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Achilles Tendon

Some questions answered


What is the Achilles Tendon?

The Achilles tendon (or heel cord) is the thick strap that can be felt running down the back of the calf into the heel. The tendon is made up of many bundles or fibres of a strong material called collagen, which is the body's main tissue building block. It is attached to, and worked by, the large muscles that make up the calf (gastrocnemius and soleus). When the Achilles tendon pulls on the heel it makes us go up on tiptoe, or pushes us forwards when walking or running. If this tendon is not working it is difficult to walk and the ankle feels weak.
 
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How does it get injured?

Most Achilles tendon problems occur in middle-aged athletes and are basically overuse injuries. In a few cases, other medical conditions contribute to the weakening of the tendon. A high-arched or low-arched foot may increase the stresses on the Achilles tendon.
 
As we get older the tendon becomes less flexible and less able to absorb the repeated stresses of running. Eventually small "degenerative" tears develop in the fibres of the tendon. The body tries to repair these tears. Sometimes the repair process is successful. However, the blood supply of the lower part of the tendon is not very strong and the combination of this and the continued stresses of running mean that the tendon may not completely heal. Instead, the tendon and its lining become painful and swollen, and the tendon may feel weak. The combination of degenerative and repair processes in the tendon is called tendonosis (or sometimes tendonitis). Because the lining of the tendon is called its tenosynovium, inflammation of the lining is called tenosynovitis.
 
Sometimes the tendon becomes weakened by the degenerative process to the extent that it tears completely.
 
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How would I know if I had an Achilles tendon problem?

If you had a complete tear, you would probably feel a sudden pain in your heel or calf. Some people say this feels as though they had been kicked in the calf, or hit them with a squash raquet. Usually the heel becomes painful, swollen and bruised, and it becomes difficult to walk.

 
Tendonosis and tenosynovitis develop more gradually. The Achilles tendon and the heel become painful and a swelling may develop in or around the tendon. At first the problem is present mainly on running or playing sport, but later it may become increasingly difficult to walk because of the painful tendon.
 
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Can I treat it myself?

Achilles tendonosis or tenosynovitis can be treated like any other athletic injury or overuse problem in the first instance. You may need to reduce your mileage or the frequency of your sports for a while. When you do run or play, warm up longer and do plenty of Achilles stretches. A change to a softer running surface and well padded running shoes may help. A 1/4" raise on your shoe will reduce the stresses on the tendon (remember to raise the other side too, to keep yourself balanced). When the pain and swelling is bad, it will usually be helped by applying an ice pack (a small bag of frozen peas or corn is ideal). For the pain, try simple pain-killers such as paracetamol. Anti-inflammatory medicines may reduce the inflammaton in the tendon, but check with your doctor or pharmacist before taking these as they can have side-effects in some people.
 
Obviously, there is no self-help solution to a complete tear of the Achilles tendon!
 
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When should I get professional advice?

If you think the tendon has torn completely, you should go to your local casualty department, as you may need to have it repaired.
 
If a painful tendon does not improve with the treatment recommended above, you should consider consulting your GP or physiotherapist.
 
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How will my doctor or physiotherapist know what's wrong?

Your doctor will listen to your complaints about your Achilles tendon and will examine you, paying particular attention to the tendon itself and looking for anything else that may be contributing to the problem.
 
Usually treatment can be started without further tests. However, if your doctor thinks the tendon problem is due to some other problem, other tests may be done, such as blood tests for arthritis or diabetes. If there is a possibility that the tendon is torn, a scan of the tendon may be arranged. Often an ultrasound scan will give enough information, but a magnetic (MR) scan is more useful in some cases. An X-ray of your heel is sometimes useful.
 
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What can be done about it?

The first thing is to check that you have tried all the simple measures outlined above. If so, a physiotherapy programme aimed at reducing the inflammation in and around the tendon would be tried. Once the inflammation is improving, the physiotherapist will start exercises to strengthen and stretch the Achilles tendon.
 
If you have a foot shape that increases the stresses on your Achilles tendon, a moulded insole in your shoe may help.
 

Most people will improve with physiotherapy. A few continue to have trouble and in this case an operation may be considered.

 
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Will I need an operation?

As explained above, most people will improve with simple measures or physiotherapy. A small number continue to have major problems which interfere with their lifestyle. In this situation an operation may be considered.

 
If an operation is being considered your GP will arrange for you to see an orthopaedic foot and ankle surgeon. The surgeon will interview you and examine you again and may want you to have further treatment before making a decision about an operation.
 
The surgeon would probably want you to have a scan before any surgery, to show whether there is a problem in the tendon which can be corrected by surgery.
 

If there is tenosynovitis but the tendon itself is reasonably healthy, stripping out the inflamed tendon lining often gives good results. If the problem is tendonosis, surgery would involve removing the degenerate tendon and repairing the remaining tendon. If the degenerate area is localised this can give quite good results. However, often the degeneration involves quite a lot of the tendon and removing it all may leave quite a large gap in the tendon which may need a major operation to repair. A big repair usually needs tendon borrowed from somewhere else, either higher up the Achilles tendon or from another tendon. As you will appreciate, such a large operation may cause a lot of scarring and stiffness and the repaired Achilles tendon may not be very strong. Other possible problems with major Achilles tendon surgery include problems with the surgical wound (the blood supply to the heel area is not very strong and the wound may be very slow to heal). There is also the risk of stretching or damaging the nerve at the back of the ankle (the sural nerve) causing numbness and tingling along the side of the foot. For these reasons surgery for Achilles tendonosis is only advised when the tendon problem is disabling and extensive non-surgical treatment has been tried.

 
The best treatment for a ruptured Achilles tendon is not known for certain. Most ruptures will heal if protected in a plaster for 6-8 weeks. After plaster treatment there is a higher risk of another rupture (about 15% as against 5% after surgical repair) and the tendon is often weaker than after surgical repair. Nevertheless many people get a good result after plaster treatment and, obviously, avoid the risks of surgery. This may be the best treatment for less physically active people. The greater strength and quicker recovery after tendon repair may be more useful to those who expect to play a lot of sport again. Your surgeon will discuss the options with you to help you decide what is best for you.
 
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Will I have to give up running?

Usually not. You may need to reduce your distance for a while to allow your tendon to heal. Some people who have surgery will not get enough tendon strength or flexibility to allow them to return to running or sport.
 
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Best CBD Oil UK: The 9 top CBD brands in the UK (2020)

CBD products are making a lot of noise in the market, and it makes complete sense judging by the slew of health benefits that they bring. We’ve gathered the best CBD oils currently available in the UK market to help you narrow down your search.

What is CBD?

CBD or Cannabidiol is a chemical compound extracted from the cannabis plant. We know what you’re thinking. How is this any different from marijuana? The answer is in their THC (tetrahydrocannabinol) content. Weed contains a lot of THC, which is a psychoactive compound that gives the user mind-altering effects. CBD, on the other hand, cannot get you “high.” CBD is widely used for its pain relieving properties. It can be used to minimize the symptoms of conditions like epilepsy, anxiety, diabetes, cancers, among others. 

Whether you have crippling anxiety or you have been dealing with chronic pain for a long time, CBD oil can offer you some relief. With plenty of scientific research emerging to back up anecdotal claims, the UK CBD market shows no signs of slowing down. CBD is 100% legal in the UK as long as its sold as a food supplement and contains less than 0.2% THC content.

If you’re ready to jump on this very promising train, take a look at the best CBD oils in the UK that we’ve tried and recommend. 

The UK's 9 Best CBD Brands (2020 Updated)

1. Blessed CBD

If you don’t want to muck around, the first CBD oil you should try should be the UK’s number one CBD oil brand. Blessed CBD is a family-run operation in the UK. It’s their goal to provide their customers with the very best CBD products, and it’s safe to say that they have been succeeding in the United Kingdom.

Their hemp extracts come in a 10ml bottle and in full-spectrum form, meaning they’re rich in all cannabinoids (CBD, CBDA, CBG, etc) and terpenes. Unlike broad-spectrum oils, full-spectrum CBD oils are extremely effective in relieving pain and inflammation (due to the entourage effect). It’s also worth noting that the hemp plants used in their products are 100% vegan and organically grown. 

cbd oil

What we love about Blessed CBD is their commitment to educating the UK public about CBD. They cater specifically to the UK market, as their products are not available elsewhere else. All their products come with an informational booklet to get you started and customer reviews are majorly positive.

They were also voted the #1 CBD oil UK by leading publications, such as Mirror, Observer, HerbMighty, Manchester Evening News, Liverpool Echo, Birmingham Mail, LA Weekly, Readers Digest, Glasgow Live, Improb and Luxury Lifestyle Mag.

Plus, each batch of oil they produce comes with its own certificate and third party lab reports, so you know exactly what you’re putting into your body and the amount of CBD in each product. 

If you're looking to truly experience the benefits of CBD, give Blessed CBD a try.

For more information, visit BlessedCBD.co.uk.

2. Bud & Tender CBD

Bud & Tender is a British company that’s relatively fresh in the market. However, they’re getting quite the praise because they produce some decent CBD oils. 

A premium CBD oil (with a premium price), it’s a bit more palatable than your average CBD tincture. It has a distinct floral note, which makes it easier to swallow. Using a CO2 extraction process/technique, all their oils are guaranteed to be of the purest quality. 

They only use non-GMO, organic hemp so you’ll know that what you’re getting is an all-natural remedy. If you want to find out more about their products, they’re very transparent about what’s in them. Comprehensive lab results are regularly published on their website. 

3. Jacob Hooy CBD

If you like to frequent Holland & Barrett on the high street, you might have come across this hemp CBD oil from Jacob Hooy. Because it’s so affordable, it’s a viable choice if you’re taking the first steps of your CBD journey. It’s not the most potent oil in the CBD industry, so it's important to have realistic expectations.

It’s also not the most palatable, but you can always wash it down with a generous drink of water. Overall, it’s a reliable starter CBD oil for those who don’t need higher potencies just yet. 

4. Hempura CBD

Hempura is an up-and-coming brand that offers a wide range of quality CBD oil products. Aside from oils, they have edibles, e-juices (for vaping devices/vape pens), and capsules. Even though it’s not full-spectrum, the oil contains a decent amount of cannabinoids. It’s by no means ineffective. 

They also use the CO2 extraction method, which is considered the most efficient and safest technique of getting CBD out of hemp plants. We also love Hempura’s packaging, which is important to some folks. 

Hempura is also part of the Cannabis Trades Association, which shows their commitment to creating high-quality products for their customers.

5. Endoca Raw CBD

Endoca Raw is the CBD oil of choice of those who want make more environmentally sound choices. Endoca Raw’s operations all happen in Northern Europe. It’s worth noting that they use supercritical CO2 extraction, which is the best way to isolate cannabinoids and flavonoids.

The growing process of the hemp crops used in their products all pass strict regulations. They’re non-GMO, vegan, gluten-free, pesticide-free, herbicide-free, and 100% natural. 

Their range of products include CBD tinctures, CBD capsules, gummies, CBD vapes, CBD e-liquid and skincare options.

6. Medterra CBD

Medterra dominates the worldwide CBD oil products market (especially in the USA) and they have only just made their products available for UK residents. Their oils comes in 500mg to 3000mg potencies, so you have a decent range to choose from depending on the symptoms that are ailing you. 

Best CBD Oil UK: The 9 top CBD brands in the UK (2020) Best CBD Oil UK: The 9 top CBD brands in the UK (2020)

Best CBD Oil UK: The 9 top CBD brands in the UK (2020)

One thing that we love about the Medterra's CBD range is its tastelessness. It doesn’t smell like anything either, making it extremely easy to consume. Plus, the dropper cap of this product has marked measurements, so you can measure out your dose every time you take it. 

7. Holistic Herb CBD

If you’re a stickler for quality and always want to go for the premium, look no further than Holistic Herb. They offer strong straightforward potencies of CBD, at 4.2% or 8.2%. If you think you’re going to need higher doses to treat your ailments, then by all means go for this oil. Just so you know, it’s very hard to overdose on CBD oil anyway. You would have to consume gallons of it for it to become detrimental. 

Every batch of their CBD oil sprays are so pure and contain no amount of THC whatsoever. You’re guaranteed to get only the holistic goodness of the crop and not its psychoactive side effects. Since it’s a premium product, it’s the most expensive one on this list, but it’s never really a bad idea to splurge on quality. 

8. NeoHemp

Hemp oil is not exactly the same as CBD oil, but it’s a good place to start if you’re on the fence about using pure CBD. Hemp oil is considered a superfood because of its high amount of fatty acids and bioactive compounds. Unlike CBD oil, Hemp oil is extracted particularly from the crop’s seeds and nowhere else. 

With a 4000mg potency, you can take this oil as is or mix it in with your creams and serums. It’s more affordable than the other picks on this list, but it is also slightly less potent. 

9. Health Hemp Holland

This is another hemp oil. As mentioned above, hemp oils are not to be confused with CBD oils. It’s extracted from the seeds of the hemp plant, while CBD oil is extracted from the leaves, flowers, and steams. 

Hemp oils are mainly used to treat skin problems like acne and visible signs of aging. A lot of folks combine them with their sunscreens and moisturizers to get evenly toned clear skin. Hemp has anti-inflammatory properties which help reduce the appearance of spots. 

This is also a great starter oil for those who only looking to get their feet wet in the wonderful pool of CBD products. 

CBD oil UK: final thoughts and takeaway

There you have it, our top picks for the best CBD oils to buy in the UK.

As a friendly reminder, its best to work your way up if you’re unsure about dosing. Start with a lower potencies and check if it relieves your symptoms. There is some trial and error involved in this. But when you find that sweet spot, you’ll soon realize that CBD oils may work wonders on your physical and mental health.

If you're looking for the best and most reliable CBD oils and CBD creams in the UK, look no further than Blessed CBD.


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