Achilles Tendonitis Treatments

Once your medical professional has diagnosed your condition, they will be able to recommend the most effective treatment for your Achilles Tendonitis injury. There are a variety of options available depending on the severity of your injury.

During your recovery, you will probably have to modify and/or eliminate any activities that cause pain or discomfort in your elbow area until your pain and inflammation settle. Scar tissue will often develop as a result of a Achilles Tendonitis injury once acute inflammation begins to decrease. As your damaged arm tissues heal this dead, fibrotic tissue will develop instead of forming brand new healthy tissue. This tissue adheres to your muscle fibers, tendons, ligaments, fascia, nerves, and joints causing pain and preventing them from moving properly (this limits your range of motion, flexibility and strength).

Often you will notice a great improvement within 6 to 12 weeks; however it can take months to return to normal. The more diligent you are with your treatment and rehabilitation, the faster you will see successful results. If you start using your arm before it has a chance to heal properly (even though it may feel better), you can end up doing a lot more damage than good!

Conservative Achilles Tendonitis Treatments:

Your initial treatment should involve relieving any pain and stress on your elbow, decreasing any swelling, and correcting any biomechanical dysfunction. Then you can focus on restoring strength and mobility to your injured elbow. It is very important to follow any instructions you receive from your physician.

• Rest your arm and limit your activity (if you are able to move your arm)
  
• Ice the area 2-3 times/day for approximately 15 - 20 minutes at a time (do not apply ice directly on your skin, rather wrap it in a cloth or towel)
  
• Compress the area if possible by adding light pressure
  
• Elevate the injured area above chest level

Pain and anti-inflammatory medication can be used if required to help manage your pain. However, these aren¹t recommended for long term use, as they can cause gastrointestinal difficulties. Some health professionals have also recommended natural supplements such as Glucosamine, MSM or Hyaluronic Acid to help strengthen the injured tissue.

Once the initial inflammation has decreased, you can provide pain relief and improve your arm function by alternating a cold and hot compress to increase the blood flow to the area. Gentle massage around the injured area or small flexing or extending elbow movements (if not painful) will also help increase blood flow, oxygen, nutrients and will prevent stiffness.

To increase your comfort and prevent further damage, you may want to use a Achilles Tendonitis strap or counterforce brace which will help support the area and reduce stress on the injured tissue; this is worn just below the elbow, around your forearm. These bands should only be used until the Achilles Tendonitis is gone, as they can cut off circulation and impede healing or development of your muscle tissue.

Ultrasound therapy is a great therapeutic option to decrease pain, inflammation and soft tissue (muscle, connective and nerve tissue) damage experienced with a Achilles Tendonitis injury. This can be received using a portable, home ultrasound device (self-administered) or by seeing a physiotherapist. The treatment is safe, easy, painless, and generally requires between 5 ­ 10 minutes. It is based on a form of deep heat therapy which is generated through high frequency sound waves (that we can not hear). These waves send vibrations deep into your body and raise the temperature of your soft tissue. The waves are delivered through a hand held transducer and medicinal conductive gel that are used together in a slow, circular motion on your skin over the injured area. You may experience a slight tingling or warm sensation during the process as a result of the gel; this enhances the therapeutic effects of ultrasound (Phonophoresis).

Ultrasound therapy increases collagen and tissue elasticity, which in turn promotes circulation (blood flow) and brings oxygen and nutrients to your injured area. This cleans your tissue by getting rid of cell waste products and allows your injury to heal correctly. If not treated properly injured tissue can heal with a weakened state, which can lead to scar tissue or calcification. If used on an ongoing basis, ultrasound will help to improve your range of motion by breaking down any scar tissue that may form in the injured area. Ultrasound waves penetrate deep into your tissues, relax your muscles, decrease chronic inflammation and accelerate your recovery rate, so you can return to your daily activities as soon as possible. For best, long term results use ultrasound in conjunction with physical therapy and an exercise program.

If pain and inflammation persist, you can see your physician to investigate cortisone/steroid injections or topical medications, which may help reduce swelling and inflammation. However, these should be used with caution and never in conjunction with ultrasound therapy.

Physical Therapy is a beneficial way to help decrease pain in the soft tissues, restore atrophied muscles and improve elbow, forearm and wrist strength and mobility. The type of physical therapy and the duration will be dependent on the extent of your injury.

Once your pain starts to diminish, a physiotherapist will also set up an individualized arm and shoulder strengthening and stretching exercise program for you to perform at home or in the gym. This will be based on your needs and abilities, and will help you return to performing your normal routines. Individuals will often lift weights on their own, to try and build up their strength, however, in doing so, they can do more damage. It is extremely important to strengthen your muscles properly, as they may have weakened during the period of non-use. A trained therapist will help to ensure your rehabilitation process is effective.

Once you return to your activities, it is beneficial for you to evaluate how you use your arm in these activities to determine if you can decrease stress on the injured tissue. This may involve changing your technique, for example using a two-handed backhand instead of a one-handed backhand in tennis, which will take stress off your forearm muscles. Or, it could also mean implementing ergonomically correct practices, structures and equipment to help you perform tasks more effectively and safely, such as using a properly weighted racquet, or taking more frequent short breaks at work to rest your wrist when using a hammer or screwdriver. Speak with a professional in the specific activity or work setting to ensure you are using correct procedures and tools.

Surgical Achilles Tendonitis Treatments:

About 85% of people with Achilles Tendonitis experience pain relief within 12 months of starting their preliminary treatments. A Achilles Tendonitis injury will usually heal without surgery. However if you continue to suffer from persistent pain, weakness or recurring inflammation after trying the above conservative treatments, you may require a surgical option.

The type of surgery you require will depend on the size, shape and location of your injury. This will be completed through day surgery; however it will require extensive rehabilitation utilizing the preliminary treatments noted above. Physical therapy and strengthening normally begin about 6 weeks after surgery. Your surgeon should provide a treatment plan to help you regain normal use as soon as possible.

Elbow Arthroscopy involves making a small incision on the outside of your elbow and inserting a pencil-thin, fiber optic camera with a small lens and lighting system. The surgeon will take a look inside your joint to investigate all the soft tissues and bones. These images will then be transmitted to a TV monitor, which allow the doctor to make a diagnosis and/or perform the repair under video control. Your surgeon may repair tears or remove damaged tissue. He/she may have to cut the tendon at its attachment to the epicondyle bone and remove a small portion of the bone to increase blood flow to the area. Afterwards, sutures (stitches and/or anchors that hold the tissue together after they have been severed) can be used to attach the tendon to the bone. At the end of surgery, your incisions are closed, a dressing is applied, and you are placed in a splint.

There are always some risks associated with any surgery, which include but are not limited to possible infection, allergic reaction to medications, and damage to surrounding nerves or blood vessels. However, modern techniques have significantly minimized the occurrence of these problems. Tenderness, pain, stiffness and weakness are very common after surgery, but with proper rehabilitation these should diminish.

Although surgery is often successful at repairing any damage and/or relieving pain, it does not necessarily return strength to your elbow or forearm. That is why a strong commitment to rehabilitation is essential. Healing and recovery time is generally dependent on the extent of your injury, your age, pre-injury level of function, and your commitment to rehabilitation.