Question:After six months of chronic calf pain, I went to see me doctor. I was afraid I might have a blood clot. I've been diagnosed with chronic Achilles' tendinopathy. I have a prescription for an antiinflammatory drug and physical therapy. Is this something I can just treat myself?
Answer:Chronic Achilles' tendinopathy can be very difficult to treat successfully. Experts advise starting with a program of conservative care. This begins with antiinflammatory medications. Even though there is no active inflammation, for some reason these drugs do seem to help.
A course of physical therapy can be very helpful along with the medications. The therapist will use heat modalities such as ultrasound and manual therapy to realign the tendon fibers. This can help promote healing.
There have been some studies suggesting that a program of eccentric loading exercises work well for Achilles' tendinopathy. But other studies have not confirmed these results. If you want to try this idea, the therapist can show you how to do these exercises.
The basic idea is to start with the foot in a neutral position and slowly lengthen the muscle. The program is gradually increased until you can do three sets of 15 repetitions.
Other forms of treatment may include special insoles in your shoes to place your foot in good alignment for healing. Shock-wave therapy has also been tried with good success for some people. A special device is used to apply a pulse through the skin to the injured tendon. Low-energy shock waves therapy brings blood to the area. Pain or nerve endings are blocked and soft tissue healing is enhanced.
Most of these treatment ideas require an initial assessment and program set up. Once you get started, you may only need occasional monitoring. For faster results it's a good idea to have an individualized program. This will allow you to ask questions and help keep you on track, too.Jan D. Rompe, MD, et al. Eccentric Loading Compared with Shock Wave Treatment for Chronic Insertional Achilles Tendinopathy. In Journal of Bone and Joint Surgery. January 2008. Vol. 90. No. 1. Pp. 52-61.
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