enlargement of the posterosuperior or posterosuperior
lateral calcaneus can result in calcaneal bursitis
and other soft tissue impingements (23). Bone
spurs (enthesophytes) or calcifications can occur
concomitantly with Haglund’s syndrome or on their
own. (24). These conditions are commonly treated
conservatively but in patients that don’t respond
conservatively, surgical options exist.
III. ORTHOSES FOR ACHILLES TENDINOPATHY
The first line treatment of Achilles tendon problems
is mainly a conservative one: rest, ice, elevation,
decreased activity and non-weight bearing for a period
of time. Non-surgical treatments are beneficial for
most patients particularly those who are less active,
older, have systemic pathology, or have wound healing
FIGURE 1: There is complete disruption of the Achilles
tendon fibers consistent with complete rupture. There is
no evidence of fracture or bone oedema.
FIGURE 2: The arrow indicates the gap in the Achilles
tendon from the complete tear, with the retracted ends.
problems. Surgery is often last resort for the less active
patients while in athletes (especially professional
athletes) it may be the first line treatment for ruptures
or partial ruptures (see: Figure 1-3).
Taping, foot and/or ankle orthoses and splints are
recommended for Achilles tendinopathy (14). When
treating Achilles tendonitis and related pathologies
of the Achilles with orthoses, it is crucial to relieve
Achilles tendon tension. This can be done by
plantarflexing the foot by using a simple heel life
in the shoe. (16) In 2017, Bartold conducted a study
on the effects that a heel lift would have on tension
in the Achilles tendon. He looked at healthy active
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