The Wrap Protocol for Managing Achilles Tendonitis and Peritendonitis

What does this work well for?

  • Achilles tendinopathy

  • Superficial tendons that are inflamed and sore

  • Peroneal tendons

  • Tibialis posterior tendons

  • Flexor tendons

  • Tibialis anterior tendons

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The night wrap serves as a localized anti-inflammatory treatment designed for inflamed soft tissues during overnight hours.

I have observed its notable effectiveness in managing tendon pain, especially in the Achilles region

While the supporting body of evidence is not extensive, anecdotal feedback suggests that night wraps can be particularly beneficial.

With any use of pharmacological agents, consult with your GP or pharmacist.

 

Here's what you'll need:

  • Glad wrap/Cling wrap

  • Gauze

  • Diclofenac gel (e.g., Voltaren gel)

  • Hirudoid cream

All these you should be able to get from the chemist

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Don't use creams that aren't the above mentioned.

How Does the Night Wrap Operate? Its proposed mechanism involves delivering a sustained and potent topical anti-inflammatory effect, surpassing the impact of mere massage. With approximately 8 hours of uninterrupted application during your sleep, the cream actively works to alleviate your discomfort.

The incorporation of Hirudoid cream is particularly advantageous for injuries accompanied by bruising or tendon crepitus (swelling around a tendon sheath, often causing a creaking sensation). It functions by inhibiting the formation of fibrin, a key factor in crepitus development.

Beyond keeping the gel in direct contact with the skin and preventing it from transferring onto bed sheets, the Glad Wrap may minimize cream evaporation, ensuring a higher active dose at the injury site.

An appealing aspect of this treatment is its topical nature, devoid of the gastro side effects or liver stress associated with oral medication.

However, it's essential to note that this treatment excels for superficial injuries, and its efficacy diminishes with deeper injuries.

1. Just before going to bed, massage a small amount of equal parts (about the size of a 20c or 50c piece) Hirudoid and Diclofenac into the painful area for 3-5 mins until it has been absorbed into the skin.

2. Apply an additional larger quantity of the cream and gel and lightly massage till they have mixed together. Leave this as a thick layer on top of the skin. It should not be completely rubbed in and still visible

3. Wrap up the injured area in glad wrap 

4. Go to bed and leave the night wrap on. Some people do find it uncomfortable to sleep in. If it is the case, try it from when you home until when you go to bed with your feet up.

Note: If the injured area is around a boney prominence, you can apply a thin piece of gauze on top of the layer of cream/gel to help keep it in place and not slide off