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Achilles tendinopathy

Several inflammatory and degenerative conditions fall under this heading, including tendinitis, tendinosis and insertional tendinitis. They may be the result of an acute injury triggered by functional over-loading, or repetitive microtraumas typically caused by unsuitable footwear, hard terrain or exercising in low temperatures.

Initially, symptoms tend to worsen during rest before easing after movement (the first few steps taken on a morning can be particularly uncomfortable). After some time, the pain may no longer ease after movement, severely hindering the patient’s movement. Over time, stress on the distal portion of the tendon can lead to inflammation of the pre-achilles bursa, further complicating the clinical situation.

Diagnosis is based on the localisation of pain (usually found around where the tendon inserts into the calcaneus) as well as swelling and flushing of the skin. These indicators are usually supported by an ultrasound scan, used to more accurately determine the location and extent of the lesion.

Tendinopathy requires delicate treatment and the chances of success vary depending on the severity of the injury and time since the onset of symptoms. Regardless, planning an effective rehabilitation program is still important as the later, less severe stages of the condition must not be ignored. 



Achilles tendon rupture rehabilitation

The patient who underwent total rupture of the Achilles tendon usually comes in Isokinetic with a brace locked in equinus at 20 ° after thirty days. After the first month you can make a medical examination and start the rehabilitation program.

The first objective is to reduce the inflammation and pain with draining massage therapy, immersion ultrasound, laser and gradually recover the motion and the correct pattern of walking: for the next month the load is permitted but only with tutor type named walker. At this stage are useful exercises in the pool, and active and passive mobilization of the posterior chain stretching to allow a more rapid recovery of mobility and a more secure recovery of gait pattern.

Once the surgeon allows the full load you can proceed to the therapeutic program in the gym with concentric and eccentric strengthening exercises, progressive twins, soleus, tibial, peroneal, intrinsic foot, quadriceps; both with free body exercises and with with tools, aerobic exercises on a bike, elliptical, treadmill, for the metabolic recovery. It is the longest phase and it is important to manage well the periods of loading and unloading, of strength, to allow to perform an isokinetic test with a difference in strength between the two limbs <20%.

Passed the test the ultimate goal is the recovery of the athletic gesture. You will carry out preparatory exercises to the recovery of straight running, cornering, jumps, routes and technical fundamentals of the sport. It is critical, before discharge, to have recovered 100% of the strength in isokinetic tests and have recovered the optimal metabolic activity measured with a threshold test.

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