Despite being the strongest tendon in the body, the Achilles tendon is an area that is often injured. There are conservative and aggressive approaches to treating injuries to the Achilles tendon. The treatment that you need will depend on the severity of your injury and your lifestyle. If left untreated, the Achilles tendon has a tendency to turn into one of those nagging chronic injuries.
At-home Therapy
The R.I.C.E. acronym applies to this injury, as well as many other muscle and tendon injuries. The acronym stands for Rest, Ice, Compression and Elevation. If you are experiencing pain in the Achilles tendon area, these suggestions can be helpful. Apply ice to the area for 15 to 20 minutes at a time, and limit or stop the activity that brought on the pain. Wrapping an ace bandage around the affected area and elevating the legs can assist with any swelling. Initially, the use of anti-inflammatory medications can be helpful for control of the pain and inflammation.
Heel lifts or cushions should be placed in both shoes regardless of if only one side is affected. This reduces the stress on the injured tendon allowing it to heal. Using the heel lifts in both shoes ensures there will be no difference in your biomechanics that might lead to another injury. These heel lifts can be purchased at your local drugstore. Gentle stretching of the calf muscles, with a slow, progressive return to activity, should put you on the right track.
Physical Therapy
Injuries to the Achilles tendon can become chronic with inflammation or general degeneration to the tissue. Conditions such as these may require more aggressive treatments, such as physical therapy. Physical therapy treatments for Achilles tendon injuries can be very successful.
Following evaluation by the physical therapist, orthotics may be recommended based on any abnormalities or misalignments that could be contributing to the injury. A regimen of consistent stretching and strengthening exercises will help to heal and prevent future injuries. Stretching and strengthening the calf muscles is particularly important in rehabilitating an Achilles injury. Massage, although not always comfortable, can increase blood flow to the area to promote healing and break up scar tissue that may be limiting the range of motion and slowing down recovery. Therapeutic ultrasound may also be recommended.
Injection Therapy
An advanced technology called Regenerative Injection Therapy has been very successful in treating Achilles tendon injuries as well as other muscle, tendon and ligament injuries. This treatment is more appropriate for those who have had pain for more than three months, and where more conservative methods of treatment have failed. Blood is drawn from the patient and a centrifuge is used to produce platelet-rich plasma, which is then re-injected into the injury site. This creates an inflammatory response, which causes the production of more collagen in the area strengthening and tightening the tendon. This option may be more aggressive, but it could eliminate the need for surgery.
Surgery or Casting
The most severe type of injury to the Achilles tendon is a complete rupture of the tendon. This is a debilitating injury with severe pain and loss of function. Surgery for an Achilles tendon rupture seems to be the most common choice of treatment by physicians. Extensive rehabilitation after the surgery will be required to gain back full function. Occasionally, if the tendon is not fully ruptured, the physician may opt to cast the patient for a period of weeks and then begin the rehabilitation process.
References
- "Arnheim's Principles of Athletic Training: A Competency-Based Approach"; William E. Prentice, Daniel D Arnheim; 2005
- Crane Clinic: Platelet-Rich Matrix Grafts
