Today, we're going to outline a detailed strategy for the complete treatment and rehabilitation of Achilles tendonitis. Firstly, we'll look at the importance of the immediate treatment (the first 48 to 72 hours), and then we'll outline the ongoing treatment necessary for a full recovery.

Immediate TreatmentThe immediate treatment of any soft tissue injury, such as an Achilles tendon injury, is vital. Proper care and treatment now will go a long way towards a full recovery later.

Without a doubt, the most effective, initial treatment for Achilles tendonitis is the R.I.C.E.R. regime. This involves the application of (R) rest, (I) ice, (C) compression, (E) elevation and obtaining a (R) referral for appropriate medical treatment.

Using the R.I.C.E.R. regime immediately after the occurrence of an injury significantly reduces recovery time. R.I.C.E.R. forms the first, and perhaps most important stage of injury rehabilitation, providing the early base for the complete recovery of injury.

When an Achilles tendon injury occurs and the tendon has been damaged there is a large amount of uncontrolled bleeding around the injury site. This excessive bleeding causes swelling, which puts pressure on nerve endings and results in increased pain. It is exactly this process of bleeding, swelling and pain that the R.I.C.E.R. regime helps alleviate.

R.I.C.E.R.R: (rest) It is important that the Achilles and lower leg be kept as still as possible. This will help to slow down blood flow to the tendon and prevent any further damage.

I: (ice) By far the most important part. The application of ice will have the greatest effect on reducing bleeding, swelling and pain. Apply ice as soon as possible after the injury has occurred.

How do you apply ice? Crushed ice in a plastic bag is usually best. Although blocks of ice, commercial cold packs and bags of frozen peas all do fine. Even cold water from a tap is better than nothing at all.

When using ice, be careful not to apply it directly to the skin. This can cause "ice burns" and skin damage. Wrapping the ice in a damp towel generally provides the best protection for the skin.

How long? How often? This is the point where few people agree. Let me give you some figures to use as a rough guide, and then I'll give you some advice from personal experience. The most common recommendation is to apply ice for 20 minutes every 2 hours for the first 48 to 72 hours.

These figures are a good starting point, but remember, they're only a guide. Also take into account that some people are more sensitive to cold than others. Also be aware that children and elderly people have a lower tolerance to ice and cold. Finally, people with circulatory problems are also more sensitive to ice. Remember to keep these things in mind when treating yourself or someone else with ice.

Use your own judgement when applying ice to yourself. For some people, 20 minutes is way too much. For others, especially well conditioned athletes, they can leave ice on for much longer. The individual should make the decision as to how long the ice should stay on.

My personal recommendation is that people should apply ice for as long as it is comfortable. Obviously, there will be a slight discomfort from the cold, but as soon as pain or excessive discomfort is experienced, it's time to remove the ice. It's much better to apply ice for 3 to 5 minutes a couple of time an hour, than not at all.

C: (compression) Compression actually achieves two things. Firstly, it helps to reduce both the bleeding and swelling around the Achilles, and secondly, it provides support for the ankle and lower leg. Use a wide, firm, elastic, compression bandage to cover the entire ankle and lower leg.

E: (elevation) Simply raise the injured leg above the level of the heart at all possible times. This will further help to reduce the bleeding and swelling.

R: (referral) If the injury is severe enough, it is important that you consult a professional physical therapist or a qualified sports doctor for an accurate diagnosis. They will be able to tell you the full extent of the injury.

Before we finish with the initial treatment of an Achilles tendon injury and move onto the next phase of the rehabilitation process, you must avoid a few things during the first 72 hours.

Be sure to avoid any form of heat at the injury site. This includes heat lamps, heat creams, spas, Jacuzzi's and saunas. Avoid all movement and massage of the injured area. Also avoid excessive alcohol. All these things will increase the bleeding, swelling and pain of your injury. Avoid them at all costs.

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