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The following article was published in Your Health Magazine. Our mission is to empower people to live healthier.
Robert M. Cohl, DC
Achilles Tendinitis Or Tendinosis?
Cohl Chiropractic Center
. https://cohlchiropractic.com/

Achilles Tendinitis Or Tendinosis?

Running is a great way to relieve stress and proper sports training provides great health and fitness benefits. People can be fit, but that doesn’t mean they are healthy. On the other side of the coin, a healthy person may not be fit. So, by definition let’s review the meaning of both terms.

Fitness: The ability to perform physical activity. For example, you define the level of your fitness by walking a mile or training for a marathon.

Health: The optimal balance of all systems of the body – nervous, muscular, skeletal, circulatory, digestive, lymphatic, hormonal.

Overuse injuries to their upper or lower extremities are common in all exercise programs. This also occurs at all ages. Outside field sports as well as indoor sports all lend themselves to creating soft tissue overuse injuries. Athletes that attend to both their health and their form and fitness are the least likely to have injuries.

So when a patient comes in with a recent injury to their Achilles tendon, there are several things to consider. The causes can be macrotrauma (one time total loading of the calf on an uneven surface) or repetitive microtrauma (running long distances). Two common reasons we see are wearing improper shoes and/or overtraining.

Tendinitis is usually new pain over a short period of time. The tendon gets inflamed with early vascular disruption. Hurts to load bear first thing in the morning when you are not warmed up metabolically. Tendinosis is long term inflammation on a daily basis and the tissue becomes degenerative. The fibers in the tendon start to break down and you also have myofascitis of the associated muscles: gastrocnemius and/or soleus with an injury of the Achilles tendon.

So how do we fix the problem? First, obtaining foot X-rays and an MRI will rule out any serious underlying pathology based on clinical examination; either image is beneficial. Treating athletes requires an immediate and correct diagnosis.

Using Applied Kinesiology methodology, all the muscles involved with back, hip, knee and ankle/foot need attention. Using manual muscle testing (MMT) we look for the inhibited muscles first. Inhibited muscles are neurologically weak and need to be turned on locally as well as distally. Golgi tendon/muscle spindle cell activation are local to the muscle. Manual therapy combined with Erchonia Cold Laser works the best for reducing inflammation.

Motor to the muscles comes from the spine and segmental dysfunction causes misfiring of the spinal nerve roots that turn on and turn off the muscles. Spinal manipulation works very well for this part of the problem.

Local myofascial (hands-on) work to individual muscle is essential: the Graston Technique is an excellent adjunct therapy for fixing soft tissue dysfunction in the tendon, muscle, ligaments and fascia. Putting together the right rehab program in the right sequence will get most athletes back to their activities.

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