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Achilles tendinitis

Achilles tendinitis is inflammation of the achilles tendon or the surrounding paratendon.

The condition occur most commonly in young adults, causing heel pain.

Achilles tendinitis is acutely treated with RICE:

* Rest
* Ice
* Compression
* Elevation

Once the acute stage has passed, stretching and strengthening exercises of the calf muscles are more important.
When stretching the tendo-achilles, the stretch should be gently held for the count of 10-30 seconds, in groups of 5-10, four times per day . This is done with the knee straight and flexed, thus stretching all the muscular components of the tendo achilles.

A heel raise, orthoses and ultrasound may also be used in the treatment of this condition.

A more aggressive treatment is the use of hydrocortisone injections. This treatment option should only be undertaken by a specialist. The injection should be into the space between the tendon and the paratendon - not into the tendon itself. Steroid injections should be used with care as scar formation is a recognised complication. Also there is an increased incidence of tendon rupture associated with steroid injections.

Note that there is also evidence that topical glyceryl trinitrate significantly reduced pain with activity and at night, improved functional measures, and improved outcomes in patients with Achilles tendinopathy .

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