Simple Winter Foot Care for Diabetics!

Simple Winter Foot Care for Diabetics

For a diabetic, the winter months are a time when more attention than usual should be given to the feet.  Reduced circulation due to cold weather is only part of the problem.

Diabetics are at risk for having reduced blood flow to the lower extremities. An otherwise minor injury, like a blister, can escalate into a serious wound. And winter time can be especially hazardous.  One reason is, the feet are covered up for longer periods of time and aren't being checked as often as they should.

Diabetic patients should pull their shoes and socks off to look at their feet to make sure that their shoes aren't tight causing any kind of friction or rubbing. You would notice a reddened spot on the top of the toes or on the sides of the bones if this were the case.  Also, you should  be checking your heels as well.

Poor circulation can also lead to increased swelling and dryness of the feet. Cold weather exacerbates the problem by further reducing blood flow and by indirectly reducing exercise.

A lot of people in the winter have a tendency to be a little bit more sedentary. They're not walking around as much. They're sitting around their houses which will make their feet and ankles swell a little bit more than usual.

During this time of year, we see more burns on the feet of diabetics, from heating pads or hot water. Try to steer clear from the heating pads, the warming blankets and the hot footbath whirlpools.  If you're going to do that, check the water with the elbows. You don't lose feeling in your elbows as you would with your fingers and toes.

Dry weather prompts some to use a moisturizer. But when the feet are covered by socks for long periods of time, athlete's foot becomes a problem. So an anti-fungal creme might be more appropriate, on the advice of your Podiatrist, Dr. Raymond A. DiPretoro, Jr..

And remember, if a sore on your foot does not begin to heal after a day or so, be sure to tell your Podiatrist at Advanced Foot & Ankle Center!

Winter Foot Care!

Winter Foot Care

Protecting and covering both the head and the feet well during the winter months is important to keep body heat in. It is also necessary in order to keep the feet warm and dry. The blood will start to flow away from the feet and towards the heart in colder weather. How can winter foot care prevent serious problems?

During the winter, it is more likely that many people will have problems with aches and pains because cold weather has always been known to cause muscles and tendons to become tight and stiff. The only way to avoid this completely is by avoiding the outdoors. Most likely, this isn’t possible for the majority of people. However, many tend to stay in a lot more during the winter season. Talk about cabin fever.

Essential Winter Foot Care Tips

This season, make sure you practice the following winter foot care suggestions daily:

• Wash and Dry Feet Thoroughly
• Keep Feet Well Moisturized
• Wear Thick Socks and Boots
• Exercise Your Feet Before Going Out

If you don’t use an exfoliator for your feet during the winter months, the dry, cracked skin can easily tear. These tears can cause germs to flock to the area. Washing and scrubbing the feet well will also help prevent infections. Keeping the feet moisturized will prevent itching and scaling. If you normally have problems with your feet during the warmer months, then you must be even more watchful during the winter.

Don’t allow warmth to escape either by wearing thin socks and shoes. Wearing two pairs of socks is actually ideal along with investing in a new pair of boots. Make sure your boots have enough room to wear two pairs of socks comfortably.

One more winter foot care tip- exercising the feet can help prevent the joints from stiffening when walking around in the cold. Doing some quick calf exercises along with moving both feet in a circular rotation will get some blood flowing to the area. Even doing leg lifts can help tremendously. No one should go unchecked this winter season. Especially those who are diabetic, have arthritis, and previously had serious foot conditions.

If you are suffering from any foot conditions, or need more information, contact Advanced Foot and Ankle Center to schedule an appointment with an experienced podiatrist today.

Kentucky Derby Winning Jockey Breaks Foot; Loses Chance at $2 Million

You know what’s worse than a painful broken foot? A painful broken foot that costs you $2 million, especially when it comes on the heels of an embarrassing loss in professional athletics!

Joel Rosario, the jockey of Kentucky Derby winning horse Orb, broke a bone in his left foot last week. He was supposed to ride in two races this past weekend; riding Orb in the $1 million Travers competition on Saturday and jockeying Game On Dude in the $1 million Pacific Classic in Del Mar on Sunday.

Instead of competing for those hefty prizes, Rosario was taken to the hospital on Friday afternoon after he fell while riding Casual Elegance shortly after the finish of the seventh race at Saratoga, where he came in last.

Adding insult to the injury of his loss, Rosario was clearly hurt and couldn’t stand properly when he tried to get up from his fall; after receiving X-Rays, Rick Alfred, a team doctor for the New York Giants', casted his foot and delivered the news that he would miss both weekend races. He was also told he’d be barred from all riding activity for the next six weeks.

Newark podiatrist Dr. Raymond A. DiPretoro, Jr. extends his best wishes for a speedy recovery to Mr. Rosario. If you’ve broken a bone in your foot, toe or ankle schedule an appointment at Advanced Foot & Ankle Center for top-quality care. Your injury may not cost you millions, but receiving high-quality treatment can prevent you from suffering the painful complications of an improperly healed bone.

Pregnancy Leg and Foot Pain

With all the extra weight, it's no wonder your feet are swollen and your legs hurt.

What causes pregnancy leg and foot pain?

While morning sickness, fatigue, and back pain are frequent complaints during pregnancy, leg and foot problems are just as common, particularly during the last trimester. Fortunately, chances are these ailments will disappear after you deliver. In the meantime, there are some things you can do to alleviate discomfort.

Beginning early in your pregnancy, alternate circulation-boosting exercise with the proper amount of rest (prop those feet and legs up!). This can prevent foot and leg problems from developing in the first place. But if those aches have already begun, here's the scoop on what's causing them and what you can do about it.

Swelling & Edema

Raised hormone levels cause you to retain water during pregnancy, making you feel swollen and bloated. Your body needs this extra fluid so it can do the work of carrying nutrients and oxygen to your baby.

Although swelling is not a huge concern, consult your doctor if you notice swelling of your face and hands along with blurred vision, severe or constant headaches, and weight gain of more than a pound a day. These can be signs of preeclampsia, a serious condition.

Typically, fluid retention is particularly pronounced in your feet, ankles, and calves because your growing uterus puts pressure on the veins that carry blood back from your lower body. This partially blocks blood flow, keeping fluid in your legs and feet.

Blood vessels are also smallest in your foot and ankle, so your body has difficulty accommodating the extra fluid pouring in there.

• Elevate your feet as often as you can. Try to raise your legs 6 to 12 inches above your heart for 15 to 20 minutes to help the blood flow back to your heart and lungs.
• Sleep on your side, not your back. This relieves pressure on the vena cava, the largest vein leading to the heart. Otherwise, the pressure slows the blood returning from your lower body.
• Consume a lot of fluids. Dehydration worsens swelling.
• Monitor your weight. Women of normal weight should gain 25 to 35 pounds during pregnancy. Excessive weight gain exacerbates swelling and can lead to other problems.
• Improve the circulation in your ankles with rotation exercises. Try sitting, with one leg raised. Rotate your ankle 10 times to the right, then to the left. Switch legs. Repeat 10 times.
• Ice your ankles. With your feet up, apply ice to the inside of your ankles for 15 to 20 minutes every half hour to an hour.

Leg Cramps

Some women can't escape leg cramps (commonly called charley horses) during pregnancy. These painful muscle contractions usually occur in the calf. It's believed that leg cramps occur because of a calcium deficiency and too much phosphorous (found in diet sodas and processed meats, so go easy on those foods) Cramps are common at night when legs and feet are tired. Eat more dairy products or ask your doctor about calcium supplements. Women who get leg cramps may also have a potassium deficiency. Some expectant mothers report that snacking on potassium-rich bananas or dried apricots nips those cramps in the bud.

Besides dietary changes, you can prevent leg cramps by revving up your circulation -- take a 15- to 20-minute walk in the evening. Also avoid standing or sitting in one position for too long; both cause fluid to accumulate, making your legs feel heavy or full of pressure.

If you find yourself in the middle of a leg cramp, try to ease the pain by resting your calf on a hot-water bottle or flexing your foot to stretch the calf. The best way to ease the pain of a foot cramp is to walk it out. But if it's the middle of the night and you don't feel like getting out of bed, try grasping your foot with both hands and gently pressing your thumbs into the arch, pushing toward your toes.

Varicose Veins

As if tired, aching legs aren't enough, about 20 percent of women develop varicose veins -- those ugly, blue, swollen, ropelike veins -- during pregnancy. Pregnant women have up to 40 percent more blood in their circulatory system and this extra blood increases the amount of pressure on the veins walls, causing veins to stretch so much that their valves don't close properly. Faulty valves allow blood to pool in the veins, causing them to become varicose. You're more likely to get varicose veins if you gain too much weight, stand for long periods during the day, or if your mother had them (they're hereditary).

With varicose veins, many women complain of aching in the legs, as well as heaviness, fatigue, and pressure. Although these symptoms usually subside after pregnancy, they tend to worsen with each new baby.

As with other leg problems, increasing circulation can help relieve discomfort -- and even prevent varicose veins in the first place. Take a walk every day or doing other low-impact exercises such as swimming or bicycling. If you can't exercise, try sitting in a rocking chair several times a day; use your legs to gently rock back and forth to encourage better blood flow.

The gentle pressure of stockings can relieve achiness, too. Put them on before you get out of bed so blood doesn't have a chance to pool at your ankles. Also ask your doctor about prescription-strength hose.

Once you've had the baby, you may choose laser therapy or surgery to remove the veins.

Swollen Feet

Besides the discomforts of pregnancy, all that swelling may make it tough to squeeze your feet into your usual heels or boots. It's not unusual for an expectant mom to go up a half to a full size in shoes. In addition to fluid retention, the hormone relaxin, released primarily during the third trimester to relax your pelvic ligaments for childbirth, flattens and lengthens foot ligaments.

In addition to needing larger shoes, your feet also need extra support and comfort. Since your center of gravity is constantly shifting as you gain weight, you need to wear shoes that actually balance you, and that means it's best to avoid high heels. Choose shoes with a broad-based one- to two-inch stacked heel. For a dressy or office shoe, try an Aerosoles style with a crepe sole for shock absorption. If you're looking for a walking or athletic shoe, buy a running sneaker, which also offers more shock absorption. If width is an issue for you, buy men's shoes in an equivalent size -- they're cut wider.

Here are some more shoe-buying tips:

• Shop late in the day. Feet tend to swell as the day goes on.
• Be sure shoes fit before you leave the store. It's a myth that you can "break them in."
• Choose shoes with a square or round toe. Avoid pointy-toed shoes.
• Buy boots with room in the calf area, because your calves may swell. Also choose a boot with a side zipper -- they're easier to get on and off than a pull-on style.
• Replace worn heels often. Uneven heels can throw you off balance.

Back to School Kids: Flat Feet Can Slow Them Down!

Flat Feet Can Slow Down Back to School Kids

The first few weeks of school are always difficult for children transitioning from the lazy days of summer to the rigorous schedule of classes and extra-curricular activities. But if a child seems more sedentary than usual, it might be something more than fatigue. About 20 percent of children have flat feet, which can cause foot and ankle pain, night cramps, pain when walking or lower back and knee pain.

If this is the case,  a child might withdraw from activities and can become more and more inactive.
While flexible flat feet are very common and usually require little to no treatment, rigid flat feet can be painful and can cause posture problems. 

Many times, flexible flat feet stem from metatarsus adductus, a sharp, inward angle of the front half of the foot. It can occur as a result of a child’s intrauterine position, where feet are bent inward. When a child with metatarsus adductus puts his or her foot into a normal shoe, the foot attempts to straighten out by flattening the arch.

Rigid flat feet can stem from tarsal coalition, a condition in which two bones in the foot fuse together as it grows, and can limit movement.
The rise in childhood obesity has also increased the instances of flat feet.

As the foot adjusts to balance weight equally, it can put pressure on the arch and cause it to fall. Changes in the foot arch affect ankle and knee function, and when the foot collapses entirely it causes instability, leading to gait and posture problems.

With flat feet, it is the instability of the foot that creates the problems. Many people can have a low arch without having a problem. 

Only a small amount of cases need surgery, Advanced Foot & Ankle Center stresses the importance of early treatment through the use of devices like orthotics, shoe inserts that are intended to correct an abnormal walking pattern, to avoid trouble later in life.

All babies and toddlers have flat feet, caused by loose ligament joints and baby fat between the foot bones. In about 80 percent of children, foot arches form by age 10.

Prior to starting the new academic year, many elementary schools recommend or require children to have a complete physical from their pediatrician. Use this visit to check for the presence of flat feet.

A pediatrician will notice flat feet right away, and can send parents to a Podiatrist for treatment.

Without the proper diagnosis, flat feet can get progressively worse. If it’s not treated properly, children can suffer from flat feet into adulthood. When this occurs, the foot can totally collapse and can create a disability which can affect the quality of life. 

Diabetic Wound Care

Diabetic Wound Care

What is a Diabetic Foot Ulcer?

A diabetic foot ulcer is an open sore or wound that occurs in approximately 15 percent of patients with diabetes and is commonly located on the bottom of the foot. Of those who develop a foot ulcer, 6 percent will be hospitalized due to infection or other ulcer-related complication.

Diabetes is the leading cause of non-traumatic lower extremity amputations in the United States, and approximately 14-24 percent of patients with diabetes who develop a foot ulcer will require an amputation. Foot ulceration precedes 85 percent of diabetes-related amputations. Research has shown, however, that development of a foot ulcer is preventable.  

Causes

Anyone who has diabetes can develop a foot ulcer. Native Americans, African Americans, Hispanics, and older men are more likely to develop ulcers. People who use insulin are at higher risk of developing a foot ulcer, as are patients with diabetes-related kidney, eye, and heart disease. Being overweight and using alcohol and tobacco also play a role in the development of foot ulcers.  

Ulcers form due to a combination of factors, such as lack of feeling in the foot, poor circulation, foot deformities, irritation (such as friction or pressure), and trauma, as well as duration of diabetes. Patients who have diabetes for many years can develop neuropathy, a reduced or complete lack of ability to feel pain in the feet due to nerve damage caused by elevated blood glucose levels over time. The nerve damage often can occur without pain, and one may not even be aware of the problem. Your Podiatrist can test feet for neuropathy with a simple, painless tool called a monofilament.

Vascular disease can complicate a foot ulcer, reducing the body's ability to heal and increasing the risk for an infection. Elevations in blood glucose can reduce the body's ability to fight off a potential infection and also slow healing. 

Symptoms

Because many people who develop foot ulcers have lost the ability to feel pain, pain is not a common symptom. Many times, the first thing you may notice is some drainage on your socks. Redness and swelling may also be associated with the ulceration and, if it has progressed significantly, odor may be present.

When to Visit a Podiatrist

Once an ulcer is noticed, call Dr. Raymond A. DiPretoro, Jr. immediately. Foot ulcers in patients with diabetes should be treated to reduce the risk of infection and amputation, improve function and quality of life, and reduce health-care costs.

Diagnosis and Treatment

The primary goal in the treatment of foot ulcers is to obtain healing as soon as possible. The faster the healing, the less chance for an infection.

There are several key factors in the appropriate treatment of a diabetic foot ulcer:

• Prevention of infection
• Taking the pressure off the area, called “off-loading”
• Removing dead skin and tissue, called “debridement”
• Applying medication or dressings to the ulcer
• Managing blood glucose and other health problems

Not all ulcers are infected; however, if Dr. DiPretoro diagnoses an infection, a treatment program of antibiotics, wound care, and possibly hospitalization will be necessary.

To keep an ulcer from becoming infected, it is important to:

• keep blood glucose levels under tight control;
• keep the ulcer clean and bandaged;
• cleanse the wound daily, using a wound dressing or bandage; and
• avoid walking barefoot.

For optimum healing, ulcers, especially those on the bottom of the foot, must be “off-loaded.”  You may be asked to wear special footgear, or a brace, specialized castings, or use a wheelchair or crutches.  These devices will reduce the pressure and irritation to the area with the ulcer and help to speed the healing process.

The science of wound care has advanced significantly over the past ten years. The old thought of “let the air get at it” is now known to be harmful to healing. We know that wounds and ulcers heal faster, with a lower risk of infection, if they are kept covered and moist. The use of full-strength betadine, hydrogen peroxide, whirlpools, and soaking are not recommended, as these practices could lead to further complications.

Appropriate wound management includes the use of dressings and topically-applied medications. Products range from normal saline to growth factors, ulcer dressings, and skin substitutes that have been shown to be highly effective in healing foot ulcers.

For a wound to heal, there must be adequate circulation to the ulcerated area.  Dr. DiPretoro can determine circulation levels with noninvasive tests. 

Tightly controlling blood glucose is of the utmost importance during the treatment of a diabetic foot ulcer. Working closely with a medical doctor or endocrinologist to control blood glucose will enhance healing and reduce the risk of complications.

Surgical Options: A majority of non-infected foot ulcers are treated without surgery; however, if this treatment method fails, surgical management may be appropriate. Examples of surgical care to remove pressure on the affected area include shaving or excision of bone(s) and the correction of various deformities, such as hammertoes, bunions, or bony “bumps.”

Healing time depends on a variety of factors, such as wound size and location, pressure on the wound from walking or standing, swelling, circulation, blood glucose levels, wound care, and what is being applied to the wound. Healing may occur within weeks or require several months.

Prevention

The best way to treat a diabetic foot ulcer is to prevent its development in the first place. Recommended guidelines include seeing a Podiatrist on a regular basis. Advanced Foot & Ankle Center can determine if you are at high risk for developing a foot ulcer and implement strategies for prevention.

You are at high risk if you have or do the following:

• Neuropathy
• Poor circulation
• A foot deformity (e.g., bunion, hammer toe)
• Wear inappropriate shoes
• Uncontrolled blood sugar
• History of a previous foot ulceration

Reducing additional risk factors, such as smoking, drinking alcohol, high cholesterol, and elevated blood glucose, are important in prevention and treatment of a diabetic foot ulcer. Wearing the appropriate shoes and socks will go a long way in reducing risks. Your Podiatrist can provide guidance in selecting the proper shoes.

Learning how to check your feet is crucial so that you can find a potential problem as early as possible. Inspect your feet every day—especially the sole and between the toes—for cuts, bruises, cracks, blisters, redness, ulcers, and any sign of abnormality. Each time you visit a health-care provider, remove your shoes and socks so your feet can be examined. Any problems that are discovered should be reported to your Podiatrist as soon as possible; no matter how simple they may seem to you. 

The key to successful wound healing is regular podiatric medical care to ensure the following “gold standard” of care:

• Lowering blood sugar
• Appropriate debridement of wounds
• Treating any infection
• Reducing friction and pressure
• Restoring adequate blood flow

What Is Achilles Tendon Inflammation? What Is Achilles Tendinitis?

Achilles tendinitis (tendonitis) or Achilles tendon inflammation occurs when the Achilles tendon becomes inflamed as a result of the Achilles tendon being put under too much strain. The Achilles tendon joins the calf muscles to the heel bone, and is found at the back of a person's lower leg. It is the largest tendon in the body and is able to endure great force, but is still susceptible to injury.

Achiles tendinitis is usually the result of strenuous, high impact exercise, such as running. If ignored, Achilles tendinitis can lead to the tendon tearing or rupturing, and therefore it is important to seek the necessary treatment. Sometimes, treatment can be as simple as getting rest or changing an exercise routine. However, in more severe cases, surgery may be required.

According to Medilexicon's medical dictionary, the Achilles tendon or calcaneal tendon is: 

the thick tendon of insertion of the triceps surae (gastrocnemius and soleus) into the tuberosity of the calcaneus.

The Achilles tendon (tendo calcaneus) seen from behind 

What are the signs and symptoms of Achilles tendinitis?

A symptom is something the patient feels and reports, while a sign is something other people, such as the doctor, detect. For example, pain is a symptom, while a rash is a sign. The most typical symptom of Achilles tendinitis is a gradual buildup of pain that deteriorates with time. Other possible signs and symptoms of Achilles tendinitis are:

• the Achilles tendon feels sore a few centimeters above where it meets the heel bone
• lower leg feels stiff
• lower leg feels slow and weak
• slight pain in the back of the leg that appears after running or exercising, and worsens
• pain in the Achilles tendon that occurs while running or a couple of hours afterwards
• greater pain experienced when running fast (such as sprinting), for a long time (such as cross country), or even when climbing stairs
• the Achilles tendon swells or forms a bump
• the Achilles tendon creaks when touched or moved

Please note that these symptoms, and others similar, can occur in other conditions, so for an accurate diagnosis, a patient would need to visit their doctor.

What are the complications of Achilles tendinitis?

A major complication of Achilles tendinitis is Achilles tendinosis. Achilles tendinosis is a degenerative condition in which the structure of the tendon changes and becomes susceptible to serious damage. This can lead to the tendon tearing and causing great pain. 

When Achilles tendinosis has occurred, and the tendon has torn, surgery would most likely be performed to repair the tendon damage.

What causes Achilles tendinitis?

There are a number of ways a person can develop Achilles tendinitis. Some causes are easier to avoid than others, but being aware of them can aid earlier diagnosis and help prevent serious injury. Causes of Achilles tendinitis include:

• using incorrect or worn out shoes when running/exercising
• not warming up properly before exercise
• increasing intensity of exercise too quickly (e.g. running speed or distance covered)
• prematurely introducing hill running or stair climbing to exercise routine
• running on hard/uneven surfaces
• calf muscle is injured or has little flexibility (this puts a lot of strain on the Achilles tendon)
• sudden intense physical activity such as sprinting for the finish line

Achilles tendinitis can also be caused by differences in foot, leg or ankle anatomy. For example, some people can have flatness in their foot where there would normally be an arch; this puts more strain on the tendon.

How can Achilles tendinitis be prevented?

Although Achilles tendinitis cannot be completely prevented, the risk of developing it can be lowered. Being aware of the possible causes does help, but the risk can be greatly reduced by taking the following precautions:

• Getting a variety of exercise - alternating between high-impact exercise (e.g. running) and low-impact exercise (e.g. swimming) can help, as it means there are days when the Achilles tendon is under less tension.
• Limit certain exercises - doing too much hill running, for example, can put excessive strain on the Achilles tendon.
• Wearing the correct shoes and replacing them when worn - making sure they support the arch and protect the heel will create less tension in the tendon.
• Using arch supports inside the shoe - if the shoe is in good condition but doesn't provide the required arch support this is a cheaper (and possibly more effective) alternative to replacing the shoe completely.
• Stretching - doing this before and after exercising helps to keep the Achilles tendon flexible, which means less chance of tendinitis developing. There is no harm in stretching every day (even on days of rest), as this will only further improve flexibility.
• Gradually increasing intensity of workout - Achilles tendinitis can occur when the tendon is suddenly put under too much strain, warming up and increasing the level of activity gradually gives your muscles time to loosen up and puts less pressure on the tendon.

How is Achilles tendinitis diagnosed?

When diagnosing Achilles tendinitis, a doctor will ask the patient a few questions about their symptoms and then perform a physical examination. To perform a physical exam on the Achilles tendon, the doctor will lightly touch around the back of the ankle and tendon to locate the source of the pain or inflammation. They will also test the foot and ankle to see if their range of motion and flexibility has been impaired.

The doctor might also order an imaging test to be done on the tendon. This will aid in elimination of other possible causes of pain and swelling, and may help the doctor asses the level of damage (if any) that has been done to the tendon.

Types of imaging tests that could be used for diagnosing Achilles tendinitis are:

• MRI (Magnetic resonance imaging)
• X-ray
• Ultrasound

How can Achilles tendinitis be treated?

The aim when treating Achilles tendinitis is to relieve pain and reduce swelling. The kind of treatment used can vary, based on severity of the condition and whether or not the patient is a professional athlete. After diagnosis, a doctor will decide which method of treatment is required for the patient to undergo, it is likely that they will suggest a combination. Methods used to treat Achilles tendinitis include:

• Ice packs - applying these to the tendon, when in pain or after exercising, can alleviate the pain and inflammation.
• Resting - this gives the tissue time to heal. The type of rest needed depends on the severity of the symptoms. In mild cases of Achilles tendinitis, it may mean just reducing the intensity of a workout, in severe cases it might mean complete rest for days or weeks.
• Elevating the foot - swelling can be reduced if the foot is kept raised above the level of the heart.
• Exercise and stretching - a doctor might show the patient some stretching exercises that help the Achilles tendon heal, as well as preventing future injury. They may, instead, refer the patient to a physiotherapist or another specialist. The exercises learned will improve flexibility of the area and likely increase calf strength.
• Pain relievers - non-steroidal anti-inflammatory drugs (NSAIDS), such as ibuprofen can reduce pain and swelling. If you suffer from asthma, kidney disease or liver disease do not take NSAIDs without first checking with your doctor.
• Steroid injections - these can reduce tendon swelling, but should be performed with caution, as this process has been associated with a greater risk of tendon rupture. A doctor would likely perform the injection while scanning the area with ultrasound to reduce this risk.
• Compression bandages and orthotic devices - such as ankle supports and shoe inserts can aid recovery, as they take stress off the Achilles tendon.
• Surgery - as mentioned earlier, surgery is performed to repair any damage to the tendon in cases of Achilles tendinosis. It might also be required if the patient has had recurring Achilles tendinitis and the ongoing inflammation has caused the tendon to rupture. A doctor may also resort to surgery when several of the above treatment methods have proved unsuccessful.