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Achilles Tendon and Physiotherapy

 Achilles Tendon and Physiotherapy

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Our Achilles tendon, known also as the tendo calcaneus, is a tendon at the back of our legs. It connects three muscles called the soleus, gastrocnemius and plantaris to the bone of the heel. It is the most strong, most thick and most durable tendon in our entire body, and it's roughly 15 cm in length.

It originates from near the centre of our calf muscles, and it attaches to the muscles all the way near to its insertion point (its location and length attributes to its strength and durability). It strong enough to carry up to four times the human body with walking, and up to eight times when running. It is very, very strong, and at the same time, if or when our achilles tendon gets injured, it'd impact us a lot.

If or when our Achilles tendon gets injured, normally we do not go and get it surgically repaired immediately as first point of intervention; often therapists such as physiotherapists and podiatrists use aids, equipment and orthotics can be used to correct any misalignments. As anti-inflammatory drugs can contribute to tendinopathy, it may not be advised to take them for the long term.

We are often referred patients with Achilles tendon injuries for physiotherapy interventions, especially for calf stretching and strengthening. Whenever necessary, the physiotherapist or the referring doctor may request for the fabrication of an ankle-foot-orthosis (often abbreviated to AFO); it's done by the hand therapist or occupational therapist. What the AFO does is it helps to correct alignment, provide a consistent and passive stretch to an adequate resting length to protect the tendon for maximum healing.

If the Achilles tendon has been 100% ruptured, surgical intervention is 100% required to re-attach the torn tendon back together to allow proper healing... plus an AFO to protect the repair. On average, it takes about ten to eighteen months for full recovery post surgery of a torn achilles tendon.

Adequate and accurate physiotherapy intervention is crucial to manage injuries such as this, as improper management can cause residual problems such as decreased range of motion in the ankle, decreased strength of plantar flexion and dorsi flexion of the ankle, decreased balance and proprioception, decreased stamina and decreased confidence.

What physiotherapists will do is that they will first manage the pain experienced using heat modalities, accelerate the soft tissue healing with ultrasound therapy, then start with gentle mobilization exercises before moving on to strengthening and stretching exercises.