Overuse Injuries of the Achilles Tendon in Children

Insertional and noninsertional Achilles tendon problems have been reported in adolescent athletes. Achilles tendon rupture from athletic activities is extremely rare under the age of 20.19 Clinical examination may identify predisposing factors such as foot pronation in stance, plantar fascia and Achilles tendon tightness, cavus foot, and obesity. Faulty running shoes and technique may also contribute to the symptoms, but a common underlying cause is excessive physical activity.19 Ultrasonography20 and magnetic resonance imaging are helpful in evaluation of these overuse injuries. The pathology of Achilles tendon pain in young athletes includes tendon sheath inflammation (paratendinopathy), occasional tendinopathy of the main body of the Achilles tendon, and ret-rocalcaneal bursitis. In adolescents with intractable Achilles tendinopathy, the possibility of juvenile chronic arthritis should be entertained and appropriate investigations performed. Modified rest, anti-inflammatory medication, and very short immobilization of the foot and ankle in a below-knee cast are successful in relieving pain in the majority of cases. A talar-neutral orthosis to prevent foot pronation and regular Achilles tendon stretching are generally successful in alleviating the symptoms. Surgical management for insertional and noninsertional Achilles tendon disorders is seldom necessary in this age group.

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Treating Rheumatoid Arthritis With Herbs Spices Roots

Treating Rheumatoid Arthritis With Herbs Spices Roots

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