| Previously, we took a look at exactly what an | | | | people agree. Let me give you some figures to use |
| Achilles injury is. We had a look at the muscles and | | | | as a rough guide, and then I'll give you some advice |
| tendons that make up the Achilles; what happens | | | | from personal experience. The most common |
| when an Achilles injury occurs; and the major causes | | | | recommendation is to apply ice for 20 minutes every |
| and risk factors that contribute to Achilles injury. | | | | 2 hours for the first 48 to 72 hours. |
| Today, we're going to outline a detailed strategy for | | | | These figures are a good starting point, but |
| the complete treatment and rehabilitation of Achilles | | | | remember, they're only a guide. Also take into |
| tendonitis. Firstly, we'll look at the importance of the | | | | account that some people are more sensitive to cold |
| immediate treatment (the first 48 to 72 hours), and | | | | than others. Also be aware that children and elderly |
| then we'll outline the ongoing treatment necessary | | | | people have a lower tolerance to ice and cold. Finally, |
| for a full recovery. | | | | people with circulatory problems are also more |
| Immediate Treatment | | | | sensitive to ice. Remember to keep these things in |
| The immediate treatment of any soft tissue injury, | | | | mind when treating yourself or someone else with |
| such as an Achilles tendon injury, is vital. Proper care | | | | ice. |
| and treatment now will go a long way towards a full | | | | Use your own judgement when applying ice to |
| recovery later. | | | | yourself. For some people, 20 minutes is way too |
| Without a doubt, the most effective, initial treatment | | | | much. For others, especially well conditioned athletes, |
| for Achilles tendonitis is the R.I.C.E.R. regime. This | | | | they can leave ice on for much longer. The individual |
| involves the application of (R) rest, (I) ice, (C) | | | | should make the decision as to how long the ice |
| compression, (E) elevation and obtaining a (R) referral | | | | should stay on. |
| for appropriate medical treatment. | | | | My personal recommendation is that people should |
| Using the R.I.C.E.R. regime immediately after the | | | | apply ice for as long as it is comfortable. Obviously, |
| occurrence of an injury significantly reduces recovery | | | | there will be a slight discomfort from the cold, but as |
| time. R.I.C.E.R. forms the first, and perhaps most | | | | soon as pain or excessive discomfort is experienced, |
| important stage of injury rehabilitation, providing the | | | | it's time to remove the ice. It's much better to apply |
| early base for the complete recovery of injury. | | | | ice for 3 to 5 minutes a couple of time an hour, than |
| When an Achilles tendon injury occurs and the | | | | not at all. |
| tendon has been damaged there is a large amount of | | | | C: (compression) Compression actually achieves two |
| uncontrolled bleeding around the injury site. This | | | | things. Firstly, it helps to reduce both the bleeding and |
| excessive bleeding causes swelling, which puts | | | | swelling around the Achilles, and secondly, it provides |
| pressure on nerve endings and results in increased | | | | support for the ankle and lower leg. Use a wide, firm, |
| pain. It is exactly this process of bleeding, swelling | | | | elastic, compression bandage to cover the entire |
| and pain that the R.I.C.E.R. regime helps alleviate. | | | | ankle and lower leg. |
| R.I.C.E.R. | | | | E: (elevation) Simply raise the injured leg above the |
| R: (rest) It is important that the Achilles and lower leg | | | | level of the heart at all possible times. This will further |
| be kept as still as possible. This will help to slow down | | | | help to reduce the bleeding and swelling. |
| blood flow to the tendon and prevent any further | | | | R: (referral) If the injury is severe enough, it is |
| damage. | | | | important that you consult a professional physical |
| I: (ice) By far the most important part. The | | | | therapist or a qualified sports doctor for an accurate |
| application of ice will have the greatest effect on | | | | diagnosis. They will be able to tell you the full extent |
| reducing bleeding, swelling and pain. Apply ice as soon | | | | of the injury. |
| as possible after the injury has occurred. | | | | Before we finish with the initial treatment of an |
| How do you apply ice? Crushed ice in a plastic bag is | | | | Achilles tendon injury and move onto the next phase |
| usually best. Although blocks of ice, commercial cold | | | | of the rehabilitation process, you must avoid a few |
| packs and bags of frozen peas all do fine. Even cold | | | | things during the first 72 hours. |
| water from a tap is better than nothing at all. | | | | Be sure to avoid any form of heat at the injury site. |
| When using ice, be careful not to apply it directly to | | | | This includes heat lamps, heat creams, spas, Jacuzzi's |
| the skin. This can cause "ice burns" and skin damage. | | | | and saunas. Avoid all movement and massage of the |
| Wrapping the ice in a damp towel generally provides | | | | injured area. Also avoid excessive alcohol. All these |
| the best protection for the skin. | | | | things will increase the bleeding, swelling and pain of |
| How long? How often? This is the point where few | | | | your injury. Avoid them at all costs. |