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Monday, May 9, 2022

Right Achilles Pain: Initiate BRISS

I just saw a patient with Right Achilles pain for 6 months. She had no increase activity or change in medications. I initiated BRISS treatment for tendinitis and advised her to email me in one month about her progress. I found swelling, but no tightness in the achilles (to see if Occam's Law applied). BRISS is a simple acronym to remember to think about all the categories of tendon injury treatment. The acronym stands for:
  • B for biomechanical treatment
  • R for Rest or Activity Modification treatment
  • I for Inflammation Treatment
  • S for Stretching or Flexibility Treatment
  • S for Strengthening Treatment
How did it help start the treatment on our first visit?
B for 1/4 heel lifts in all her shoes, no barefoot next 6 weeks, heeled shoes as much as possible
R for day to day activities only, will consider cross training with bike, elliptical, swimming
I for ice twice daily and contrast bathing for swelling reduction each night
S for gastrocnemius stretching and no negative heel stretching now
S for two positional heel raises with the heels only on one inch book and no shoes each evening

This patient was given an RX for 8 PT visits and will email me in one month. We did talk about posterior sleeping splints, but since she is a poor sleeper, she was worried that it would bother her. So, the splint was not in our initial treatment. 

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Thank you very much for leaving a comment. Due to my time restraints, some comments may not be answered.I will answer questions that I feel will help the community as a whole.. I can only answer medical questions in a general form. No specific answers can be given. Please consult a podiatrist, therapist, orthopedist, or sports medicine physician in your area for specific questions.