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t friction betd, the conditiormally limitnd the heel.

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chilles tendo, causes para

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mbled due to

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ration, other

r tissue tries egenerative ctendon. Tinr the possibi

fibers break

to repair thecondition wiy tears in theility of actua

k, and the

e tendon.thout infe tissue a

al rupture

Sympto

What do

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the leg, just. Pain is pres

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vent. Some bto being viols.

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rapist may p

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may report acd in the calf.

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may be visiult to tolerat

hilles tendonpushing off o

ctually hearif. Following

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ts if a ruptur

ble rednee shoe w

n in this aon the to

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re is susp

therapist may move your ankle in different positions and ask you to hold your foot against applied pressure. Palp(feeling for any abnormalities in the tendon) and muscle function tests may also be included. By stretching the caand feeling where these muscles attach onto the Achilles tendon, we can begin to locate the problem area.

Some patients may be referred to a doctor for further diagnosis. Once your diagnostic examination is complete, tphysiotherapists at BodyZone Physiotherapy have treatment options that will help speed your recovery, so that yquickly return to your active lifestyle.

Our Treatment

Non-surgical Rehabilitation

When you begin physiotherapy at BodyZone Physiotherapy, the rehabilitation program that our physiotherapist pwill depend on the specific type of problem (tendonitis or tendinopathy/tendonosis/tendon rupture) present.

Tendonitis/Tendinopathy

In the past, nonsurgical treatment for tendocalcaneal bursitis and Achilles tendonitis started with a combination oand anti-inflammatory medications prescribed by your doctor.

Since it is now recognized that many tendon problems occur without inflammation, the use of anti-inflammatoriehave come into question. In the case of true inflammation, the overuse of these modalities may prevent a normal,inflammatory process. Preventing inflammation needed to clean up cellular debris in the injured area may lead toincomplete healing. The result may be future chronic problems of tendonosis and/or tendinopathy.

Many experts suggest that when there is any doubt about inflammation, treatment should proceed as if there are ninflammatory cells present. Our approach would then focus on pain relief and restoring proper motion and weighyou can return to your usual activities.

If there is an inflammatory process, then the condition should respond fairly quickly to drug and antiinflammatorinterventions. Limiting, but not eliminating, inflammation is the new goal.

Our physiotherapists know when and how to apply cold modalities to reduce swelling and pain, while still allowihealing inflammatory process. We may also apply treatments such as ultrasound, moist heat, and massage are usepain and inflammation. As pain eases, we will progresses your treatment to include stretching and strengthening

Tendonosis

If the problem is one of tendon tissue degeneration, healing and recovery may take longer. This type of injury wirespond to treatment designed to reduce inflammation. Correct treatment of tendonosis involves fostering new cotissue growth and improving the strength of the tendon. Rehabilitation following rupture of the tendon is quite diis described later.

An acute injury needs rest. We recommend that initially, you limit activities that require walking on the sore leg.the time required for rehabilitation varies among patients, in cases of Achilles tendinopathy, or when a partial ten

being treated without surgery, patients may require two to three months of physiotherapy.

Your physiotherapist may recommend that a small (one-quarter inch) heel lift be placed in your shoe to minimizeputting slack in the calf muscle and Achilles tendon. A similar sized lift will also be placed in the other shoe to keverything aligned.

Injured tendons shorten and need to be stretched. Only gentle stretches of the calf muscles and Achilles tendon afirst. As the tendon heals and pain eases, more aggressive stretches are given. Our therapist may also use ultrasoumassage to help the tendon heal.

As your condition improves, exercises to strengthen the calf muscles begin. Strengthening starts gradually using exercises that work the muscles but protect the healing area. Eventually, specialized strengthening exercises, calleccentrics, are used, working the calf muscle while it lengthens.

The physiotherapy provided by BodyZone Physiotherapy enables patients to gradually return to normal activitiesspecialized programs to guide athletes in rehabilitation that is specific to their type of sport.

Tendon Rupture

Nonsurgical treatment for an Achilles tendon rupture is somewhat controversial. It is clear that treatment with a callow the vast majority of tendon ruptures to heal, but the incidence of rerupture is increased in those patients trecasting for eight weeks when compared with those undergoing surgery. In addition, the strength of the healed tensignificantly less in patients who choose cast treatment. For these reasons, many orthopedists feel that Achilles teruptures in younger active patients should be surgically repaired.

Nonsurgical treatment might be considered for the aging adult who has an inactive lifestyle. This allows the patiewhile avoiding the potential complications of surgery. The patient's foot and ankle are placed in a cast for aprroxeight weeks. Casting the leg with the foot pointing downward brings the torn ends of the Achilles tendon togethethem until scar tissue joins the damaged ends. During this time, your physiotherapist will instruct you in safe andcrutch utilization. After your cast is removed, our physiotherapist can have your fitted with a large heel lift to weapprximately another six to eight weeks after the cast is taken off.

Post-surgical Rehabilitation

Although the time required for recovery is different for each individual, patients are typically placed in a cast, brfor six to eight weeks after surgery to protect the repair and the skin incision. Your physiotherapist will help you properly use crutches to keep from putting weight onto your foot too soon after surgery.

Devices used to immobilize the leg can cause joint stiffness, muscle wasting (atrophy), and blood clots. To avoidproblems, our therapist will have you start doing motion exercises very soon after surgery. Patients typically weabrace that can easily be removed to do the exercises throughout the day.

In this early-motion approach, you begin our physiotherapy program within the first few days after surgery. Yourphysiotherapist may initially use ice, massage, and whirlpool treatments to limit (but not completely prevent) sw

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