Achilles tendon bursitis: causes, symptoms and treatment methods

Achilles tendon

- one of the main tendons that are responsible for the full movement of a person.
Without it, it is impossible to bend the foot and turn it inward - movements that occur when walking. Given the constant daily stress, the Achilles tendon
is susceptible to injury and inflammation.
They occur especially often (about 6 times more often) in men. Also, people of postmenopausal age are predisposed to diseases and ruptures of the Achilles tendon
.
Is it possible to protect yourself from the problem and what to do if the Achilles tendon hurts
? Read below.

Achilles bursitis - what is it?

The Achilles tendon withstands enormous loads every day. It connects the foot to the lower leg and runs behind the heel bone. It is this tendon that works when walking.

Achilles bursitis is an inflammation of the tendon, characterized by the accumulation of exudate in the joint capsule. The pathology causes serious discomfort. With prolonged walking, injuries, or wearing tight shoes, the disease worsens, swelling increases and severe pain appears.

Achilles tendon bursitis requires timely treatment. In case of heavy load, there is a risk of its rupture due to the pressure of the accumulated liquid. This can lead to severe mobility impairment and lameness.

With Achilles tendon bursitis, its synovial bursa becomes inflamed (in Fig. 4)

Symptoms of inflammation and rupture of the Achilles tendon

Timely noticed symptoms of rupture or inflammation in the Achilles tendon

They often help with outpatient treatment - at home, with periodic consultations with a doctor.
And ignoring them can lead to surgery, because constant injury to already deformed collagen fibers can lead to complete rupture of the Achilles tendon. Signs of inflammation in the Achilles tendon
are:

• pain when palpating and stepping in the heel area, which intensifies after physical activity and subsides during rest;
• swelling of the ankle;
• redness and heated skin on the back of the ankle;
• crunching and pain when trying to rotate the foot;
• deterioration of plantar mobility;
• noticeable tendon stiffness, loss of normal stretching ability;
• difficulties when climbing stairs, jumping, rising on toes.

A ruptured Achilles tendon
is accompanied by the following symptoms:

• swelling in the ankle joint with “retraction” at the site of the rupture;
• sharp pain, especially when trying to stand on your heel or toe;
• severe difficulty walking.

Types of disease

The disease can occur in two forms - acute and chronic. In acute Achilles bursitis, severe swelling and pain occur when walking. Chronic bursitis is characterized by periodic exacerbations. This occurs with minor injuries to the heel bone or due to wearing uncomfortable shoes. Often, chronic bursitis is a complication of diseases of the musculoskeletal system, for example, arthrosis of the foot or arthritis of the toes.

Acute bursitis, despite severe symptoms and very severe discomfort, can be treated quickly and successfully. Chronic inflammation is characterized by moderate or mild symptoms, but is difficult to treat.

Based on location, anterior and posterior bursitis are distinguished. Posterior bursitis causes deformation of the heel bone due to inflammation of the synovial sac between the skin and the tendon. Anterior bursitis is an inflammation of the heel bursa at the front of the heel bone.

ACHILLES TENDON: MAIN DISEASES AND TREATMENT METHODS

Achilles can be found on his heels. Surely, many of you have heard this phrase, but not everyone fully understands its true meaning. So here it is. In common parlance, the Achilles heel is the most vulnerable spot of any person.

Historically, the Achilles heel is a Greek myth that tells how Achilles' mother, Thetis, wanted to make her son's body invulnerable. Dipping him into the sacred river Styx, she held his heel, which was not touched by the water, so the heel remained Achilles’s only vulnerable spot, where he was mortally wounded by Paris’s poisoned arrow. This is where the expression “Achilles' heel” comes from, meaning the weak side of something or the most “sick” and unprotected place of a person.

Today we will talk about such a concept as the heel (Achilles) tendon.

In orthopedics, the calcaneal tendon is the largest tendon and the most powerful part of the human musculoskeletal system and is called the Achilles.

The Achilles tendon (lat. tendon Achillis) is a massive tendon, which is formed by two muscles - the gastrocnemius and soleus, and is located between the heel and the gastrocnemius muscle, which, combining into a single mechanism, transmit the forces of the lower leg muscles to the foot. It acts as a kind of shock absorber, as it raises the heel, restrains the influence of traumatic factors, and is also responsible for a person’s movements with the entire foot.

MAIN DISEASES OF THE ACHILLES TENDON

Among the main diseases of the heel tendon, orthopedists identify tendinitis and achillodynia (achillobursitis), which we will discuss in more detail below.

Achilles tendonitis

This disease is an inflammatory process that occurs as a result of injury or overuse of the Achilles tendon, located along the back of the lower leg and connecting the head of the calf muscle to the heel bone. In simple terms, tendonitis is a pathological inflammation of human tendon fibers.

Most often it affects professional runners, tennis players, basketball and volleyball players who do not control the intensity and smoothness of sports training.

Symptoms of tendonitis

This disease is accompanied by classic symptoms - redness, swelling, pain and stiffness of movement. Typically, pain occurs during activity and subsides during rest. During inflammatory processes in tissues, the removal of salts and metabolic products is disrupted, causing fibers to lose their strength and flexibility. If they continue to receive stress, cracks and micro-fractures form. Over time, the tendons recover, but lose elasticity and acquire scars, therefore, in order to prevent chronic consequences, it is necessary to seek professional medical help in a timely manner, in particular, to the specialized Ladisten clinic.

Treatment method

The only effective way to get rid of pain and reliably cure tendonitis is to undergo complex treatment, one of the most effective methods of which is shock wave therapy (SWT). Without timely and proper treatment, tendon rupture may occur. This is a much more serious condition and often requires surgery. If the inflammation of the tendon does not go away after several weeks or months, the patient may develop tendinosis (a disease of the tendons and ligaments of a degenerative-dystrophic nature, in which they become thinner, wear out, and become brittle).

Achillodynia (achillobursitis): what is it?

Achillodynia is an inflammatory process that affects the tendon bursa, resulting from inflammation of the Achilles tendon and the surrounding membranes, which often develops precisely after excessive physical exertion. Often this disease is also called achillobursitis.

Who most often suffers from Achilles bursitis?

This disease occurs quite often, along with inflammation of large joints, mainly in middle-aged men. Also, after intense training, physically unprepared people suffer from Achillodynia. This applies not only to running disciplines, but also to other sports. Overweight people also often have problems with the Achilles tendon. It is important to note that rheumatism and foot deformities significantly increase the risk of developing Achillodynia, so people suffering from these diseases need to be especially vigilant.

Causes

The reasons for its development are various types of injuries, tight and uncomfortable shoes, arthritis, arthrosis, endocrine system disorders, hereditary malformations in the foot area, poorly developed ligamentous apparatus, hypothermia, obesity, excess weight, diseases of the musculoskeletal system, infections acquired after receiving various injuries (staphylococci, streptococci, pyogenic microbes), as well as gout and hormonal problems.

Types of Achilles bursitis

Depending on which side of the tendon its focus arose, posterior and anterior bursitis are distinguished.

• Posterior bursitis. Occurs mainly in women as a result of wearing high heels. The lift provokes so-called “bumps”, which lead to the disease. Early symptoms include pain, redness and hyperthermia, and late symptoms include a hard and tender growth known as Haglund's deformity.
• Anterior bursitis. A disease that is also known as Albert's disease. It can be caused by any condition accompanied by a load on the tendon area. Associated diseases are gout and rheumatoid arthritis. If the cause is a bruise or gout, the symptoms develop quickly, but if other disorders develop gradually. Symptoms include pain, swelling and red spots spreading on both sides of the heel.

Symptoms of Achillodynia

With Achillodynia, the patient experiences a protrusion in the heel area due to the accumulation of fluid in the joint capsule.

Characteristic symptoms of inflammation: pain, local increase in temperature, swelling and functional impairment.

Diagnosis of the disease

The diagnosis of achillodynia (achillobursitis) is made to the patient based on the characteristic clinical picture and the presence of fluid in the joint, which is detected by puncture of the joint capsule. For differential diagnosis with other diseases, it is necessary to conduct an X-ray examination.

Treatment options

For treatment, it is necessary, first of all, to provide rest to the joint, for which the patient is given a pressure and warming bandage, and the patient’s joint is fixed.

The most effective way to treat Achillodynia today is shock wave therapy (SWT), which restores cellular structure, reduces pain, improves metabolism and microcirculation, resolves fibrosis and stimulates collagen production. Physiotherapeutic measures such as high-intensity laser, electrotherapy, TR-therapy, phonophoresis and magnetotherapy also provide excellent results in the treatment of achillodynia in a short period of time. If the disease does not go away on its own for a long time, then the patient is punctured into the joint capsule and the fluid is removed, followed by the introduction of antibiotics and glucocorticoids into the joint cavity. In the case of the development of purulent bursitis, surgical opening of the joint capsule with the installation of drainage and secondary healing without suturing the wound is indicated.

Contraindications

The main contraindications to surgery on the Achilles tendon are:

• poor general health of the patient;
• unsatisfactory condition of the lower leg tissues, which prevents adequate regeneration of postoperative sutures;
• severe bleeding disorders;
• decompensated pathology of internal organs;
• local infection of the skin and subcutaneous layer.

Rehabilitation period

After surgery, rehabilitation time is on average 1–3 months. Not only the strength of the sutures, but also the likelihood of re-injury depends on compliance with restorative measures. Such measures include a state of complete rest, lack of physical activity and fixing the foot in an elevated position. Traditionally, rehabilitation includes the following stages:

• The use of painkillers and anti-inflammatory drugs.
• Wearing a plaster cast for the first week after surgery.

After removing the plaster, careful development of the joint begins, but without putting stress on the sore foot. In this case, crutches are used. After one to two months, bandages and orthoses are applied.

In addition to physical rehabilitation, physiotherapy is carried out aimed at eliminating postoperative swelling, improving trophism and restoring muscle function. Massage, magnetic therapy, UHF, and electrical myostimulation can be used.

The most important thing in rehabilitation is its gradualness, because any premature measures can lead to rupture of the stitches. The Ladisten Clinic will help you keep your heels in perfect order. We are always happy to help you!

Your Ladisten Clinic.

Reasons for the development of the disease

The disease can be caused by various reasons. Acute bursitis appears due to:

• wearing uncomfortable shoes,
• excessive stress on the foot,
• injuries and damage to the foot,
• infection of the synovial sac of the joint,
• hypothermia of the feet,
• circulatory disorders in the foot.

A fairly common cause of the disease is uncomfortable shoes. Wearing shoes that are too narrow or the wrong size leads to constant compression of the Achilles tendon. First, a callus forms at the site of compression, and over time an inflammatory process develops, affecting the tendon and joint. Inflammation is often caused by narrow shoes made of artificial materials, the back of which strongly compresses the tendon. Also, the reason may be hidden in the incorrect position of the foot when walking, for example, during long walks in high heels.

Read also: Osteoporosis in men: features, causes, symptoms and treatment, prevention

Constantly wearing uncomfortable shoes can cause inflammation

Bursitis can develop as a result of trauma, damage, or heavy stress. For this reason, professional athletes often encounter pathology.

Inflammation of the tendon due to infection is another common form of the disease. This can occur due to infection of the entire body by pathogenic microorganisms. Also, large calluses on the heels can cause the development of the disease. When calluses are damaged, the risk of infection increases. Infection of the wound leads to pathogenic bacteria spreading through the bloodstream to surrounding tissues, including the joint capsule and tendon.

When hypothermia occurs, the normal blood flow of the foot is disrupted. If a person wears uncomfortable shoes or accidentally gets injured, there is a high probability of tendon inflammation.

Inflammation due to impaired blood flow can be caused by injuries, and is also often observed in obese people due to the heavy load on the tendon.

Chronic bursitis develops due to:

• rheumatoid arthritis,
• infectious arthritis,
• arthrosis of the joints,
• gouty arthritis.

In this case, bursitis is considered to be a complication of these diseases, but not an independent pathology. Such secondary bursitis is quite difficult to treat, as it worsens every time the underlying disease worsens.

Chronic bursitis can also be a consequence of improper treatment of acute inflammation. In this case, it worsens when wearing narrow shoes with hard backs or long walking. In women, exacerbation of chronic inflammation occurs when wearing high heels.

What types of heel spurs are there?

To answer all questions, you need to understand the terminology:

Plantar fasciitis is a foot disease characterized by inflammation of the heel fascia.

Fascia consists of muscle tissue, fat pads and is located:

• on the base (plantar);
• on the back side (rear).

The dorsal fascia is very thin and closely adjacent to the Achilles tendon. The main function of the plantar fascia is to protect the bones from impact loads, i.e. depreciation. The main purpose of the dorsal fascia and Achilles tendon is to flex the foot when walking.

Inflammation can occur on any part of the fascia: both plantar and dorsal. In 90% of cases, fasciitis develops on the bottom of the heel, resulting in the formation of a bone growth in the form of a claw-shaped spike.

This growth is called a plantar spur of the heel bone and manifests itself as typical symptoms of a heel spur: severe pain, redness around the spine, increased pain when trying to lean on the heel, etc.

In this case, it is recommended to use special heel pads for shoes.

When the dorsal fascia becomes inflamed, which in 99% of cases is associated with Achilles tendon injuries, a posterior heel spur is formed. The mechanism of formation of an Achilles spur is exactly the same as that of a plantar spur: bone-salt deposits form at the site of damaged fascia, and a spike begins to grow.

Symptoms of the disease

When inflammation occurs, a lump forms above the heel

Externally, bursitis resembles a small tumor on the back of the foot. It is located just above the heel and looks like a small bump of inflamed skin. The maximum diameter of inflammation is 10 cm.

This neoplasm is a consequence of the accumulation of exudate between the heel bone and the synovial bursa of the joint or directly in the bursa. When bursitis worsens, the skin becomes very red, the affected area becomes hot to the touch and causes serious discomfort. Characteristic symptoms:

• swelling of the skin in the affected area,
• severe hyperemia,
• pain when pressing,
• severe leg fatigue
• pain when walking on your toes.

The intensity of the pain syndrome depends on the severity of the disease. With mild inflammation, the tubercle is small in size and only hurts when pressed. A large affected area is characterized by severe pain when wearing any closed shoes. This is because the heel of the shoe usually has a seam that is slightly thicker than the rest of the material. The suture puts pressure on the inflamed and swollen area, constantly irritating the nerve endings. As a result of wearing uncomfortable shoes, bursitis not only worsens, but also progresses rapidly. Due to compression of the inflamed tendon, the affected area grows and the swelling increases in size.

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A characteristic feature of the disease is the absence of discomfort at rest. As soon as you take off your uncomfortable shoes, the tendon will ache for a while, and then the discomfort will go away.

With chronic bursitis, the pain is not so intense, but is present almost constantly. Due to swelling of the leg ligaments at night, the peak of pain is observed in the morning. A person needs to “disperse” for the pain syndrome to subside. Thus, if the symptoms of acute bursitis subside, you just need to take off your shoes; chronic bursitis subsides only with exertion.

The pain syndrome with achillobursitis, regardless of its type, increases when walking on the heels. As soon as you lean on the back of your heel, the pain immediately intensifies. This allows you to conduct self-diagnosis and suspect the development of the disease in time.

You can recognize the disease yourself by increased pain when standing on your heels.

Achilles or plantar heel spur: diagnosis

Until a visible spike appears, heel and Achilles spurs have the same symptoms. Therefore, before wondering how to remove a heel spur, you need to accurately determine its location.

To diagnose a heel spur, the orthopedist prescribes the following tests:

Radiography

The picture will accurately show the location and size of the growth. Typically, a plantar heel spur is larger than the spike on the back of the heel.

Ultrasound

If the growth is not sufficiently looped, it may appear unclear in the image. An ultrasound examination will accurately determine not only the nature of the spur, but also the condition of the surrounding tissues.

X-rays and ultrasounds are performed for both feet, because In most cases, patients are diagnosed with bilateral heel spurs - inflammation of the fascia and spines on both heels. The size of the growths and pain may vary.

Treatment of bilateral fasciitis requires especially careful treatment of the legs. Walking on tiptoes is not allowed to protect sore heels from stress.

The best option for protection is the use of therapeutic insoles for heel spurs, heel pads and instep supports. At night, it is recommended to wear a Strasbourg sock, which helps restore the fascia.

How dangerous is the disease?

For Achilles tendon bursitis, treatment must be carried out promptly. At best, acute bursitis will turn into a chronic form, which is very difficult to get rid of. Chronic bursitis will constantly remind you of itself when buying new shoes. New shoes will always put pressure on the Achilles tendon due to the rigidity of the heel, provoking an exacerbation of the inflammatory process and the appearance of pain.

Dangerous complications of acute bursitis:

• sepsis,
• involvement of the foot joints in the inflammatory process,
• tendon rupture.

The risk of developing sepsis exists with infectious inflammation. In this case, pathogenic microbes can spread throughout the body through the bloodstream. Sepsis requires long-term and complex treatment.

Advanced bursitis can lead to the development of inflammation of large and small joints of the leg. This occurs due to a violation of the distribution of body load on the affected leg when walking. Pain will cause a person to lean more heavily on the healthy leg, which can lead to joint problems.

The most dangerous scenario for bursitis resolution is a tendon rupture. Without timely help, this leads to a complete loss of the ability to lean on the affected leg. As a result, you will have to use a cane to walk, since it is not always possible to restore the functionality of the tendon.

Establishing diagnosis

Achilles tendon bursitis has such characteristic symptoms that there are no problems with making a diagnosis. The doctor makes the initial diagnosis after a visual examination. Additionally, you need to take a blood test to determine the presence of an inflammatory process. To exclude the infectious nature of the disease, a synovial fluid analysis is performed. Studying its composition helps to accurately determine the type of bursitis and the cause of its development. If there are significant changes in the heel bone, an additional x-ray should be taken.

Conservative treatment

Achilles tendon bursitis should be treated comprehensively; the exact treatment regimen is selected by the attending physician individually for each patient. Treatment includes:

• use of analgesics and non-steroidal anti-inflammatory drugs,
• corticosteroid injections,
• physiotherapy.

Read also: Surgery for gout: indications, types, stages, is it possible to do without surgery?

To relieve pain, analgesics or non-steroidal anti-inflammatory drugs are prescribed. These include Ibuprofen, Diclofenac, Nimesulide. Additionally, ointments containing these agents can be used, but only for mild forms of the disease.

Anti-inflammatory drugs relieve unpleasant symptoms

Severe bursitis with severe tissue changes and severe swelling is treated with corticosteroids. These hormonal drugs are injected directly into the site of inflammation. This procedure helps to quickly stop the inflammatory process, eliminate pain and prevent the development of complications. Since these drugs are unsafe and are synthetic analogues of hormones, treatment is carried out only under the supervision of a doctor.

Treatment of Achilles tendon bursitis is complemented by the use of anti-inflammatory gels, creams and ointments - this quickly eliminates pain and improves local blood circulation.

For infectious or bacterial bursitis, when suppuration occurs at the site of accumulation of exudate, antibiotics are prescribed. Additionally, the joint capsule is cleaned. To do this, the doctor makes a puncture and removes the accumulated fluid with a special syringe.

After drug therapy, removal of exudate and relief of inflammation, treatment is continued with physiotherapy. If the Achilles tendon is damaged, shock wave therapy is prescribed. This stimulates metabolic processes in cartilage tissue, improves blood flow and helps reduce growths. Laser treatment is also practiced.

Achilles tendon treatment

Conservative treatment of the Achilles tendon

is based on pain relief, relieving swelling and providing rest to the affected tissues.
The etiology of the problem makes its own adjustments to the treatment strategy. For example, if an x-ray reveals calcification of the Achilles tendon
, characteristic of tendonitis, it is recommended to use shock wave therapy, and, if necessary, surgical treatment.

If the Achilles tendon

pain due to injury, local anesthesia (for example, novocaine) and a plaster cast are used. For complete ruptures and avulsions, suturing surgery is always performed.

Medicines

For the treatment of Achilles tendon

There are 2 main groups of drugs used: NSAIDs (non-steroidal anti-inflammatory drugs) and chondroprotectors.
NSAIDs (same as NSAIDs) help relieve symptoms of inflammation and reduce pain and swelling. They are usually prescribed in the form of gels, ointments and compresses, but in case of severe inflammation of the Achilles tendon
, tablets can also be used.
The course of treatment with oral NSAIDs usually lasts 10-12 days. You can use external remedies for inflammation for several weeks or even months (for tendon injuries). If the Achilles tendon hurts
even after taking NSAIDs, with severe tendonitis or inflammation, glucocorticosteroids are prescribed.

The value of chondroprotectors for the treatment of Achilles tendon

lies in their effect on collagen synthesis and the health of joint structures. This group of drugs also has a preventive effect, and therefore is recommended for regular use by people who are at risk for Achilles disease (professional athletes, patients with musculoskeletal diseases). Because the Achilles tendon lacks blood vessels, tissue repair is usually very slow. Taking chondroprotectors helps speed up this process and prevents the appearance of abnormal, unstable collagen fibers.

Chondroprotectors should be taken for at least 2-6 months a year, since they have a cumulative and prolonged effect. A classic example of a chondroprotective drug is Artracam - these sachets with glucosamine should be taken daily for 2-4 months. Artracam not only relieves pain and promotes normal collagen synthesis in the tendon, but also protects other joints and tendons involved in maintaining upright posture.

Fixation

Since the Achilles tendon is extremely sensitive to loads associated with body movement, patients are recommended to wear fixing bands and orthoses. It is also important to provide rest to the sore limb: you should avoid running, jumping, and suddenly stepping on the foot and heel; During everyday activities, such as climbing stairs, the body weight should be compensated by the calf muscles.

Ankle bandages help prevent further injury to the Achilles tendon, relieve swelling and promote normal tissue repair without unwanted scarring. At the first signs of an inflammatory process, it is recommended:

• applying a pressure bandage;
• rest with the ankle joint raised higher than the hip joint (for example, you can place a pillow or sofa cushion under your leg);
• applying ice or an ice compress (for no longer than 20 minutes).

To fix the affected tendon, you can tightly bandage the foot and lower leg with a regular or elastic bandage. It is advisable to consult a doctor before doing this. Practicing traumatologists say that it is extremely rare for patients to be able to apply the bandage correctly the first time and actually fix the muscles, ligaments and tendons in a stable position.

Exercises

For diseases and injuries of the Achilles tendon, therapeutic exercises are allowed only after the inflammatory process has resolved. At the initial stages, gentle stretching of the ankle muscles is performed. Strengthening them allows you to reduce the load on the tendon, and stretching them helps to properly structure the “young” collagen fibers, which were initially twisted like spaghetti.

With painless movements in the ankle joint, incl. when rotating the foot or lifting on the toes, you can move on to the main exercise therapy complex. Physical activity is increased gradually. adding from 5 to 10% per week. If your Achilles tendon hurts

after exercise, the load is reduced. Each therapeutic exercise session should begin with a warm-up (warming up the muscles) and a cool-down (stretching). This helps to avoid re-injury of the tendon and adjacent structures of the musculoskeletal system. The following groups of exercises are used:

• Balancing exercises. They train not only large, but also small muscles that are responsible for maintaining balance and serve to prevent tendon injuries.
• Stretching exercises for the short and long calf muscles.
• Exercises to stretch the muscles of the foot.
• Exercises to strengthen the calf and other muscles.

Therapeutic and preventive gymnastics for injuries and diseases of the Achilles tendon involves all the muscles of the legs, lower back, abdominals - i.e., those parts of the skeletal muscles that are directly responsible for stabilizing the human body and keeping it in an anatomically correct position. Such complex training, carried out every day to maintain tone, can significantly redistribute the load from the Achilles tendon.

During exercise, it is recommended to wear sports shoes that stabilize the ankles and provide good shock absorption of the foot (especially the heel). As an example, the following are effective exercises for restoring and strengthening the tendon.

• Stand upright until you feel a stretch in your ankles, then gently shift your weight to your affected leg. Trying to take the weight off your ankles through your calf muscles, shift your weight to your heel, lifting the front of your foot. Use your healthy leg to return to the starting position. When performing the exercise, noticeable discomfort is possible, which, however, should not turn into acute pain. The exercise is performed in 3 sets of 15 times twice a day. If necessary, you can increase the load with a small backpack.
• Place your heels on a step or other small raised surface so that your toes hang freely from it. Extend your right hand in front of you and place your left hand on your belt. Without losing your balance, slowly squat down and then straighten up. It is recommended to perform 3 sets of 10 exercises daily.
• Stand facing a wall at arm's length (not including your palm). Place one foot on the wall, pressing your heel into the surface with both hands. After a minute, change legs.
• Sit on the floor with your legs straight. Place a rolled towel over the instep of your foot, holding it by the ends. Gently extend your foot away from you, creating moderate resistance using the towel. It is recommended to perform 2 sets of 10 times throughout the day.
• Place a massage roll under your shin. Perform back and forth movements on it, trying to knead the calf muscles, but without touching the sore tendon. The shin can be rotated in different directions to increase the area of ​​the muscles being stretched.
• Sitting on a chair, alternately “write” in the air with the toe of first one foot and then the other (letters, numbers, shapes). 10-15 approaches are recommended at intervals of 20 seconds.

To strengthen the calf muscles, patients may be recommended swimming, water aerobics, and cycling.

Physiotherapy

Physiotherapeutic procedures contribute not only to the elimination of local symptoms and speedy recovery from injuries. They also trigger the formation of healthy collagen fibers in the Achilles tendon (i.e., straightening and strengthening them). If your Achilles tendon hurts

, the following physiotherapeutic techniques are used:

• magnetic therapy;
• shock wave therapy;
• ultrasound therapy with medications (most often these are anti-inflammatory drugs that prevent the formation of unstable and rupture-prone scar tissue in the tendon and its sheaths);
• ozokerite;
• cryotherapy;
• paraffin applications;
• balneotherapy (especially mud therapy);
• therapeutic massage and exercise therapy.

As a rule, the duration of a course of physiotherapy is 10 sessions, but it can be extended as prescribed by the attending physician.

Surgery

Surgical treatment of Achilles tendon is used in cases where the Achilles tendon hurts

, despite complex therapy - i.e., when conservative treatment methods have already been exhausted or a priori cannot resolve the pain syndrome.

Typically, it is indicated for the formation of a bone spur on the back of the heel bone (called Haglund's deformity), severe ruptures, or even complete separation of the Achilles tendon. There are 3 main types of operations used:

• removal of bone growths;
• excision of damaged tissue that cannot be restored;
• stitching the tears with a lavsan or nylon seam.

Also, in case of ruptures, tendon repair may be recommended. Recovery after surgery on the Achilles tendon involves immobilizing the limb (including the knee joint) and wearing a special “boot” made of plaster or other material for 45-60 days. In the absence of contraindications, for a speedy recovery, massage, physiotherapy and exercise therapy are carried out under the supervision of a qualified rehabilitation physician.

Folk remedies

An alternative method is to treat Achilles tendon bursitis with folk remedies. For this purpose, dry heating and therapeutic compresses are used. Warming is carried out using calcined salt, which is poured into a tight bag and applied to the affected area for 5 minutes twice a day.

Important! Warming up is prohibited in case of infectious inflammation. This can lead to dangerous complications and infection entering the general bloodstream.

Vinegar with honey, alcohol, and cabbage leaves are used as compresses. Before the compress, the feet are steamed in a bath, and then the remedy is applied under a gauze bandage overnight.

Before using any folk remedies, you should consult your doctor.

Prevention

To prevent the development of the disease, it is necessary to choose the right shoes. It must be made from natural fabrics and selected exactly to size. Women are advised not to wear too high heels all the time, preferring shoes with small, stable heels. Injury and damage to the Achilles tendon should also be avoided. It is important for athletes and people who spend a lot of time on their feet to rest their feet. It would also be a good idea to use special orthopedic insoles and heel inserts.