Effective Recovery Strategies for Achilles Tendonitis: Beyond Medication

Achilles tendonitis

Hello Doctor, last week I visited a nearby orthopedic clinic due to pain in my heel.
The doctor diagnosed it as Achilles tendinitis.
However, the doctor only prescribed muscle relaxants and anti-inflammatory medication, and advised me to soak my foot in warm water at home, without any physical therapy.
After finishing three days of medication, my symptoms improved, but I noticed swelling in my foot, a sensation of floating while walking, and difficulty urinating, with very few trips to the bathroom in a day.
After stopping the medication, my bathroom visits returned to normal and the swelling in my foot decreased, but the pain returned, and now I also feel discomfort in my calf, with tightness and pain while walking.
Doctor, aside from medication, what exercises or methods can help my foot recover? Additionally, when I bend down to pick something up with my heel on the ground, I feel a pulling sensation in the tendon above my heel, as if it is being stretched in segments.
Is this normal? Thank you, Doctor!

Zoe, 30~39 year old female. Ask Date: 2020/04/16

Dr. Wang Shouji reply Orthopedics

Hello, for tendonitis of the foot, in addition to medication treatment, it is important to pay attention to heat therapy and wear shoes that are soft and provide adequate arch support.
Additionally, perform foot stretching exercises regularly, and you may consider consulting a rehabilitation specialist for physical therapy.
Changhua Hospital cares about your health.
Sincerely, Wang Shou-ji.

Reply Date: 2020/04/16

More Info

Achilles tendonitis is a common condition that can significantly impact your daily activities and overall quality of life. It typically arises from overuse, leading to inflammation of the Achilles tendon, which connects the calf muscles to the heel bone. While medication, such as anti-inflammatory drugs and muscle relaxants, can provide temporary relief, a comprehensive recovery strategy that includes rehabilitation exercises and lifestyle modifications is essential for long-term healing and prevention of recurrence.

Effective Recovery Strategies Beyond Medication
1. Physical Therapy: Engaging in a structured physical therapy program is one of the most effective ways to recover from Achilles tendonitis. A physical therapist can design a personalized exercise regimen that focuses on strengthening the calf muscles, improving flexibility, and restoring range of motion. Eccentric exercises, where you lengthen the muscle while it is under tension, have shown to be particularly beneficial for tendon healing.

2. Stretching and Strengthening Exercises: Incorporating specific stretching exercises for the calf muscles and Achilles tendon can help alleviate tightness and improve flexibility. Strengthening exercises, especially for the calf muscles, can enhance the support around the tendon and reduce strain. Examples include calf raises and toe stretches. Always ensure that these exercises are performed within a pain-free range.

3. Ice Therapy: Applying ice to the affected area can help reduce inflammation and pain. It is advisable to ice the tendon for 15-20 minutes after activities that exacerbate your symptoms. This can be particularly helpful after exercising or prolonged walking.

4. Footwear Modifications: Wearing supportive shoes with adequate cushioning can alleviate pressure on the Achilles tendon. Avoid high heels or shoes that lack support. Consider using orthotic inserts if necessary to provide additional arch support and reduce strain on the tendon.

5. Activity Modification: It is crucial to modify your activities to avoid exacerbating the condition. Low-impact exercises, such as swimming or cycling, can help maintain fitness without putting undue stress on the Achilles tendon. Gradually reintroducing activities that involve running or jumping should be done cautiously and only when symptoms have significantly improved.

6. Gradual Return to Activity: Once your symptoms have improved, it is important to gradually return to your normal activities. Sudden increases in activity level can lead to a recurrence of symptoms. Follow a structured return-to-sport protocol that allows for gradual increases in intensity and duration.

7. Massage and Manual Therapy: Soft tissue massage and manual therapy techniques can help relieve tension in the calf muscles and improve blood flow to the area, promoting healing. This can be performed by a qualified therapist.

8. Hydration and Nutrition: Maintaining proper hydration and a balanced diet rich in anti-inflammatory foods can support recovery. Omega-3 fatty acids, found in fish and flaxseeds, and antioxidants from fruits and vegetables can help reduce inflammation.

Addressing Your Symptoms
Regarding the sensation of your Achilles tendon feeling "pulled apart" when bending down, this could be due to tightness or strain in the tendon or surrounding muscles. It is not uncommon for individuals with Achilles tendonitis to experience unusual sensations as the tendon heals. However, if this sensation is accompanied by significant pain or discomfort, it is advisable to consult with a healthcare professional for further evaluation.

Conclusion
In summary, while medication can provide temporary relief from the symptoms of Achilles tendonitis, a multifaceted approach that includes physical therapy, exercise, and lifestyle modifications is crucial for effective recovery. Always consult with your healthcare provider or a physical therapist before starting any new exercise program, especially if you are experiencing pain or discomfort. They can guide you on the appropriate exercises and modifications tailored to your specific condition.

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