Achilles tendon pain: causes, diagnosis and treatment. Pain in the Achilles tendon. Causes and prevention

The Achilles tendon, also known as the heel tendon, is the strongest tendon in the human body, as it can withstand loads of up to 400 kg without rupture. However, despite this fact, it is the most frequently injured tendon.

Inflammation of the Achilles tendon (how it occurs, what reasons can cause it)

In most cases the reason inflammation of the Achilles tendon is wearing uncomfortable shoes for a long time. Most often, the inflammatory process occurs in athletes and dancers, whose feet bear a large load.

Another cause of inflammation may be impaired metabolism. As a result of what is in the blood a large number of fats and cholesterol, and also in the case of gout, an acute inflammatory process may develop due to the fact that urate microcrystals begin to be deposited in the tissues of the body.

In addition, pain in the tendon area can occur due to diseases of the bones or joints, in the presence of a heel spur or an inflammatory process in the arch of the foot.

Factors that can lead to inflammation include:

Microtraumas. Chronic diseases of the musculoskeletal system. Incorrectly formed tendon. Age-related changes. Flat feet, which is characterized by the presence of hyperpronation. Uncomfortable shoes.

Symptoms of an inflammatory process localized in the Achilles tendon

The main symptom of an inflammatory process in the Achilles tendon is pain in the heel area or under the calves. In most cases, pain occurs after a long rest, that is, after sleep, when a person gets up and starts walking. This is explained by the fact that during sleep the tendon relaxes and the pain subsides, but when a load appears, the pain manifests itself and prevents you from taking a normal step. In addition, there may be other symptoms:

Thickening and redness of the skin may be found in the tendon area. Local hyperthermia. Slight swelling. Crunchy sound.

Appearance pain in the bones, in the Achilles area tendon may indicate the development of not only Achilles tendinitis, but also other diseases, such as bursitis or arthrosis of the foot.

How does fluid accumulation in the Achilles tendon manifest?

Fluid in the Achilles tendon may manifest itself with the following symptoms:

Pain in the tendon area. Redness. Swelling in the heel area. Movement in the ankle and ankle is significantly difficult.

How to treat inflammation of the Achilles tendon

How to treat Achilles tendon? When identifying an inflammatory process, the first thing you need to do is:

Avoid stress on the tendon. Apply cold compresses for 10 minutes throughout the day. Limit movement in the tendon. To do this, you can use an elastic bandage and wear low-heeled shoes.

what drugs are used to relieve pain and relieve inflammation in the treatment of Achilles heel

First of all, after examining the patient, the doctor prescribes x-ray, where you can see whether there really is inflammation of the Achilles tendon. If inflammation is present, the doctor may prescribe:

Painkillers. Non-steroidal anti-inflammatory drugs. In some cases, antibiotics may be prescribed.

Medicines may be given as tablets or injections that are given directly near the tendon.

traditional methods of treatment

How to treat inflammation of the Achilles heel joint using traditional medicine? You can try to cure inflammation of the Achilles tendon using traditional medicine. However, before using any methods, you should consult a doctor, since self-medication is harmful to the body. Among the methods of traditional treatment are:

The spice curcumin is a natural antibiotic, antioxidant and anti-inflammatory agent. You need to eat about 0.5 g per day. Tincture of partitions walnut on vodka. To prepare it, you need to take 0.5 liters of vodka and 1 glass of nut partitions. Mix and leave for 20 days. After this, this remedy can be taken 2 times a day, 1 tsp. Oil solution mountain resin mumiyo. This remedy can be rubbed into the tendon area, and also taken orally 0.1-0.5 g of resin, which is dissolved in warm milk. This can be done for 2 weeks, after which a 10-day break is required. Pine-salt foot baths. Ice massage. To do this, you need to massage the tendon area with pieces of ice.

what physiotherapeutic methods can be used to treat inflammation of the Achilles tendon

In combination with drug treatment, the inflammatory process can be treated with physiotherapy, which includes the following methods:

Magnetotherapy. Laser therapy. Ultrasound therapy. Shock wave therapy. Electrophoresis with lidase. Mud applications.

Prevention of disease development

To prevent inflammation of the tendon, it is necessary to prevent the disease:

It is necessary to stretch the tendon before doing heavy exercises. It is necessary to periodically pump up the calf muscles and increase the load over time. You need to do jumping, which will provide elasticity not only to the Achilles tendon, but also to other tendons of the legs. After exercise, it is necessary to stretch the calves.

Conclusion

In conclusion, I would like to say that, despite the fact that the Achilles tendon is the strongest tendon, it is most often subject to stress and can be injured. Therefore, before performing any exercises, you need to do a little warm-up and prevention.

Tendinitis or Achilles tendonopathy is a degenerative process (inflammation or tissue damage) that occurs in the heel tendon.

In adults after 40 years of age, this pathology occurs due to a decrease in the elasticity and extensibility of connective tissue, however more often This condition occurs in athletes and people whose main activity involves excessive physical exertion.

Timely consultation with a doctor allows you to quickly recover damaged tissue tendons, and lack of treatment and prevention can lead to chronic tendonitis.

What does it represent? Forms of the disease Causes Symptoms and signs Diagnostic methods How to treat? Prevention

What does it represent?

The Achilles or calcaneal tendon is one of the strongest and strongest tendons in the human body:

The upper part of the tendon is located at the junction of the gastrocnemius and soleus muscles; The lower part is attached to calcaneal tubercle(its back surface); The gastrocnemius muscle, along with the calcaneal tendon, lifts the heel when lifting the leg and pushing off the ground with the toes, and also lowers the forefoot after the heel touches the ground.

Climbing up and down hills, running on uneven inclines, and wearing the wrong kind of hard-soled, soft-heeled shoes place high and uneven stress on this tendon, which is why it is most likely to be injured.

Injuries where the tendon attaches to the bone are caused by overuse. A load on a tendon that is equal in strength and intensity in one case can lead to its successful adaptation and strengthening, and in another can reduce its strength, contributing to the occurrence of dystrophic changes. It all depends on the condition of the tissue at the time of the load.

Various disorders of tissue conductivity can lead to deterioration of metabolism and drying of connective tissue due to water loss.

Metabolic products are poorly excreted, salts accumulate - this significantly reduces the elasticity of collagen fibers and their extensibility.

The stability of the tendon when stretched deteriorates and with sudden movements various micro-tears can occur.

Similar processes occur at the age of 40 years and older.

But in athletes and people engaged in physical labor, tissue aging in tendons is accelerated by constant overload and periodic injuries at the cellular and tissue level.

Experts call tendinitis mainly sports injuries caused by increased stress and lack of normal full recovery between workouts.

Heavy loads on a poorly stretchable muscle lead to inflammation or damage to the connective tissue of the Achilles tendon - as a result, any movements of the foot (running, walking, jumping) cause severe pain.

In the absence of adequate measures, the tendon may separate from the heel bone or rupture.

The occurrence of damage to the Achilles tendon indicates a heavy load that was undertaken due to a sedentary lifestyle without prior preparation, or a violation of the training regime and overload.

The damage can be mechanical in nature without the onset of an inflammatory process, but in some cases, tendinitis is associated specifically with inflammation.

Tissue with micro-tears and cracks heals over time, but becomes less elastic with numerous microscopic scars.

Treatment of inflammation in the tendon tissue is carried out quickly with the use of anti-inflammatory drugs, and mechanical damage require long-term therapy and special training until tissue restoration and tendon endurance are complete.

Forms of the disease

There are 3 forms of achilles tendonitis:

Peritendinitis- inflammation of the tissues surrounding the tendon. It may be accompanied by tissue degeneration. Tendinitis- inflammation and damage to the tendon. The surrounding tissues are not involved in the process. Enthesopathy- degeneration and inflammation of the tendon at the site of its attachment to the bone. Sometimes accompanied by the development of heel spurs or calcification.

The beginning of treatment for each of these forms is similar.

Initially, acute pain appears and the tendon is subject to stress.

Without proper treatment, the pain may go away for a while, but then return and become chronic form In the worst case, the tendon ruptures completely.

Causes

The reasons why Achilles tendon problems occur can vary.

Age-related changes

The tendon consists of collagen and elastin fibers: the former provide it with strength, and the latter with extensibility.

Normally, the Achilles tendon is capable of stretching by 5% of its original length - this helps the leg to make springy movements, that is, the tendon performs a shock-absorbing function.

But with age, the extensibility of the tendon decreases, and stress can lead to fiber damage and micro-tears.

That is why, after 35 years, untrained people are not recommended to start any training without first warming up the muscles and warming up.

People who experience pain in the heel tendon area and those who have previously had problems with it should pay great attention to this warning.

Excessive loads

Even professional athletes and trained people can experience heel tendon problems.

This occurs as a result of overtraining and excess tension on the tendon.

Without the necessary rest, tissues do not have time to recover and lose their ability to relax.

Very often, athletes ignore the onset of the disease.

The resulting inflammation begins to cause mild pain - this may indicate that microtears have occurred in the tissues and there is a need to temporarily stop training or weaken the training regimen.

But on various reasons the athlete does not do this and is neglected or even chronic inflammation and tissue damage can lead to complete rupture of the tendon.

Therefore, it is necessary to treat tendinitis in a timely manner, and the time when you can return to classes is determined by the doctor.

Flat feet with overpronation

Overpronation of the foot is the physiological movement of the foot inwards.

In this position, the tendon experiences excessive stretching and is injured when walking and other loads.

Wearing uncomfortable shoes

Incorrect footwear can contribute to the development of tendonitis:

The use of incorrectly selected sports shoes during training significantly affects the distribution of load on the legs and can increase it. Women who wear high-heeled shoes all day long experience pain in the heel tendon and calf muscles in the evening when switching to flat soles. This is due to the fact that the muscle and tendon were in a shortened state all day, and when they try to stretch them in the evening, they “protest.”

Haglund's deformity

This is peculiar bone spur on the heel bone near the place where the tendon attaches - outwardly it looks like a bubble on the heel.

Because of this growth, the tendon has to stretch even more under different loads.

Depending on whether there is inflammation of the tendon bursa or whether tissue swelling develops, this growth can be either soft or hard.

Infections

The cause of the inflammatory process in the tendon can be various acute and chronic infections.

Symptoms and signs

Achilles tendonitis can occur in acute or chronic form.

The acute form is characterized by a gradual increase:

At first, the patient experiences pain at the beginning of training or exercise; after warming up, the pain subsides, and rest completely eliminates all pain. Some discomfort may be felt upon palpation.

The subsidence of pain after a break and aggravation when walking is explained by the fact that during a long rest all micro-tears grow together, and with a new movement they are injured again.

If left untreated, this symptom quickly causes the development of chronic tendinitis.

With chronic Achilles tendonitis, pain increases gradually over several months or weeks:

during exercise it intensifies and even after warming up the stretching does not go away; long rest does not bring relief - pain can appear even in the morning after sleep; going up and down stairs or an inclined surface causes the development of pain.

In both cases, you may also experience:

tendon thickening; feeling of tension in the calf muscle; redness and hyperthermia of the skin; limited mobility in the ankle area. pain - can be localized along the entire tendon, or closer to the heel; at a height of 2 to 6 cm, swelling may occur; it is difficult to dorsiflex the foot and stand on your toes; sometimes - a characteristic creak when moving the joint in the ankle.

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Diagnostic methods

The following examination methods are used for diagnosis:

physical examination; radiology diagnostics; Magnetic resonance imaging; ultrasonography.

Most often, the diagnosis is made based on a conversation with the patient and a physical examination; by palpation, the doctor determines the points of greatest localization of pain.

A characteristic feature of calcaneal tendonitis is that when moving the foot and further palpation, the pain moves slightly, as the tendon and muscles are stretched.

WITH special attention inspected for any ruptures.

X-ray examination may show the presence of inflammation or degenerative changes, only if there are foci of calcification.

If there are no calcifications, then radiation diagnostics will not help make a diagnosis.

MRI and ultrasound can determine whether there are ruptures and whether there is a need for surgery.

How to treat?

If minor pain in the heel tendon occurs once, the legs need rest.

All loads should be limited for a while. To relieve swelling and redness, you can apply ice, and to cope with pain, you should apply an elastic bandage to the painful area.

If the pain is very severe, does not go away even after rest, and intensifies with exercise, when there is a suspicion of tendon rupture, you should immediately consult a doctor.

He will conduct an examination and, if necessary, prescribe additional examination.

To treat inflammation, he may prescribe special drugs, give advice folk remedies and draw up a rehabilitation plan. Immobilization, partial or complete, or surgery may be required.

Folk remedies

It is possible to treat tendinitis using traditional medicine, but the methods must be agreed upon with your doctor:

Using curcumin seasoning- a natural antibiotic, antioxidant and anti-inflammatory agent, can treat tendon inflammation. To do this, you need to eat half a gram of this product per day. You can prepare a tincture of walnut partitions with vodka. For one glass of nut partitions you need to take 0.5 liters of vodka and leave for about 20 days. Take 2 times a day, 1 teaspoon. If there are any problems at work thyroid gland, you should consult your doctor before taking it. Oil solution of mountain resin mumiyo You can rub it into the affected area, and also take orally about 0.1–0.5 g of resin dissolved in warm milk. Such two-week courses can be repeated with a 10-day break. You can make pine-salt foot baths. Ice massage using ice cubes helps reduce pain. Pieces of ice should be massaged into the painful area for 20 minutes.

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Exercises

With the help of special exercises, you can treat achilles tendinitis, restore after drug and surgical treatment, alleviate the condition of connective tissue, stretch it and reduce the load, as well as carry out prevention of this disease.

The most important and simple exercise is walking. It should be carried out in comfortable shoes, using a special technique: a soft roll from heel to toe, without excessively turning the toe out. During rehabilitation after surgery, step length, walking time and load force increase gradually. Half-squats on toes, lifting on toes and returning to the starting position, and running are useful, but they should be done after a light warm-up and stretching exercises for muscles and tendons. Exercising in water is also beneficial. The human body loses most of its weight in water, so it is in water that you can begin to perform all the exercises recommended by the instructor. During dry training, the most difficult ones can be performed 1–2 weeks later than in water.

Exercise to stretch the calf muscles and Achilles tendon:

Stand facing the wall and rest your hands on it. Stretch back and rest on your toes the leg whose tissue you want to stretch, and bend the other leg slightly at the knee. Maintain this position for about 30 seconds and then return to the starting position. You need to repeat 3-5 times.

Exercise to increase the strength and elasticity of the Achilles tendon:

Place your heels on the edge of a small rise or a special step platform and squat. It is necessary to perform 3 hikes of 12 squats daily. On the same platform, stand with your toes on the edge and go down and up.

Both of these exercises are eccentric, aimed at simultaneously stretching and tensioning the tissue and are excellent for restoring the heel tendon.

However, errors in execution can be dangerous, so initially it is advisable to conduct training under the supervision of an instructor.

When performing any exercise, you need to remember that the restoration of physical activity should occur gradually.

You should not return to sports, dancing or your usual physical activity immediately, but slowly increase the intensity.

To prevent muscles from losing strength and ligaments from losing mobility, there are different kinds ground gymnastics, exercises of which are performed in a lying or sitting position.

Drug treatment

The first thing that needs to be ensured before starting treatment is to reduce the load on the tendon.

You can immobilize the foot in this area in different ways:

splinting; gypsum; use of crutches; elastic bandage; taping; application of orthoses that completely or partially restrict movement.

In most cases, this disease is treated with the following course of treatment:

non-steroidal anti-inflammatory drugs are used - Nimesil, Naklofen, etc.; in the most difficult cases may prescribe antibiotic therapy; You can use ultrasound to inject Voltaren ointment, Dolobene gel and Solcoseryl into the affected area; to remove pain symptom At night, you can put a compress of Analgin, Novocaine and Dexamethasone in equal parts or give intramuscular pain-relieving injections.

Operation

If conservative methods Treatments do not bring the desired result, then surgery may be necessary.

During the operation, an incision is made and the affected areas are excised, and then the tendon is sutured; in case of Haglund's deformity, the bone growth is removed.

Fig.: surgical repair of the Achilles tendon

After the operation, the patient wears a special boot for about 6 weeks.

Over time, after 2-3 weeks, you can already step on the operated leg, and after removing the immobilizing orthosis, a course of rehabilitation is carried out for recovery, which lasts from 1 to 3 months.

Prevention

For prevention purposes, it is necessary to follow certain rules:

physical exercises should be performed with gradual intensification; before any physical activity, it is advisable to warm up the muscles and tendons and perform stretching exercises; for training and everyday wear you need to choose comfortable shoes; If pain occurs, you need to stop training.

Achilles tendonitis - a disease of athletes, people doing physically demanding work and women who prefer to wear high-heeled shoes - on early stages very effective and easy to treat.

But if it is neglected, complications may arise in the form of tendon rupture or chronic inflammation.

A whole range of measures is used for treatment: special exercises, drug therapy and immobilization of the painful area in various ways.

It is impossible to carry out all these measures on your own, so if you experience pain in the Achilles tendon area, you need to seek help from a specialist.

Video: Achilles tendon injuries

The source of pain, localized in the back of the leg above the heel, is a variety of diseases of the musculoskeletal system.

However, factors that provoke the development of deviations may also be of a different nature. To understand the reasons why the leg hurts above the heel, it is important to understand the functional characteristics and role of the Achilles tendon.

What is the Achilles tendon?

The Achilles (heel) tendon, which takes its name from the mythological Achilles heel, is the largest and one of the most important tendons. human body, formed by the fusion of three leg muscles and attached to the outside of the heel bone. Thanks to it, mobility and stability of the joints are ensured, muscle function and shock absorption occur. The development of pathologies of the heel tendon is accompanied by problems with flexion of the foot, limitation of motor functions of the leg due to deterioration of elasticity and extensibility, usually against the background of the development of pain.

Causes of the disease

Of the many reasons why the tendon on the back of the ankle, above the heel, hurts, several main ones can be identified. Pain can be caused by:

• diseases of periarticular tissues;
• traumatic injuries(sprains, tears);
• structural features of the foot;

People whose activities involve high physical activity or prolonged stereotypical movements (athletes, dancers), as well as women during menopause, who are especially susceptible to obesity, liver and biliary tract diseases, are most susceptible to diseases of the soft periarticular tissues. Hypothermia, dampness, focal infections or a combination of several negative factors.

Excessive loads

Soft tissue damage in adults can cause physical strain. Pain of this kind occurs when:

• increasing the functional load on unprepared, weak muscles;
• intense training;
• improperly selected shoes.

Tendon pain can also occur in children due to so-called growing pains. Similar pain in the legs, associated with tension in the tendons and muscles due to the rapid increase in bone length, is noted at night, most often after physical activity.

Age-related changes

Various options congenital and acquired pathological deformation Over time, the feet can become aggravated by inflammatory and degenerative diseases. The development of flat feet is also provoked by general atrophic phenomena that occur in old age.

Age-related changes associated with decreased elasticity , often lead to injury to the tendon, increasing the risk of micro-tears. The incidence of secondary Achilles inflammation increases in the presence of chronic arthritis.

Diseases of periarticular tissues

The etiology of diseases is mainly associated with excess stress and functional overload. Pathologies of the heel tendon can be of the primary (degenerative) or secondary (inflammatory) type. The cause of primary disorders are microtraumas during movement (running, walking) associated with significant tension on the tendon. When the degenerative process affects the nearby tendon (serous) bursa, tendobursitis develops.

In approximately a third of patients, calcium salts are deposited in necrotic areas of the damaged tendon (calcification) and/or dense formations develop in the area where the tendon attaches to the heel bone (tenoperiostitis).

Tendinitis

If there is severe overuse over a long period of time, ligament damage may explain why the tendon above the heel hurts. Trauma (for example, during heavy physical labor or intense training) leads to tendinitis (myotendinitis) - an isolated lesion of the tendon at the site of its ingrowth into the muscle, accompanied by minor secondary inflammation. The cause of the pathology may also be metabolic disorders, rheumatism or autoimmune processes. Further spread of inflammation during tendinitis often causes bursitis or leads to ligament rupture due to loss of elasticity of the connective tissue.

Achilles bursitis

Sometimes the pain is accompanied by the formation of a round, painful tumor at the junction of the Achilles tendon and the heel bone. At first, the swelling may be slight, but gradually it increases in size and becomes noticeable redness. Most often, this condition is caused by inflammation of the serous bursa - bursitis. The pathological process is usually a consequence of injuries and develops due to contact with a damaged tendon (tenobursitis). Swelling may be observed on both sides of the heel. Affecting the tissues of adjacent ligaments and muscles, achillobursitis spreads more widely.

Posterior Achilles bursitis is often referred to as Haglund’s deformity (osteophyte of the calcaneus), which occurs due to chronic microtrauma of the tendon. In this case, the formation of osteochondral growths occurs in the heel area, and as the growth and changes in the Achilles tendon increase, an inflammatory process develops and pain occurs.

Paratenonitis

The back of the ankle may hurt due to inflammation or degenerative lesion the middle part of the heel tendon and its sheath (fibers of dense connective tissue covering the tendon), called paratenonitis or tenosynovitis. The disease can occur in three forms:

• mild, characterized only by hyperemia;
• exudative-serous, with the formation of a round swelling;
• chronic stenotic, accompanied by sclerotic changes.

Primary tendovaginitis is usually caused by abnormalities in the structure of the foot, prolonged static load, trauma, varicose veins, thrombophlebitis or lymphostasis. Secondary ones arise against the background of joint damage, infections, and may be the result of allergic processes. If left untreated, the disease can become chronic.

Periarthritis

Damage to the tendon apparatus during periarthritis (heel spur) leads to the development of a pathological process that can extend beyond the affected tendon. When inflammation spreads to nearby serous bursae, bursitis occurs. Supracalcaneal tendobursitis can cause severe pain in the Achilles tendon.

Video

Inflammation of the Achilles tendon

Nature of pain

The resulting pain may differ in character, intensity, and may also be accompanied by other phenomena: the absence or presence of redness and swelling.

After increased functional load, there is an aching nature of prolonged pain in the calf muscle.

When the feet are deformed, there is pain, heaviness in the legs, and swelling. Sometimes cramps and a feeling of numbness are possible.

Pain in diseases of the periarticular tissues occurs only after the tendon sheath and serous bursae are involved in the process. As a rule, painful discomfort manifests itself only as a result of intense work of the tendon during active movements, however, over time, the leg begins to hurt more and more, and motor functions are limited.

The main symptoms of paratenonitis (tenosynovitis), in addition to pain when moving the joint, are swelling and pain of the entire Achilles tendon. Sometimes muscle atrophy is possible.

Superficial bursitis is accompanied by little or no pain, and pain when palpating the tumor in the area of ​​the inflamed tendon. After infection joins with the formation of pus, the swelling becomes hyperemic, hot, pressing on it causes sharp pain.

Signs of myotendinitis are characterized by severe pain with active leg movements and pain at the beginning of the Achilles tendon.

First and mandatory feature periarthritis there should be pain in the heel that occurs when stepping. A painful swelling (Achilles bursitis) may be found at the tendon insertion site. The tendon itself is thickened and painful when pressed.

Treatment methods

Treatment tactics depends on the reason why the tendon behind the shin and on the heel hurts. Limiting the load or immobilizing the limb using splints and bandages for mild forms of the disease or a plaster cast for more severe forms is almost always required. Foot deformities in adulthood are practically impossible to correct, so treatment is aimed at relieving inflammation, as well as supporting the functionality of the feet (massage, arch supports, gymnastics). Periarthritis and tendovaginitis require complex treatment over a long period of time.

Drug treatment

Treatment medications, usually based on the application:

• anti-inflammatory and painkillers;
• corticosteroids – for bursitis, tendinitis and tendovaginitis;
• antibiotics if there is an infection.

Symptomatic treatment in mild cases can lead to complete recovery or significant relief of the condition. At running forms illness, contractures and decreased ability to work may develop.

Physiotherapy

In addition to the appointment medicines physiotherapy is prescribed, which gives positive effect in the treatment of Achilles tendon diseases. Physiotherapy, depending on the type of diseases of the periarticular tissues, is carried out:

• ultrasound;
• hydrocortisone phonophoresis;
• calcium electrophoresis;
• sinusoidal currents (amplipulstherapy);
• diathermy (deep heating with high-frequency currents);
• balneological methods;
• paraffin applications;
• X-ray therapy.

Physiotherapeutic procedures have an analgesic effect and also improve blood circulation. Appointed when subsiding acute inflammation.

Exercises

For tendon diseases, massage and physiotherapy, however, due to the risk of complications, they should be used with extreme caution. For example, with tendovaginitis, massage is performed bypassing the affected area, and gymnastics throughout acute period carried out using only passive movements. Active ones are introduced only after the exacerbation and pain have subsided.

With flat feet, exercises aimed at maintaining the arch of the foot play an important role. In case of muscle strain, muscle relaxation becomes the basis.

Surgery

It is not always possible to successfully treat a tendon that hurts using conservative methods. If the condition of the heel continues to worsen, then surgical treatment is resorted to. The operation can be performed to remove the resulting formations and serous bursa, cut the tendon, or reconstruct the foot in severe deformities.

ethnoscience

You can also help the body cope with the disease using alternative medicine methods.

Infusion of pine branches

Good effect gives an infusion of pine or spruce branches. Number of branches when preparing in cold water should make up more than half of the enamel pan. The mixture, boiled for half an hour and then infused, is used for medicinal baths and foot baths.

Vegetable oil mixture

Lavender oil, its mixture with fir (two drops per teaspoon vegetable oil) or clove and geranium oil (five drops per teaspoon of vegetable oil) can be used to rub into the area where the leg hurts.

The Achilles tendon is considered the strongest in the human body. This ligament is located in the area located between the heel bone and the calf muscles. It is often subject to increased stress, which contributes to the development of inflammation and discomfort. If your leg hurts severely above the back of the heel, it is important to get diagnosed in a timely manner and get necessary treatment. As the pathology progresses, it can lead to the development severe complications and loss of full motor ability.

Achilles tendon diseases can occur in two forms - acute or chronic. In the first case, pain occurs sharply, with increased loads. This can happen during weight lifting or sports training. At rest, the pain decreases and gradually disappears. When palpating the location of the inflammatory process, discomfort is felt. At this stage, microdamages grow together, but after the next load the process repeats again.

Ignoring the problem leads to the development of a chronic form of pathology, in which pain takes on a new character. At this stage they differ:

• increasing intensity;
• constant presence during motor activity.

The pain does not go away even in a state of rest; it is felt immediately after getting up in the morning, as soon as a person steps on his foot. This can be explained by the fact that during night sleep the tendon is in a relaxed state and the pain subsides. When the slightest load appears, it resumes, making it impossible to move normally. The sensations can spread not only to the heel area, but to the entire tendon.

The main causes of pain include:

1. Inflammatory processes.
2. Injuries.
3. Achilles bursitis.
4. Tendinitis.
5. Paratendonitis.
6. Tendinosis.
7. Tendon rupture.
8. Heel spur (Haglund deformity).

Inflammation of the Achilles tendon often develops when wearing low-quality shoes, excessive loads in men, as a result congenital pathologies in a child caused by intrauterine hypoxia during the mother's pregnancy. The pain is sharp, cutting or pulling. It is localized in the heel area, but can be felt under the calves. Sometimes its intensity does not allow you to step on your foot completely. The condition may be accompanied by redness of the skin, swelling of the soft tissues, increased body temperature, creaking in the ankle joint that occurs when moving the foot, and pulsation in the leg.

Injury to the Achilles tendon is most often caused by intense sports activities, during which the risk of pulling the ligament increases. The pain becomes sharp, pulling, and can spread throughout the entire leg up to the thigh. It is difficult to walk or run. The part of the heel at the base becomes swollen and red.

In order to prevent tendon injury, you should not neglect warming up and do not put too much strain on your legs.

Other causes of Achilles pain may include: increased content cholesterol and fats in the blood, gout, the development of inflammatory processes in the arch of the foot, flat feet, age-related features.

Diseases contributing to the development of pathology

Achilles bursitis is an inflammation of the synovial bursa located between the Achilles tendon and the heel bone. The acute form of the disease is often caused by infection. At this stage, the pathology develops sharply, accompanied by severe pain and other unpleasant symptoms. If fluid accumulates in the heel area, redness and swelling appear, and the mobility of the ankle and ankles worsens.

Tendonitis is an inflammatory process that causes degeneration (thinning) of the ligaments. The disease is more susceptible to men who do not control excessive physical exercise on the body.

Signs and symptoms of tendinitis are localized to the affected area. The pathology is accompanied by:

• pain that rarely radiates to other areas and gets worse with activity;
• difficulty moving together with swelling of the joint;
• redness of the skin, formation of nodules under it;
• crunching when walking;
• the appearance of swelling;
• local temperature rise.

The location and degree of pain indicates the type of disease.

With paratendonitis, the inflammatory process covers a wide area - the ligament, the connective tissue around it, the tendon bursa. The pathology develops against the background of wearing uncomfortable shoes and provokes severe pain and degenerative changes.

Tendinosis can lead to complete rupture of the Achilles tendon. With this disorder, a patch of scar tissue forms at the site of the received microtraumas, the ligament becomes denser, and growths and irregularities appear. The pain is felt in the area above the heel.

Tendon rupture and heel spur

A ruptured Achilles tendon on the right or left leg is not uncommon among professionals and amateur sportsmen. Also, such damage can be caused by wounds and cuts.

Characteristic symptoms of the pathology are:

• sudden pain in lower limb, spreading directly to the damaged area;
• depression above the rupture site;
• palpation of the defect;
• dysfunction of the ankle;
• positive Thompson effect - pressure on the calf of the leg, not accompanied by reflex flexion of the foot.

A rupture can be diagnosed by palpation and examination by a traumatologist.

Heel spur is also called Haglund's deformity or plantar fasciitis. It is a growth (exostosis) that develops near the heel bone, above the Achilles. In some cases, diagnosing the pathology becomes problematic, since the disease can occur similar to bursitis or rheumatoid arthritis. On initial stages development of the heel spur of the Achilles tendon, there is no pain, and the bone growth is almost invisible. In the future, the lump can grow to the size of an egg, injure adjacent tissues, and cause acute pain. Unpleasant sensations intensify when walking, in the evening, after waking up in the morning and after a long rest.

The heel turns red skin covering roughens and hardens. An Achilles spur can have different characteristics. It can be cartilaginous, hard or soft to the touch. Constant friction often leads to the formation of swelling, a water bubble on the back of the heel. With absence quality treatment the risk of suppuration and infection of soft tissues increases.

Diagnosis and treatment

Treatment measures should be carried out only after a detailed diagnosis. For this purpose, experts resort to the following methods:

• collecting anamnesis (questioning the patient regarding the circumstances accompanying the development of the disease);
• physical examination (palpation of the place of greatest concentration of pain);
• magnetic resonance imaging (MRI), which allows you to determine the presence of ruptures;
• X-ray examination, identifying foci of the inflammatory process;
• ultrasound examination (ultrasound), which determines the need for surgical treatment.

In some cases there is a need for laboratory diagnostics(taking blood). In this case, various deviations from the norm can be identified (increased levels of leukocytes, protein, uric acid). Similar phenomena indicate the presence infectious processes and become the basis for antibiotic therapy.

Treatment of the Achilles tendon of the heel is aimed at extinguishing inflammatory and infectious processes, restoring cartilage and bone tissue, relapse prevention. As a rule, it is carried out comprehensively and consists of several stages:

1. Conservative therapy.
2. Physiotherapeutic procedures.
3. Additional recommendations.

In number medicines, used for diseases of the Achilles tendon, include painkillers and anti-inflammatory drugs, antispasmodics, antibiotics, antipyretics, drugs to improve blood circulation, multivitamin complexes.

Doctors are well aware of the traditional methods of treating pain above the back of the heel, in the tendon area.

The patient is often prescribed Voltaren, Solcoseryl, Nimesil, Indomethacin, Minocycline, Dimexide. Pain relief is facilitated by the use of compresses with Novocaine, Analgin, Dexamethasone. These drugs can be administered intramuscularly.

Dexamethasone is prescribed to relieve inflammation and pain in the Achilles tendon.

If tendonitis develops, the lower limb is subject to immobilization for 2 days (by applying a splint, plaster, special elastic bandages, fixing muscles). Orthoses can be used at night (in severe cases - around the clock).

In progress conservative treatment It is recommended to limit physical activity, use orthopedic insoles, wearing shoes with hard backs. Women should avoid walking high heels(they can be replaced with lower ones). If your heel tendon is very painful, it is recommended to stay in bed until it improves.

Overweight patients will need to change their diet. Gradually losing weight will reduce the burden on the inflamed areas. It is recommended to give preference to low-calorie foods - fresh vegetables and fruits, fish, low-fat meat, cereals, whole grain bread.

In order to speed up the healing of the Achilles tendon, patients are prescribed various physiotherapeutic procedures. They are carried out after completing a course of drug therapy. Most often, patients are recommended ultrasound, laser, magnetic therapy, paraffin applications, electrophoresis with decongestants, massage, mud therapy, and therapeutic exercises.

Surgery

Indications for surgery are present in the following cases:

• with low effectiveness of drug therapy;
• with severe tendon damage or rupture.

Surgery necessary only in extreme cases with severe damage to the tendon.

Surgery involves suturing the ends of the damaged tendon with a synthetic thread. If Haglund syndrome occurs, the bone growth is excised with a special surgical chisel (osteotome). The procedures are mainly performed under local anesthesia.

After discharge from the clinic, a rehabilitation period is required. It takes from 1 to 3 months. At this time, it is advisable for the patient to avoid even minor physical exertion on the lower extremities, regularly treat the operated area with antiseptics, and use sterile bandages.

During the first 30 days after surgery, you will need to wear a fixative. plaster cast. To normalize blood circulation, the leg should be kept above the level of the pelvis as often as possible.

Traditional medicine and preventive measures

There are simple folk recipes, telling you how to treat pain above the back of the heel, and alleviating the condition of inflammation of the Achilles tendon. They can be used in combination with the main therapy, but require mandatory consultation with a doctor.

Infusion of pine branches

You will need to fill a 5-liter container halfway with dry branches and fill them with water. Boil the product for at least half an hour, after which it is kept and used daily for foot baths. An infusion of elderberry branches is made and used in a similar way.

Foot massage with various healthy oils speeds up the healing process.

Vegetable oil mixture

Various oils are combined (options: fir, sunflower, lavender; geranium, clove, lavender; sunflower, lavender). They treat the inflamed area twice a day.

Clay compress

Mix 0.5 kg of dry clay, a small amount of water and Apple vinegar. The resulting homogeneous mass is applied to the tendon as a compress before going to bed, and wrapped with a bandage on top.

To prevent the development of inflammatory processes in the Achilles tendon area, the following recommendations must be followed:

1. Wear comfortable shoes made from natural materials.
2. Adhere to the principles of healthy eating.
3. Control your body weight.
4. Avoid injury.

Before carrying out sports training, it is important to organize a warm-up. If the heel area is injured or discomfort occurs, you should immediately visit a doctor. Early diagnosis and treatment will avoid the progression of pathology and the occurrence of unwanted complications.

The Achilles tendon is the largest and strongest tendon in the human body. It was named after the mythical hero Achilles, whom Homer described in his works. Its formation is associated with the result of the connection of flat tendons, which are located in calf muscles with soleus muscles. Another name for the Achilles tendon is the calcaneal tendon. It is attached to the tubercles of the heel bones.

As a result of the contraction of the muscles that begin to pull on this tendon, a person can bend his lower limbs at the ankle joint. Thus, a person can rise on his toes, jump in place, pushing off with his feet. But it happens that the Achilles tendon can become injured or inflamed.

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Biomechanical factors of etiology

There are a number of specific biological and mechanical factors that can cause tendon damage. It can be affected, for example, by high arching of the feet, deformation of the heel bones, insufficient stretching of the muscles in the calf area and muscles located in the rear surfaces hips

In most cases, an Achilles tendon injury is the result of numerous, minor injuries, to which a person does not attach much importance and ignores the first ones. symptomatic manifestations diseases. This in turn leads to more complex injuries.

The process of inflammation, which appears under the influence of small injuries, can already bring slight discomfort at the first stages of the disease. In such cases painful sensations may appear sporadically with increased physical activity. As a result of such a chronic inflammatory process, the strength in the fibers decreases, their elasticity decreases, and areas of microscopic tears can become covered with scars.





Characteristic manifestations of the disease

Very often, the symptoms of inflammation of the Achilles tendon are pronounced. Therefore, a person can immediately notice a number of symptoms that characterize this disease:

1. 1. Painful sensations in the place where the heel bone is located and in the area under the calves. The pain is acute, burning in nature. A person begins to feel them in the morning, and their increase occurs during physical activity. It also happens that the pain becomes so severe that it does not allow the patient to even move.
2. 2. Edema appears, swelling in the tendon area, it begins to thicken.
3. 3. The skin above the tendon begins to turn red.
4. 4. The temperature in the localization zone increases.
5. 5. A characteristic crunch appears during motor activity in the ankle joints.



In patients, symptomatic manifestations will vary: different intensity, different damage, individual characteristics of the body. For example, some people will suffer from unbearable pain, and they will not be able to fully move. And others will talk about discomfort and minor pain.



How do inflammatory processes occur?

The causes of inflammation of the Achilles tendon can be various, the most common of them are the following:

• excessive, increased loads on the muscles of the calves of the lower extremities, which lead to a state of tendon overstrain;
• the presence of flat feet and club feet;
• in case a person wears uncomfortable shoes that do not stabilize the feet while walking;
• metabolic dysfunction in the body: increased concentrations of cholesterol, urates and uric acid.



It is important to remember that inflammation in the tendons is not life-threatening, but if not treated timely assistance and ignore the disease, then it will torment for a long time with its unpleasant symptoms, and the person will constantly feel severe pain.

The structure of the Achilles tendon is such that it consists of tendon fibers twisted in the form of spirals, which in turn consist of collagen protein; it is very strong and almost does not undergo stretching. These fibers contain another protein called elastin, which can lengthen and repair itself.

If a person is healthy, then his Achilles tendon can lengthen by 5% of its total length, this makes it possible to spring back and act as a kind of shock absorber. But over time, the tendon's ability to stretch decreases, so any increased physical activity can lead to the appearance of microscopic tears.



People over 35 years old are recommended to engage in fitness or any other sport only after a good warm-up. During the warm-up, it is important to perform at least a couple of stretching exercises for the Achilles tendons. Problems may also arise if a person undergoes aggressive training.



Therapy methods

Athletes, dancers, and sprinters often suffer from tendon sprains. These categories are the most vulnerable. This is explained by the fact that a person may not carefully, at a sharp pace, take off and, for example, start running, which results in an injury to the lower limb.

Treatment of an inflamed tendon begins with the patient being prescribed the correct organized regime: you need to rest as much as possible, eliminate physical activity and muscle strain in the lower limb. In some cases, they may apply a plaster splint, or simply bandage it tightly. The patient must remember that if he continues to be physically active and plays sports, this will aggravate the course of the disease and may lead to unwanted complications.

It is imperative to use drug therapy against inflammation; the most important place in this process is occupied by painkillers and anti-inflammatory drugs.



Much attention is also paid to physiotherapeutic procedures, in which applications of paraffin, ozokerite, and mud are used. The doctor may prescribe a massage to the patient on the affected area. If conservative methods do not help, and the disease begins to become severe, specialists may prescribe surgical intervention.

The disease is considered very capricious, so it is not recommended to start it. Patients are advised:

• give the sore lower limb rest, eliminate all stress;
• apply cold to the affected area for 10 minutes 3-4 times;
• try not to lift weights;
• the lower limb can be wrapped in a bandage to limit motor activity;
• temporarily you can wear shoes with a slightly larger heel than you wore before, this will help relieve the tendon;
• It is important to make sure that you are using the correct sports shoes, you can consult your doctor and trainer.

If a number of these measures do not help or improve the condition, you should seek medical help to accurately diagnose the disease.



There are also situations when the disease stubbornly does not give up. Therefore, braces or orthoses will help to completely or partially immobilize the joint in the ankle.

In some cases, orthoses that fix the feet can only be worn at night. And there are also those that need to be worn in daytime. In the very severe case The patient is advised to use crutches.

A huge role is assigned special massage. When the doctor can eliminate acute painful sensations in the patient, he moves on to the next stage of treatment. The doctor will recommend strengthening the tendons using special strengthening and rehabilitation exercises.

In medicine, the concept of kinesio taping is used - this is an important section in sports traumatology. This method consists in the fact that the patient is glued with a specialized sports tape (plaster) called tape, thanks to which the tendons are unloaded. If it is not possible to purchase such tape, then you can use a wide adhesive plaster.

There are 2 types of kinesio taping: simple (1 strip is glued) and complex (a strip and 2 rings are glued). If the disease persists, the patient may undergo surgery. It is better not to self-medicate, but to immediately consult a specialist.

Inflammation of the tendon is dangerous for humans because it has a greatly reduced blood supply, and this entails a long healing time. Also, if there is inflammation, the Achilles tendon can simply rupture. Therefore, under no circumstances should you let the disease take its course; you should immediately seek medical help. It often hurts so much that it is difficult for a person to make any movements, and this limits him in living conditions. Painful sensations increase when moving, while sitting, when walking, while running. Therefore, doctors strongly recommend not to make sudden movements, not to rush anywhere, and to think first of all about your health.

There is such a thing as tendinosis - these are inflammatory processes in the Achilles tendon. For treatment, you should contact a general practitioner, who will provide a referral to a surgeon or sports doctor. Specialists should advise medications and a course of a rehabilitation program.

Helping a sick person at home

At home, it is important to rest the sore lower limb, reduce wearing heavy objects. To relieve pain, swelling and redness, you can use an ice pack and apply a bandage to the lower limb.



It may be necessary to consult a doctor rather than self-medicate. Medical attention is needed if the walking process is difficult and the person suspects a tendon rupture. Medical attention is urgently needed if a person feels pain in the heels, which intensifies during exercise (a feeling as if he was hit in the back of the lower limb).

There are many treatment methods and ingredients you can use at home. You can use colostrum, milk, eggs, herbal infusions, herbal decoctions, ointments, clay. Many people use bear bile, wraps, and heat. You can make decoctions from herbs: elecampane, elderberry, plantain seeds, hay dust, pine twigs.

Tendon inflammation can be treated various oils: lavender, fir, sunflower, geranium, carnation. Ointments are prepared from calendula flowers, as well as wormwood and pork fat.



Preventive measures

It is recommended to perform a number of exercises to stretch the muscles and tendons in the lower extremities so that the muscles are strong and elastic. It is important to pay due attention to stretching the muscles under the knee, systematically pump the calf muscles of the lower extremities, and increase their strength. Before any sports training, give due consideration to warming up and stretching the tendons. If you feel pain, you should stop training.



If a person is jogging, you need to choose comfortable shoes that fit in the right way the instep supports are fixed. Do balance training, stand on 1 lower limb alternately. This exercise is very beneficial for your calves and Achilles tendons.

The duration and intensity of any training should be increased gradually. Exercises in water are considered very useful.

Inflammation of the Achilles tendon is a degenerative process that occurs in soft tissues ankle joint. The main causes of this disease in people over 35 years of age are considered to be chronic injuries. Tendinitis is especially often diagnosed in athletes and people whose work involves increased physical activity.

Early treatment allows for complete restoration of the affected tissue, otherwise pathological process acquires chronic nature.

The Achilles tendon consists of the strongest and strongest tissues. Its upper part is located at the junction of two muscles. The lower one is fixed to the heel tubercle. It is this section of the musculoskeletal system that experiences the greatest load when walking. An impact of equal strength in one case leads to strengthening of tissues, in another - to a decrease in their extensibility and strength. It all depends on the condition of the tendon at the time of loading.

Malnutrition of tissues leads to their drying out. In some diseases, metabolic products are not excreted from the body, but begin to accumulate in the joint area. Tendons become less resistant to stretching and microtraumas occur.

Such changes are almost always found in people over 40 years of age. The occurrence of ruptures may be a consequence of increased stress placed on the legs after prolonged use. sedentary lifestyle life. In some cases, tendinitis has no signs of inflammation. The fabric recovers over time, but loses the required elasticity.

Types of disease

Doctors distinguish 3 forms of inflammation of the Achilles tendon.

1. Peritendinitis is an inflammation of the soft tissues surrounding the ankle joint.
2. Tendinitis affects the tendon itself without affecting nearby areas.
3. - inflammatory process at the junction of soft tissues and bones. In some cases, it leads to the formation of bone spurs.

The first sign of all forms of inflammation is pain. At improper treatment it disappears for a while, the disease enters the chronic phase.

The causes of inflammation of the Achilles tendon can be different. First of all, this is old age. Tendons contain elastin and collagen fibers. The former give it elasticity, the latter - strength. The tendon can increase by 5%. This allows the legs to jump.

With age, the above indicators worsen, even minor loads lead to fiber rupture. Therefore, people over 35 years of age should not start vigorous training without preparation. This is especially true for people experiencing pain in the heel area.

Achilles tendon lesions can also occur in athletes. This is explained by excessive loads and excessive tissue tension. With continuous training, the tendon does not have the opportunity to recover and loses its ability to relax. Quite often in the early stages the disease goes undetected. Then it begins to cause minor inconvenience. This indicates the appearance of micro-fractures.

Another reason for the development of tendinitis is considered to be flat feet with overpronation - the foot recesses inwards. Being in this position, the tendon experiences extra stress during movement.

Wrong footwear can also contribute to inflammation. The risk group includes women who prefer high-heeled shoes. Acute tendonitis is often caused by infectious diseases.

Signs of inflammation

The disease can occur in both acute and chronic forms. The first is characterized by a gradual increase in the intensity of symptoms. Initially, the patient experiences pain when running and jumping, but after a long rest they disappear. This is due to the fact that micro-tears have time to heal during this time, and with repeated movements they appear again. If left untreated, tendinitis becomes chronic. The intensity of the unpleasant sensations increases gradually. The pain intensifies during training and does not disappear even after a long rest.

Other symptoms of Achilles tendon inflammation include:

Photo. Inflammation of the Achilles tendon

• feeling of tension in the calf muscle;
• skin redness;
• local temperature increase;
• limited ankle mobility.

The pain may cover the entire affected area or be concentrated at the junction of bones and soft tissues. The person is unable to stand on his toes or jump. A characteristic sign of tendinitis is a crunching sensation in the joint.

Ultrasound, CT and MRI are used to detect inflammation of the Achilles tendon. Often the diagnosis is made based on the results initial examination and interviewing the patient. Characteristic feature Tendonitis is a shift of pain during palpation performed after moving the foot. X-ray examination allows you to identify the presence of ruptures and degenerative changes in soft tissues. In the absence of calcifications, this technique is ineffective. MRI and ultrasound allow the doctor to select the most effective therapeutic technique.

Treatment options

At acute forms tendonitis accompanied by minor painful sensations in the heel area, long rest is indicated. It is necessary to exclude any loads for a while. Cold compresses are used to eliminate swelling and redness. A tight bandage applied to the affected area helps to cope with the pain.

If discomfort after the procedures described above do not disappear, you must consult a doctor.

There are several ways to treat inflammation of the heel tendon. Your doctor may recommend immobilizing the joint. Various orthopedic devices, which can be seen in the photo, help with this.

Drug treatment begins with taking NSAIDs to help relieve inflammation. For tendinitis infectious origin held antibacterial therapy. Using ultrasound, Voltaren is also injected into the inflamed areas. To eliminate pain, apply compresses with analgin at night.

During the recovery period, special exercises and massage are recommended.

Depending on the cause of inflammation of the Achilles tendon, surgical interventions may be used. During the operation, the doctor makes an incision in the skin and dissects the affected tissue. In Haglund syndrome, the osteophyte is removed. After surgery, fixation devices are used. Stepping on the foot is allowed after 3–4 weeks. Recovery period lasts 1–3 months.

Alternative Treatments

Treatment is considered auxiliary; its use does not imply abandonment of traditional methods:

1. Inflammatory processes can be eliminated with the help of curcumin. This seasoning has antiseptic and analgesic properties. It is eaten 0.5 g once a day.
2. Alcohol tincture is no less effective. walnuts. 1 glass of partitions is poured with 0.5 liters of vodka and infused for 3 weeks. Take 2 times a day before meals. This drug is not recommended for people with thyroid disease.
3. Shilajit oil solution is used as a rub. Mountain resin can be taken orally, first dissolved in hot milk. The course of treatment lasts 2 weeks, after which a 10-day break is taken.
4. Conifers help improve tendinitis foot baths and massage using cold.

With the help of special exercises you can eliminate unpleasant symptoms in the area of ​​the heel tendon and restore the elasticity of soft tissues. They reduce the load on the joint, speed up the healing process after surgical interventions. The simplest exercise is walking. Before going for a walk, you should choose comfortable shoes. You need to walk by rolling your foot from heel to toe. During the rehabilitation period after surgery, the load on the leg should be increased gradually. Squats and running are useful, but such exercises should be done after warming up.

Exercises in water are no less effective. In this case, the human body loses most of its weight, which reduces the load on large joints. All activities must be performed under the supervision of an experienced instructor. Start training simple exercises, gradually moving on to more complex ones.

You can also develop your Achilles tendon at home. To do this, stand facing the wall, resting your hands on it. Place one leg on your toes, bend the other slightly. You must remain in this position for at least 30 seconds. The exercise is performed 4–5 times.

Tendonitis is a disease of athletes and people involved in physical work. In the early stages, it can be cured completely, otherwise the disease becomes chronic. Most dangerous complication is, depriving a person of the ability to walk for a long time.