achilles tendon injury -
Retro calcaneal bursitis
Retro calcaeneal bursitis is a swelling of the bursa at the back of the calcaneus (heel bone). A bursa is a fluid-filled sac that acts as a cushion and a lubricant between tendons and muscles sliding over bone. Repetitive or over use of the ankle, by doing excessive walking, running, or jumping, can cause this bursa to become irritated and inflamed.
achilles tendon injury -
Anatomy of retro calcaneal bursitis
The retro calcaneal bursa can be found where the achilles tendon inserts into the heel bone. This is an anatomical bursa (in other words it should be there and has not developed as a result of trauma). Its normal job is to allow the smooth movement of the achilles against the heel bone. However if irritated it can swell and become painful.
achilles tendon injury -
symptoms of retrocalcaneal bursitis
The area between the achilles tendon and the heel bone will be tender to the touch. The area will be warm and possible also red. The area will also look and feel swollen. The achilles tendon should not itself feel sore, if it is see achilles tendinits.
Events that can cause retro calcaneal bursitis in a runner might include:
Inneficient running biomechanics.
Fell running or running that involves a lot of hill work.
Tight psoterior muscle groups ie Hamstrings and calf muscles.
Increasing mileage or speed too quickly.
Returning to running after a period of inactivity.
Trauma caused by sudden and/or hard contraction of the calf muscles when putting out extra effort such as in a final sprint.
Irritation from the heel portion of a running shoe
achilles tendon injury -
treatment of retro calcanel bursitis in the early phase
R - I - C - E
Rest - It is advisable to rest from all activities that cause pain or limping.
Ice - Use a plastic bag filled with ice on the heel for 10-15 minutes, 4-6 times a day for the first 24-48 hours. Leave at least 1 1/2 hours between applications.
Compression - use a compression bandage to provide support. Loosen the wrap if your toes start to turn blue or feel cold.
Elevate - elevate the ankle above hip level
IF SYMPTOMS PERSISTS OR NUMBNESS/ DISCOLOURATION OF THE FOOT OCCURS CONSULT A MEDICAL PROFESSIONAL IMMEDIATELY.
achilles tendon injury -
To help to restore normal function and return to running
| Technique: | Sit with your knee straight and hold the foot position as long as possible. Do as frequently as possible for the first 3-10 days. |
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Pullback
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| Technique: | Hold each exercise 30 seconds at a gentle stretch. Do not bounce! |
| Frequency: | 6-10 repetitions/exercise, 5-7 days per week |
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Begin stretching regimen for gastrocnemius and soleus complex. Warning: There should be no pain when doing this exercise. If there is stop! |
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achilles tendon injury
stretching exercises
| Technique: | Hold each exercise 30 seconds at a gentle stretch. Do not bounce! |
| Frequency: | 3 sets 10 repetitions/exercise, 5-7 days per week progressing to 3 sets of 15 |
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Begin eccentric exercise program 7-10 days after pain has subsided Warning: There should be no pain when doing this exercise. If there is stop! |
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| Technique: | Hold each exercise 30 seconds at a gentle stretch. Do not bounce! |
| Frequency: | 6-10 repetitions/exercise, 5-7 days per week |
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Perform a toe raise on a 4-6 inch box or step with both legs. Once on your toes, lift the uninvolved leg and lower yourself slowly into dorsiflexion (heel down, toes up). Warning: There should be no pain when doing this exercise. If there is stop! |
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achilles tendon injury -
strengthening exercises
| Technique: | Hold each exercise 30seconds at a gentle stretch. Do not bounce! |
| Frequency: | 3 repetitions/exercise, 5-7 days per week, and incorporate into warm up and cool down exercises. |
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Perform a toe raise on a 4-6 inch box or step with both legs. Once on your toes, lift the one leg and lower yourself slowly into dorsiflexion (heel down) with the other. Repeat on the other side Warning: There should be no pain when doing this exercise. If there is stop! |
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achilles tendon injury -
to help prevention of retrocalcanel bursitis
Remember, in runners many retro calcaneal problems occur at contact phase of gait (when the foot hits the ground) due to the mechanical stresses placed on the foot and ankle at this point. It is therefore vital to improve your biomechanics with orthotics designed for your chosen sport.
IMPORANT- Don't ignore the problem, it won't go away!
The way we function biomechanically is predominantly controlled by genetics, its hereditary (runs in the family). The way you function is set and cannot be cured. What you can do however is control lower limb biomechanics by altering foot position during the contact phase of gait. This can only be done by wearing a good shoe and with orthotics (foot beds). This is the cheapest and most cost effective way for any athlete to reduce the risks of injury from occurring and from helping to prevent re-injury. Overall costs for the average athlete will run into pennies per mile/hour of sport.
Orthotics are designed to alter the biomechanics during the time the foot is on the ground. They are also used to provide increased shock absorbency working in harmony with the sport shoe worn.
Check your running shoes, are they worn, how long have you had them? Trainers used for running are designed to last at most about 750 miles. If you think you have done more mileage then replace them with a new pair.
Check the heel counter on the shoe. Is it too restrictive or too rigid. Usually the bursa is irritated by the frictional forces of poor biomechanics combined with an extrinsic component usually the shoes.
returning to normal sporting activity after injury
The aim of sports rehabilitation is to return you to your sport or activity as soon as is effectively possible. Warning! If you return too soon you may worsen your injury, which could lead to permanent damage. Everyone recovers from injury at a different rate. Return to your activity is determined by how soon your ankle recovers, not by how many days or weeks it has been since your injury occurred.
Under normal circumastances you may safely return to your sport or activity when, starting from the top of the list and progressing to the end, each of the following is true:
You have equal and full range of movement in the injured ankle compared to the uninjured ankle.
You have full strength of the injured ankle compared to the uninjured ankle.
You can jog straight ahead without pain in the ankle or without limping.
You can sprint straight ahead without painin the ankle or without limping .
You can do 45-degree cuts, first at half-speed, then at full-speed without ankle pain.
You can do 20-yard figures-of-eight, first at half-speed, then at full-speed without ankle pain.
You can do 90-degree cuts, first at half-speed, then at full-speed without ankle pain.
You can do 10-yard figures-of-eight, first at half-speed, then at full-speed without ankle pain.
You can jump on both legs without pain and you can jump on the injured leg without pain.