1 Heel Pain: Achilles Tendonitis
1 Heel Pain: Achilles Tendonitis
1 Heel Pain: Achilles Tendonitis
Pain in the heel localized at the achilles tendon A repetitive stress injury characterized by pain, inflammation, and swelling of the achilles tendon and its sheath. The entire calf muscle group may be affected.
palpated from the popliteal fossa at Bl 40 inferiorly to Bl 57. This area of the muscle may present with ah shi points that are often incorporated into the treatment protocol. You may also want to perform two simple orthopedic tests: 1. Resisted plantar flexion The action of the calf muscles is plantar flexion, which is pointing the toes. Pain on resisted plantar flexion helps to confirm involvement of the achilles tendon. 2. Passive dorsiflexion As the practitioner flexes the patients ankle past 90 degrees, there may be discomfort in the heel as the muscle-tendon unit is passively stretched. Achilles tendonitis usually is of insidious onset, and is frequently associated with a change in training, such as increased mileage, hills, or speed. A change in running shoe or running surface may also be contributing to the condition. As with most lower-extremity injuries, consider having the patient evaluated for foot biomechanical imbalances. Both abnormal pronation or supination create additional repetitive strain and may need to be corrected. In summary, achilles tendonitis is usually mid-tendon, about 2 to 6 centimeters proximal to its attachment to the calcaneus. But occasionally there may be lesions proximally at the muscle-tendon junction as you approach the area of Bl 57. Strain may also occur at the attachment to calcaneus, which may not present with the inflammation and tenderness that is so characteristic at the mid-portion of the tendon. In general, proceed with acupuncture with confidence most patients can be helped if not totally cured with proper treatment.