Achilles tendinitis

　　Achilles tendinitis is located between the Achilles insertion and the surrounding soft tissues, between the heel bone and the back of the shoe. Long-term repeated compression and friction between the two can form bursitis.

　　Firstly, the abnormal突出的部位 of the bone structure, due to long-term, continuous, repeated, concentrated, and slightly strong friction and pressure, is the main cause of bursitis. Wearing pointed and narrow shoes for a long time can cause Achilles bursitis.

　　Secondly, the bursa can also become inflamed and the synovial blood vessels can rupture due to a single large injury on the basis of chronic injury, resulting in blood-stained synovial fluid.

　　Bursitis can be caused by injury, some of which are direct violent injuries, while others are due to excessive flexion, extension, abduction, and external rotation of the joints. Repeated long-term and continuous friction and pressure can lead to bursal fatigue and inflammation. The bursa can also thicken due to wear and tear.

　　Due to long-term continuous pressure and friction, patients with Achilles tendinitis and bursitis may experience congestion, edema, and serous exudation in the Achilles tendons and bursae. This can lead to fibrous hyperplasia, adhesion, thickening of the bursal wall, and adhesions around the Achilles tendons.

　　Patients with Achilles tendinitis usually first develop a hard, painful area behind the heel bone. When the inflamed bursa swells, the skin under the heel bone becomes red, swollen, and painful. If the inflammation becomes chronic, the swollen area will gradually become hard.

　　Posterior Achilles bursitis is caused by the fact that the heel is prone to move in an inward position throughout the gait cycle, leading to excessive compression of the soft tissue between the outer posterior aspect of the calcaneus and the shoe upper, so it is very important to prevent pressure.

　　One, pay attention to hygiene, strengthen labor protection, and develop the habit of washing feet with warm water after work.

　　Two, pay attention to rest, rest is the primary method to solve any joint pain, so the joint should be well rested.

　　Three, appropriate exercise, moderate activity of the heel, can promote blood circulation, relieve pain.

　　Patients with posterior Achilles bursitis have normal or flushed local skin color, slightly increased temperature, and marked tenderness. When at rest, the Achilles tendon is relaxed, and pain decreases, but there is a possibility of calcification or ossification of the Achilles tendon or bursa in chronic patients with recurrent pain. X-ray examination in the early stage shows no change, while in the late stage, there may be decalcification of the os calcis tuberosum, cystic change, and bone hyperplasia. It is necessary to pay attention to whether the bursal prominence has hyperplasia and compresses the Achilles tendon.

　　Patients with posterior Achilles bursitis should eat foods that activate blood circulation and resolve stasis, such as Sanqi, hawthorn, huoxiang, allium fistulosum, shepherd's purse, etc. In addition, eating more fresh vegetables, fruits, and legumes is a good choice. It is advisable to avoid foods such as fried, grilled, salty, and sweet foods in daily life.

　　During the late stage of the disease, it is advisable to eat foods that tonify qi and nourish the blood, such as grapes, black beans, goji berries, longan, turtle meat, etc., and avoid spicy, greasy foods, and stimulants such as cigarettes and alcohol.

　　Elevate the heel with foam rubber or felt pads to relieve the pressure from the shoe upper. To control abnormal heel movement, shoe orthopedic devices are required. In a small number of patients, stretching the shoe upper or removing the heel seam of the shoe can alleviate inflammation, and placing the pad around the bursa can reduce pressure. Oral non-steroidal anti-inflammatory drugs can temporarily alleviate symptoms. Intra-articular injection of soluble corticosteroids and local anesthetics can reduce inflammation. If conservative treatment is ineffective, it may be necessary to perform a posterior lateral heel resection surgery.