What are the treatments for Achilles tendinitis?

Achilles tendonitis is often caused by improper exercise, trauma, infection, and flat feet. Achilles tendonitis will affect the patient's ankle joint. The patient will experience pain in the lower calf or behind the heel, and the pain will be more obvious in the morning because the Achilles tendon is in a relaxed state at night. Once you get up, the Achilles tendon will be stretched, so the pain will be more obvious. Achilles tendonitis, like other diseases, needs to be treated as early as possible so that the effect will be better. During treatment, patients should pay attention to rest, reduce exercise load, and take anti-inflammatory measures in time. If the condition is serious, they should undergo surgery in time under the guidance of a doctor.

1. Educate patients: Doctors must patiently explain the pathological changes and possible consequences of tendinopathy to patients and coaches. Collagen lesions are very difficult to treat. In addition to pain and interference with movement, the brittleness of the tendon increases, and the possibility of rupture increases several times. Therefore, a period of rest is necessary and athletes who continue to participate in sports after warming up are warned.

2. Biomechanical unloading: This disease is often related to local overload of tendons and training errors. Therefore, it is very important to check the equipment used, such as running shoes, rackets, etc., check the mechanics of the movements, such as running, throwing, and force posture, and diagnose and correct possible muscle imbalances.

3. Anti-inflammatory measures: Commonly used cold therapy, electrotherapy, cortisone injection, etc. Cold therapy is necessary for tendinopathy because there are many new blood vessels in the tendinopathy tissue, and cold therapy can constrict the blood vessels. Electrotherapy mainly uses laser, high-voltage electrical stimulation, etc. Under laboratory conditions, electrical stimulation can stimulate collagen synthesis and is effective in treating tendinopathy. There is no indication that NASIDs and cortisone are of any help in tendinopathy, but COX-2 inhibitors are under investigation as to whether they are effective. Treatment with cortisone injections provides only short-term results, and symptoms quickly return. It also inhibits collagen synthesis, leading to partial tearing or complete rupture of tendon tissue.

4. Reduce exercise load: Using a brace or protective gear can reduce the mechanical load on tendon collagen fibers and help treatment. There are many proven effective protective gear such as knee and elbow braces, heel pads, and Achilles and patellar tendon braces that deserve further research.

5. Physical therapy and sports therapy: It is very important to communicate with physical therapists and rehabilitation therapists. Tell them the pathological changes of the disease and reach an agreement on the possible recovery time. According to literature reports, the average treatment time is 2 to 3 months before returning to the game for the first attack; for patients with chronic symptoms, it may take 4 to 6 months to achieve the treatment effect. The actual time varies from person to person.

6. Appropriate strength training: Eccentric strength training has been proven to be effective. It may be that special eccentric gymnastics can stimulate the mechanical receptors of tendon cells, produce collagen, help reverse the cycle of tendinopathy, and achieve the treatment goal. Animal experiments have confirmed that appropriate tendon load helps collagen arrangement and stimulates the formation of collagen cross-connections, both of which promote the tensile strength of collagen.

7. Surgery: As the last option for tendinopathy treatment, resection of the diseased tissue can be performed with a success rate of 75% to 85%, or better. It may take 4 to 6 months to recover after surgery.