What's the best treatment for achilles tendinitis?
I've been rehabbing my achilles tendinitis for almost one year. ART has proven the most effective, but I have not done it consistently due to the high cost. Physical therapy was mainly about calf raises and strengthening my hips and glutes, which I'm sure has helped, but when it comes to relief, ART has been the best bet. Any fellow achilles tendinitis (or chronic achilles tendonopathy) sufferers out there? What worked for you?
I have pretty high arches and I supinate a lot, which I assume is related. I wear orthotics (not medical grade, but the makeshift kind the podiatrist can make out of your shoe's sole), which has helped I think. But I am still on the hunt for the perfect shoe for my feet.
That said, it's an injury that takes a loooong time to heal because of its location and the lack of vascularity in tendons.
Are you "rolling" your foot? As previously mentioned the stretching of the foot is very important - especially for the fascia. But not just stretching it; the actual rolling of the foot releases any tightness, trigger points (hot spots) and makes a huge difference. This should/can be done upon waking as well as before exercise. And this can (should) then help with many other issues as well (ie., tight calfs, knee tracking and hip centration); hence, healing. Ground forces travel up...so make the energy flow smooth.....starting at the base.
FYI, my favorite is a spikey ball....but rolling over anything (even square) is most excellent.
And you can also freeze cups of water and roll over the cup to help with inflammation. I do believe wrapping (and K-tape if you can get) are important while healing in day to day living.
Be gentle; and here's to healing, Joy
I suggest that you check out www.melthmethod.com to see whether there is a MELT instructor anywhere near you. You can also find more information about MELT at that web site. And you are more than welcome to check out my web site www.meltnc.com to look at the information that I have compiled.
I have heard people drawing comparisons between MELT and ART because they are in the same ballpark. One major difference is that MELT is self-treatment.
It sounds like you have a pretty good grip on treatment methodologies and the responses that you have recieved are the typical and are correct. I think if is really awesome that you have tried so much but maybe there's are a few more things that you can try that have yet to be mentioned.
The human skeletal system is set up such that bones stack on top bones so that forces can be evenly disapaited throughout. In a perfect world, the muscular system is set up so that there is an agonist-antagonist relationship that is in balance and movement follows a predictable pattern.In the case of your foot, you have made an excellent observation by noticing that your foot oversupinates. Yes, that certainly does indicate that your peroneals, gastroc/soleus, and posterior tibialis are overactive at the knee and below. This can increase the tension on the Achilles tendon. But if we look further at the kinetic chain we are likely to see that external rotators of the hip (glutes, pirformis) will be tight, in addition to the rectus abdominis. Based on the attachment points of the rectus this also means that the rib cage will be pulled forward, which is normally accompanied by rounded shoulders and a forward head carriage to keep the eyes level with the horizon. Kind of think of the downhill skiers position, which is a common runners posture.
My point is that since our body is a kinetic chain and treatment at the the hip and for hasn't seemed to the answer, the real problem could be in your upper body. For me this would indicate daily corrective work. Being that you have tried to treat this for more than a year isn't surprising. Feet tale a really long time to recover from since we are on them so much. I do think you are correct in that, a change in footwear is necessary. Flip flops and heels of any kind are out, neutral shoes abd orthotics are in. You may also want to check out negative heeled shoes. These probably will take some getting used to but in long run will help stretch the plantar flexors.
For me, assessment is everything and definitely not perfect on the first try. If I were you, I would look I try to look at your upper body. Maybe have someone take a picture of you from the side to see how well you cheek lines up above your collar bone. Also, you can do some self inventory and evaluate hoow many headaches you experience as well as how much time you spend with protracted shoulders (at cpu, in car, maybe you are a runner, etc.) All these things are clues.
hope this helps,
Nightly icing (done properly, again consult your doctor), myo fascial release, light stretching, massage (self or therapist), and ROM exercises would be in my program design. And I highly recommend deep water exercises like a class or water jogging. I would need to actually assess your situation to give any more advice. Be careful no matter what you choose to do. Go slow and stop if you have more than slight discomfort. And keep your doctor informed of what you are trying/doing and what is happening.