En los últimos años ha aumentado el conocimiento que tenemos sobre la fisiología de la tendinopatía aquílea y del funcionamiento del tendón en general, lo que ha cambiado la forma de tratar esta lesión y mejorado los resultados evitando unas sencillas directrices que hace unos años eran el pan de cada día de los pacientes con inflamación o degeneración del tendón.
- REPOSO ABSOLUTO. El reposo absoluto debilita aún más al tendón. Hay que disminuir la carga o actividad a niveles aceptables para introducir una progresión según mejoren los síntomas.
- PONER HIELO O TOMAR ANTIINFLAMATORIOS. La inflamación es un mecanismo de defensa natural que atrae factores de crecimiento y una serie de proteínas que regeneran la estructura dañada. Detenerla es un error (salvo en casos seleccionados que deben ser valorados uno a uno).
- IGNORAR EL DOLOR. El dolor es simplemente la punta del iceberg de un daño de larga evolución en el tendón. Por mucho que lo ignores no va a mejorar. Busca ayuda profesional cuanto antes.
- ESTIRAR EL TENDÓN. Un tendón enfermo al ser estirado sufre más, disminuyendo su oxigenación y aumentando el estrés celular. En caso de rigidez muscular habrá que buscar el masaje de un fisioterapeuta o, en casos leves, hacerse automasaje.
- INFILTRAR CORTICOIDE. Muy especialmente si es intratendinoso. Provoca degeneración del tendón y favorece la rotura del mismo, con consecuencias realmente graves. Si queremos adelantar la fase clínica y resolver el problema cuanto antes deberemos inyectar sustancias como el PRP o realizar electrolisis intratisular.
- NO TENER PACIENCIA. La base de solucionar este problema de forma duradera es el ejercicio excéntrico durante al menos 3 meses.
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