Corto y pego lo más interesante que, sobre la tendinitis aquílea, aparece en la web http://www.achillestendon.com/. Está en inglés, y siento no verme con coraje de plantar una traducción decente. Me lo dejo ahí de recordatorio, para evitar tentaciones, porque tengo unas ganas locas de calzarme mis nuevas asics y el tendoncito de las narices dice que cuidadín con tocarle las ídems.
The Achilles tendon is fibrous tissue that connects the heel to the muscles of the lower leg: the calf muscles. Leg muscles are the most powerful muscle group in the body and the Achilles tendon is the thickest and strongest tendon in the body. Contracting the calf muscles pulls the Achilles tendon, which pushes the foot downward. This contraction enables: standing on the toes, walking, running, and jumping. Each Achilles tendon is subject to a person’s entire body weight with each step. Depending upon speed, stride, terrain and additional weight being carried or pushed, each Achilles tendon may be subject to up to 3-12 times a person’s body weight during a sprint or push off. For more information on Achilles tendon anatomy see: Physiology.
Larger version of Achilles Tendon IllustrationsCauses of Injury Overuse, misalignment, improper footwear, medication side effects, and/or accidents can all result in Achilles tendon injuries. Multiple causes often contribute to the same Achilles tendon injury. For information on each of these Achilles tendon injury causes, see Causes of Injury
The best way to prevent an Achilles tendon injury is to a) stay in overall good shape, and b) warm-up, stretch, and strengthen the Achilles tendons. The best way to prevent an Achilles tendon injury from getting worse is to address the injury immediately: it will get worse if not addressed. For more information on preventing Achilles tendon injuries see: Preventing Injuries.
Undue strain results in over 230,000 Achilles tendon injuries per year in the U.S. alone. The undue strain could be caused by a variety of factors, including: tightness or weakness of the leg, knee, hip, or back; high or low arches; uneven leg lengths; alternating between high (2”) heels and exercise shoes; and/or sudden (rather than gradual) increases in training, such as running faster, further, or up steeper hills. The most common Achilles tendon injuries are Achilles tendinosis (formerly called Achilles tendonitis) and Achilles tendon rupture. Achilles tendinosis is a soreness and stiffness that comes on gradually and continues to worsen until treated. It often starts with stiffness and creaking when first getting out of bed in the morning. Lightly pinching the Achilles tendon with the forefinger and thumb will indicate soreness. Achilles tendinosis is a common injury among middle and long distance runners.
Treatment for Achilles tendinosis includes: relative rest, muscle strengthening, physical therapies (i.e. ultrasound, laser photostimulation, electrical stimulation), and ice.
Correct footwear can be one of the keys to preventing, recovering from, and preventing the reoccurrence of, Achilles tendon injuries. Incorrect footwear can cause or exacerbate Achilles tendon injuries. Selecting the right shoe or sneaker in terms of cushioning, arch height, and pronation is always beneficial. Some people experience a tremendous temporary benefit from a little extra padding or cushioning under the heel. The temporary heel padding reduces the length of Achilles tendon stretching made with each step or stride.
Treatment includes five simultaneous steps. In cases of tendonitis an anti-inflammatory may also be used.
Relative rest. Stop doing the activity that caused the injury for between a week and a few months, depending upon the degree of degeneration. Relative rest should last at least 1 week for a grade 1 or 2 injury, at least 3 weeks for a grade 3 injury, and at least 1 month for a grade 4 injury. For an understanding of injury grades see: injuries. During the relative rest period also stop performing activities and sports that are similar to the one that caused the injury, i.e. soccer is similar to running, handball is similar to tennis, etc.
Achilles tendinosis is not an excuse to get out of shape: relative rest is the treatment, not total rest. During the relative rest period do alternate sports that are easy on the Achilles tendon, such as swimming, moderate cycling, upper body weight lifting, etc. After the relative rest period, resume gradually. For example, if you are a runner with a grade 3 injury resume with jogging until you are sure that you are down to at least a level 2 injury, then resume running moderate distance with no speed work or hills until you are down to at least a grade 1 injury, then resume running at the same intensity as prior to the injury.
Stretch the calf muscles for 20 or more minutes per day. If the other leg muscles, the hip muscles, and the back muscles are tight, they may be causing tightness of the calf muscles, so stretch these other muscles as well. In addition to standard stretching, muscles can also be stretched by strengthening their opposing muscle group. For example, strengthening the anterior tibialis, the small muscle group on the front of the lower leg, stretches the calf muscles. As part of stretching, consider massage.
Eccentric strengthening of the leg muscles, particularly the calf muscles. Do daily or every other day calf raises on a stair or using a calf raise machine in a gym. Start slowly using just your body weight doing three sets of 10 or 15. When this can be done without pain, gradually increase the speed, number of repetitions per set, amount of weight, and number of sets. Concentrate on the eccentric rather than the concentric portion of the exercise (the calf lowering rather than the calf raising portion of calf raises). On each repitition, be sure to go all the way down for a full stretch of the Achilles tendon. Do the calf raises after, rather than before, any other exercises that you are doing.
Physical therapy. Therapies applied by professional physical therapists to repair tendon degeneration include: ultra sound, electric
stimulation, and laser photostimulation.
Ice therapy. Apply ice to reduce the degeneration. Ice should not be applied directly to the skin, use an ice pack instead. Apply the ice pack to the Achilles tendons after exercise or physical therapy. Apply as often and as for as long as possible.
Avoid anti-inflammatory and pain killing drugs. The anti-inflammatory drugs will not help because Achilles tendinosis is a degenerative injury rather than an inflammation (see injuries). The pain killing drugs will mask the problem, which is likely to cause the degeneration to get worse. In addition to being ineffective, anti-inflammatory and pain killing drugs are also expensive.
In the very worst cases of Achilles tendinosis, surgery may be required, but only as a very last resort. Consider surgery if all the above steps have been taken completely and repeatedly, and the Achilles tendinosis has not improved for at least six months.