How do you suggest I walk a mile to the nearest bus stop? To people who slag me off for complaining about this - my family have paid a fortune in taxes over the years and we don't get anything at all for it. The amount of tax my parents have paid, the least they can expect is for their daughter to recieve some medical treatment but it seems this is too much to ask.
    And no, Mr A it isn't free, it is paid for by taxes. My family are paying for medical treatment with their taxes but not getting the treatment we've paid for. I actually did have a job before this started and I paid taxes. And no, it doesn't help alot of people, there are millions of stories about the NHS even worse than mine, just google it.

    • ANSWER:
      Wow this is truly ruining your life I feel so bad for you the only thing I can really think of is to go straight to the ER and you'll probably wait a few hours but you'll get your foot in the door that way & they're not going to send you out in that kind of condition {hopefully} , and if they do.... call the news station! You clearly need MEDICAL ATTENTION & instead your just falling thru the cracks, 6 years of that b/s, that is a devastating story.

      @Rachey B.. england has free insurance for everyone

  39. QUESTION:
    MRI shows calcaneus and talus are fused....help with treatment options from doctor/specialist?
    I am a 19 year old female. I was born with my right foot twisted 180 degrees. Doctors deemed it "club foot" and therapy was assigned. Throughout childhood, excessive walking/running caused pain. Sitting for extended periods caused stiffness/inability to move my right leg (bear weight). My right foot extends outward, about 45 degrees from my other foot. When I walk, my foot rolls inward on itself also.
    At 14 I began marching band and experienced severe pain. X-rays revealed my tibia and fibula to be fused. I was told to take Ibuprofen to lessen pain. However, excessive movement still caused ankle pain.
    At 16, I fell down a flight of stairs and tore my Achilles tendon. Was in a boot for six weeks. Ankle pain was still severe. At 18, I had more x-rays and MRIs. Orthopedic surgeon said I was not eligible for surgery on my ankle (where the pain was) because nothing appeared to be wrong. Tibia/fibula fusion causes no pain.
    At 19, another set of MRIs revealed my talus and calcaneus to be fused. Podiatrist said this was caused by malformation in utero. He put me in a tape-wrap to limit movement of my heel/ankle. He said ankle pain was caused by my other bones over-compensating for the lack of movement of my heel bones. Following treatment with this tape, I was fitted with an brace inside my shoe to limit extra movement of my ankle and hopefully prevent pain. I was given Loritab and Miloxicam (anti-inflammatory).
    Doctor said that, if this brace does not ease pain, I will need surgery to separate my talus and calcaneus. He told me also that I have arthritis there. At 19, this is not something I want to hear.
    I do not really want surgery, as I am a member of my college marching band and this would set me out for an extended period. I am also afraid of surgery because I have ITP and don't want to risk excessive bleeding. Are there other options for treatment/pain relief/therapy that could ease the pain or "reverse" arthritis? The brace I wear now really restricts my movement and hurts worse than before I was fitted.
    If any doctors/orthopedists/medical professionals could provide input or assistance, it would be greatly appreciated.
    Thank you SO much to the person who answered this question first. However, don't try to be cute. I'm seeking actual advice, not the "I've never heard of this" answer. Unless you are a doctor and have really never heard of it, then that answer won't suffice.

    • ANSWER:

  40. QUESTION:
    Severe headache! Enough to seek medical treatment?
    I have had a severe heachache since Halloween. I attributed it to stress and then to sinus pressure. I have taken Excedrin Migraine, Excedrin Back & Body, oral Percocet, Aleve and I have recieved a shot of Toradol. I am in excruciating pain and I am at a loss as to what to do. I have had the headache, dizziness, severe nausea and now muscle spasms in the upper back underneath the shoulder blade. I am not sleeping well, I am irritable and also my upper calves and Achilles Tendon is very tender and throbbing. Should I go to ER or do I wait this out? Any advice would be appreciated! :)

    • ANSWER:
      I think you should seek treatment, whether at an ER, local doctor or clinic. You may just need some pain relief but if this has been chronic and constant you should probably see a specialist sooner rather than later. There is also the possibility of more serious causes of chronic headache that can be outruled with simple tests. Good luck.

  41. QUESTION:
    Problem with both Achilles tendons?
    Just been to the doctor had an ultra scan done on both achillies tendons, left one has alot of small tears and both tendons showing signs of wearing out. Does anyone know why this would happen and what is the treatment? Am seeing a specialist on Monday, the tear injury occured two months ago with no healing since. It is affecting the way I walk as I seem to have problems lifting my foot of the ground. And my calf feels very sore and full.

    • ANSWER:

  42. QUESTION:
    I Have a Possible Meniscus Tear? What are the treatments?
    2 summers ago I dislocated my right kneecap. It later led to tendinitis in the knee, a screwed up Achilles tendon, rotated pelvis and vertebrae. (Basically everything that could go wrong, did.)
    Last month my knee made an odd noise and has been hurting awfully bad since. My doctor says it might be a Meniscus tear or a torn other thing. Or there might be something wrong with my cartilage.
    If it is a meniscus tear, what are the treatments? Is surgery the only option?

    • ANSWER:
      For a meniscus tear it is probably surgery. Physiotherapy will help rehabilitate the knee afterwards though.

  43. QUESTION:
    Achilles Tendinitis - Help/How do I heal?
    In the morning and after resting, I feel consistent stiffness and a throbbing in my achilles tendon, which dissipates with activity and running. I stretch a lot, and cool down after running, but it seems to stay and even feel slowly worse in the morning. I'm 23, don't have overly arched feet or structural problems with my gait, run 4 times a week, am not overweight, but can't shake this injury. Because the achilles tendon is so important, I'm afraid if I don't watch it, I'll tear it. I've gotten a professional opinion on it, and he said surgery is only required for tears, if it does not improve and continues to worsen, a boot or short-leg walking cast for 2-6 weeks is a possibility. So far the treatments I have received, stretching exercises, support soles, and elevating it at night haven't helped. Has anyone else had achilles tendonitis and what should I do? And what alternative treatments should I seek?

    • ANSWER:
      I had achilles tendonitis and it was the most painful thing I've ever experienced in my life. I couldn't even walk so when I went to the doctor they gave me some sort of muscle relaxant and I had to ice it a couple times a day for a few weeks. I also had to stop running for a while, I swam instead and stretched it a lot. That worked for me. Massage might help too, you want to make sure your calves aren't too tight I think.

  44. QUESTION:
    Achilles tendinitis - Need advice?
    In the morning and after resting, I feel consistent stiffness and a throbbing in my achilles tendon, which dissipates with activity and running. I stretch a lot, and cool down after running, but it seems to stay and even feel slowly worse in the morning. I'm 23, don't have overly arched feet or structural problems with my gait, run 4 times a week, am not overweight, but can't shake this injury. Because the achilles tendon is so important, I'm afraid if I don't watch it, I'll tear it. I've gotten a professional opinion on it, and he said surgery is only required for tears, & so far stretching exercises, support soles, and elevating it at night haven't helped. Has anyone else had achilles tendonitis and what should I do? And what alternative treatments should I seek?

    • ANSWER:
      I would think that the running is probably the culprit. It may be a good idea to pick up cycling or swimming as these are not weight bearing activities and will give your tendons a chance to heal. Further, a non-steroidal anti-inflammatory drug (NSAIDs) might be of some use for you.

  45. QUESTION:
    Ankle sprain(?) treatment?
    Seven weeks ago I suffered a nasty ankle sprain playing basketball. My foot was inverted (outside-in) when I went up for a layup, but instead of pushing off the floor I stepped on the defender's foot. I'm fairly certain I heard popping, but that could have just been my shoe. I went to a walk-in physical therapy clinic the next day and the nurse there told me to R.I.C.E. and gave me a walking boot in case anything was broken. After getting my foot x-rayed, it was discovered that I had no broken bones. The doctor told me I may have partial tearing, however. After resting, icing, compressing, and elevating for about three weeks there was significantly less swelling and the bruising had completely gone away. However, there is still some swelling (or possibly fluid build-up) right around the actual "ankle bone" on the inside and outside. Also, the inside part of my ankle and my achilles tendon are extremely tight. The tightness on the inside of my ankle is what concerns me the most, considering the type of sprain I had (inversion) would usually warrant the worst of the injury being on the outside of the ankle. I've tried to play basketball with no luck because my tendons seem to be tightened up so bad that I can't jump or run very hard. I've been doing some stretching exercises, and it seems to be helping slightly. I guess I have several questions for anyone who has good advice to give:
    1) Should I still be icing my ankle daily?
    2) Should I try some light running or other exercise requiring use of my foot?
    3) Do I need to spend the money on a doctor visit or an MRI?
    4) When I elevate my foot, the fluid seems to drain away from the ankle somewhat. However, when I start to walk around or sit with my foot down it usually swells to the same size again. What can I do about this?
    5) Finally, the league I play basketball in starts on Jan 31. Is it likely that I will be able to play by then?

    • ANSWER:
      Ashton,
      1. No, stop the ice. Recent studies have shown that the use of ice stops or slows down the rate of healing. Use warmth but not hot. Warm moist compresses work the best.
      2. You are describing difficulty in playing ball due to the fact that the tendons are tight. Since that is the case running or jogging is going to stress them when they are not in their normal length. This would be opening you up for another injury. Better to wait until you get full mobility and strength in the leg.
      3. If you are going to see a doctor about this see a podiatrist. They are the foot and ankle experts. If you are not having any other problems except for the tightness I would say no. If on the other hand you are still experiencing pain and other problems then you should go.
      4. The leg is a cylinder and all of the laws of physics apply to it. Since you are walking on a cylinder with limited muscular work the normal pumping mechanism is not working as well as it should. The fluid is always going to drop down to the lowest point unless you have a strong pump to push it back up. If you were to take a measurement of the opposite ankle when you first got up and then again when you went to bed you would find that it also was larger. You have to use your calf muscles more to pump the fluid out. I will give you a simple exercise to do that after these answers.
      5. This is a little over 3 weeks off. It might be possible but in all honesty I would say no. The reason for the no is that unless your leg and ankle have full mobility and strength you are asking for another injury. As soon as the leg is strong enough you can return.
      6. Do this movement to gain mobility and help to pump some of the fluid out of the leg. Assume a long sitting position on the floor. Have the muscles of the feet pull them backwards towards the shins. The only movement that should be taking place is at the ankles. You will know that it is being done correctly as you will feel a pulling sensation in the calves. Hold that pull for 10 seconds and then relax for 5 seconds. Repeat this until you have done 10. You can do this as many times a day as you want. Once you learn the basic movement you can also do this standing and sitting. The best position is lying down.
      7. There is an exercise called the 180. That number stands for the total number of reps that you have to do for this exercise. In the beginning you are not going to be able to do this number so just do what you can. Stand on a step with the balls of the feet on the edge. Raise both heels up as high as they go. Now take the injured foot off the step and hold it up not touching anything. Now slowly lower the heel of the foot you are standing on. At the bottom of that movement replace the injured foot on the edge of the step. Now using both feet raise the heels up to the highest that they can go. Again take the injured foot off the step and lower the other foot down as low as it can go. Do this until you have done 15 reps. Now reverse positions of the feet and you are going to work the injured foot. Attempt to do as many as you can always attempting to get the heel as low as it can go. Do this exactly as you did the other foot until you have either tired or done 15. Now switch back to the original position and do 15 on that foot. If you are able do some more on the injured foot. In this way you only do what the leg is capable of doing. Don't force the leg to do more than it is capable.
      8. You will be able to return to playing when you can run this drill. This is called a figure 8 drill. Make a large 8 somewhere like a basketball court. Walk the 8 as fast as you can. If you have no pain or restrictions then make the 8 a little bit smaller. Do the walk as fast as you can in that 8. No problems make the 8 smaller. Keep doing that until you have the smallest 8 you can. If you have no problems then go back to the largest 8 and jog it. No problems do the next smallest one and so forth until you are able to do the smallest one or you have a problem. Return to the large 8 and run it at 3/4 speed through all of the 8's. If you have no problems run it at full speed through all of the 8's. If you can run through the smallest 8 without any problems then you are ready to play.

  46. QUESTION:
    statistical questions 10 points PLEASE HELP!!!?
    2) Chronic Achilles tendon pain (i.e. tendinosis) is common among middle aged recreational athletes. A group of Swedish physicians investigated the use of heavy-load eccentric calf muscle training to treat Achilles tendinosis. (British Journal of Sports Medicine, Feb 1, 2004.) A sample of 25 patients with Achilles tendinosis undertook the treatment. Data on tendon thickness (measured in millimeters) were collected by ultrasonography both before and following treatment of each patient. The researchers want to compare the mean tendon thickness before treatment with the mean tendon thickness after treatment.

    Is this a designed experiment or an observational study? Explain why.

    What is the experimental unit of the study?

    What is the response variable of the study

    What are the treatments in this experiment?

    • ANSWER:
      See links:

      http://en.wikipedia.org/wiki/Design_of_experiments
      http://en.wikipedia.org/wiki/Observational_study

      Good luck!

  47. QUESTION:
    famous uk sporting injury?
    i am looking for detailed information about a sporting persons injury
    how they did it?
    outline of the injury medically?
    treatment?

    such as david beckhams achilles tendon, or rooney's metatarsal

    thankyou!!

    • ANSWER:
      headache

  48. QUESTION:
    achilles tendonitis help please?
    i am asking this question for a third time because i have not recieved any answers other than see a doctor, i have. i have been struggling with Achilles tendinitis for a few months now, i practically cant run which is bad since i run track at a division 1 college. None of the trainers know what to do about it, even the doctor is stumped. i have tried rehab, medicine, a new treatment called Graston, and the last step will be a cortisone injection, although if i get an injection it could increase my chances of rupturing the tendon completely so studies show. there has to be something i can do, the pain is directly on the back of my heel and hurts when running jumping stretching or even pushing on it. im not sure if this is bursitis or what. Any ideas other than to cut my leg off? :) all answers are greatly appreciated.

    • ANSWER:
      Yeah, I don't know much about acupuncture but I do know people with your problem that had to wear a cast for awhile in more extreme cases. I'm assuming you haven't because you didn't mention it. Was there are reason your MD or PT didn't suggest this?

  49. QUESTION:
    I have pain in my left foot on the inside of my ankle above heel
    It is located about 1 inch above the bottom of my heel and to the right of the achilles tendon. It feels like something is tight and needs to be stretched out.

    Any suggestions, and treatment?

    • ANSWER:
      More then likely you have stretch you tendons . So just take it easy and it will go away before you get married anyway .Good luck

  50. QUESTION:
    how come achilles tendonitis is caused by high heels but...?
    heel cups are recommended for treatment? wouldn't it be lifting the heel and shortening the tendon as well?

    • ANSWER:
      I work in a Pedorthics phacility in GA and from what we are taught....
      Tendonitis is caused by damaging the tendon that runs along the back of your ankle, under your heel and the lenght of your foot to the ball area. A high heel/pump shoe while walking has changed the layout of your foot and forces the entire presure of your gait to land directly on the tendon in question at both the heel and at the ball... also a pump causes extra tention in the arch of the foot because it gives no support during impact.
      Your foot is a very important part of your body and for a normal persons day they cant place the equivilant pressure of a fully-loading cement truck on your feet.
      Imagine that without any padding, support or even the minimum of being erganomically correct.

      For the secon part of your question. There is more in the insole for treating Achilles Tendonitis that just a heel cup. We also incorporate arch support (for all 3 of the arches in your foot) as well as a heel cup to try and reduce the presure directly on the tendon and to try and make up for foot fat-pad atrophy which can occur with tendonitis

      I hope this helps

      For good support - you have to start with the right kind of shoes and support - try www.comfortwarehouse.com for some more information