Achilles Tendinosis – The causes and treatment
The Achilles tendon is the large fibrous band that attaches the calf to the heel. It is the thickest tendon in the body. It gives us great power to drive off from our foot when running or walking. The Achilles plays an important part in the wind up of the fore foot (pronation). Until relatively recently most people seeing their Chiropractor for Achilles pain/injury would have come from the sporting community. Now increasingly it is the relatively sedentary individual who is complaining of tendinosis. How Chiropractic can help prevent injury and some basic self help strategies are covered in this article.
| Achilles tendinosis |
Achilles tendinosis, which is also known as Achilles tendinopathy, is soreness and stiffness that comes on gradually and continues to worsen until treated. It is a common injury among middle and long distance runners. The severity of Achilles tendinosis can be broken down into four stages, each of which can be measured in terms of how the Achilles tendon feels during exercise, the amount of stiffness and creaking, and Achilles tendons soreness to the touch (the pinch test).The four stages, or grades, are:
Stage 2. Pain during exercise or running, but performance is not affected. The stiffness and creaking continue to appear when first getting out of bed and continue to disappear shortly afterward. Lightly pinching the Achilles tendon with the forefinger and thumb in the morning or after exercise will be sore. The injury is getting worse, but most of us ignore the signs. 3. Pain during exercise or running that is detrimental to performance. The stiffness and creaking continue to appear when first getting out of bed, but may continue for some time and reappear at other points during the day. Lightly pinching the Achilles tendon with the forefinger and thumb in the morning or after exercise will indicate soreness. This is the stage when most people will try to resolve the problem by rest. The problem is that the cause of the injury has not been identified so the injury will persist even after rest. Stage 4. Hurts too much to exercise or run. The stiffness and creaking continue to appear when first getting out of bed, but may continue for most of the day. Lightly pinching the Achilles tendon with the forefinger and thumb at almost any time of day will indicate soreness. The next step is rupture, either complete or partial. The average person will rupture their Achilles and wonder why it “suddenly went” |
| Causes of tendinosis and treatment
One of the proven causes of Achilles tendinosis is hyperpronation (going over too much on the heel). Most cases can be improved simply by changing your running shoes. In fact the first thing a person should do with a grumbling Achilles is change their shoes to a high anti pronation shoe which can be bought from any good running shop. If this has little effect then the person needs to have a thorough professional foot scan along with Chiropractic adjustments to the ankle and lower back. At the Emirates Medical Center we have the latest technology in foot scanners and we can make individual custom made insoles which should help to resolve the problem. We also have very experienced Chiropractors and physiotherapist who have many years experience dealing with this condition.Tendon cells have a turnover of one hundred days. So the true repair time, with optimal nutrition is one hundred days. This does not mean that you should do nothing for one hundred days; on the contrary you need to be doing plenty of exercising, just the correct type. Eccentric exercises are the only type of exercise that have any scientific data to support the use of them. These exercises are performed on a step with your toes just on the lip of the step and slowly lowering down till a stretch is felt. Supplementation with leucine has been proven to aid recovery. You should avoid using chondroitine and glucosamine sulphates as these proteoglycans inhibit the uptake of certain metabolites that are in an injured tendon. If you have any queries about Achilles injuries please feel free to call the clinic and either myself or one of the other doctors will be able to help. Dr. Peter Jarvis www.chiropracticdubai.com
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