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Your first step to recovery

Managing Your Osteoarthritis

Osteoarthritis impacts millions of people worldwide and is typically known as the most common form of arthritis. It is associated with the wear and tear of the protective cartilage which cushions the ends of your bones in your joints over time. Though this condition may cause damage to any joint in the body, osteoarthritis primarily impacts the joints in your spine, hands, hips, and knees.

 

Causes and Risk factors

Over time, the gradual deterioration of the cartilage which cushions the ends of your bones in your joints causes arthritis. Cartilage is a solid slippery tissue which allows almost frictionless joint movement. As the cartilage wears down, bone will eventually rub on bone.

This condition is typically characterized as a wear and tear degenerative disorder. However, in addition to the breakdown of the cartilage, it also impacts the joint as a whole. Osteoarthritis triggers alterations in the bone and damages connective tissue which holds the joint together and attaches your muscles to your bones. Inflammation of the lining of the joint is also triggered.

Factors which may put you at higher risk of developing osteoarthritis include but are not limited to:

  • Your age- the risk increases with getting older
  • Gender- though unclear why, but women are more perceptible to developing osteoarthritis
  • Bony deformities- those with abnormal joints or defective cartilage
  • Sustaining bony or joint injuries like those which take place during sport or from an accident.
  • The risk increases with obesity- the more you weigh, the greater your risk, as it adds more stress to your weight-bearing joints (particularly hips and knees)
  • Your occupation or a sport that you play which puts repetitive and excessive stress/loading on the joints, can eventually lead to the development of osteoarthritis.
  • Certain co-morbidities such as diabetes

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Common symptoms

Below are some common examples of symptoms you may experience with arthritis. These may develop and worsen gradually over time

  • Pain: Your joints may hurt before and/or after undertaking an activity
  • Loss of joint range of motionโ€“ loss of overall joint flexibility and movement
  • Tenderness felt on applying light pressure to the joint
  • Joint stiffness that is most noticeable on waking up first thing in the morning or after a prolonged period of inactivity
  • Noticeable changes in joint pain with changes in the weather- particularly colder weathers
  • Sensations of grating and grinding// sounds of clicking and popping (crepitus) when you use the joint
  • You may notice swelling and redness around the joint, which may be triggered by soft tissue inflammation
  • Bony spurs that feel like hard bumps may develop around the impacted joint

 

How will I be diagnosed?

Osteoarthritis is typically diagnosed based on your medical and occupation history and a physical examination undertaken by your doctor. During the physical examination, your doctor will assess your affected joint(s) for swelling, tenderness, redness, and stiffness. X-rays may be recommended to reveal cartilage loss (the narrowing of the space between the bones of your joints), changes in bone, and bony spurs around the joint. Blood tests may be used to rule out other causes of joint pains like rheumatoid arthritis. Joint fluid analyses may also be used to test for inflammation to ascertain if the pain is triggered by an infection or gout instead of osteoarthritis.

 

Management

Though there isnโ€™t a cure for osteoarthritis, various treatments which can help relieve symptoms of pain and disability are available.

Lifestyle modifications: Changes to your daily life may protect your joints and slow the progression of osteoarthritis. ย Minimising activities which exacerbate your symptoms such as climbing stairs, squatting. Swapping high-impact activities like running and jogging to lower-impact activities such as cycling or hydrotherapy will decrease the stress on your joints. Weight-loss reduces the stress and loading on your joints, which then results in less pain with increased function.

Assistive aids: Using assistive aids like a stick/cane, wearing proper shoes w orthotics and supportive braces/sleeves may improve your stability and support your functional capabilities.

Physiotherapy: Targeted exercises may help improve your flexibility as well as build strength in your muscles. Your physiotherapist will develop a personalised active rehabilitation program which is safe and will meet your requirements and lifestyles.

Medications: Various kinds of medication (such as paracetamol and NSAIDs) maybe helpful in treating and controlling the symptoms of osteoarthritis. As everyone responds differently to medications, your doctor will prescribe medicines (type and dosage), which is safe and will work best for you.

Cortisones: Strong anti-inflammatory agents which is injected into the affected joint to give pain relieve and decrease inflammation for a short period of time. Due to potential side-effects, it may be recommended to restrict the number of injections to 2-3 per year.

Other: Heat and ice applications, self-massaging with pain-relieving creams/ointments and/or wearing elastic supports may provide some relief from your pain and give you support.

Surgery: Surgery may be recommended if there is considerable degeneration in your joints and/or if your osteoarthritic pain causes disability that is not relieved with conservative management. Your doctor or specialist will discuss your options with you.

Carpal Tunnel Syndrome – What is it?

Have you been experiencing pain, pins and needles or numbness in your wrist and hands, especially after using the keyboard, chopping up a few veges, reading a book, using your mobile phone or with driving?

If you answered yes โ€“ then you are most likely to have Carpal tunnel syndrome.

What is Carpal Tunnel Syndrome?

Carpal tunnel syndrome is the most common condition in the arm. It is caused by compression of one of the three major nerves in the forearm โ€“ the median nerve, which travels through the wrist into the hand and fingers. Entrapment of the median nerve usually due to inflammation, occurs in the wrist commonly resulting in tingling of the wrist and hand (in some cases forearm), numbness, pain and weakness of the hand.

Signs and Symptoms

Often unrelated to a specific incident or an injury, symptoms of carpal tunnel syndrome usually develop gradually overtime. Symptoms may be worse in the morning and night. Many people find that the frequency and duration of symptoms increase as the conditions worsen.

Signs and symptoms may include:

  • Tingling, numbness or burning sensation of the thumb, index, middle and ยพ of ring fingers of the hand
  • Electric shock like radiating pain through the hand into thumb, index, middle and ยพ of ring finger
  • Weakened grip, loss of dexterity and fine movements such as picking up a hair pin, buttoning clothes.
  • Hypersensitivity or in other cases lessened sensation of hand to pressure, heat or cold temperatures
  • Swollen wrist

Letโ€™s take a closer look at the anatomy!

As its name suggests โ€“ a group of small bones aka carpal bones form a tunnel like passageway in the wrist (palmar view). This unique architectural design allows for the tendons of the forearm muscles and the all-important median nerve to pass through the narrow tunnel through the wrist and into the hand and fingers, supplying sensation and motor function.

Causes

Common causes and risk factors that increase the likelihood of carpal tunnel syndrome include:

  • Repetitive wrist & hands movements – during work related tasks or leisure activities may irritate the tendons in the wrist, resulting in inflammation that irritates the nerve.
  • Wrist or hand injury โ€“ recurring sprains, swelling and reduced wrist movements reduces the space in the carpal tunnel
  • Pregnancy and menopause โ€“ hormonal changes can increase fluid retention in body increasing pressure in the carpal tunnel compressing the median nerve
  • Genetic history โ€“ petite
  • Medical conditions (rheumatoid arthritis, diabetes, hyperthyroidism)

Interesting facts about carpal tunnel syndrome

  • Women are 3 times more susceptible to develop carpal tunnel syndrome than men. This can be due to hormonal changes during pregnancy or menopause and also because women tend to have smaller carpal tunnels.
  • Not all fingers are affected. Median nerve supplies movement and sensation in the thumb, all fingers except the little finger.
  • Computers/keyboard are not the only reasons to blame โ€“ repetitive nature of any work related or leisure word increases risk of developing carpal tunnel syndrome

Diagnosis

Carpal tunnel syndrome is fairly easily diagnosed by your physiotherapy, doctor or a hand therapist.

Your health practitioner will gather information on your general health, history and nature of your symptoms. They will then carefully conduct a thorough clinical assessment to assess the movements of your hand and wrist, strength and use a collection of tests in effort diagnose your symptoms. In some cases, your therapist may examine your neck, shoulders and arms to rule out other potential causes.

You may often hear the physiotherapist or hand therapist mention that they want to conduct a functional assessment โ€“ A functional assessment is activity specific, where the therapist will watch you perform the activity that aggravates your symptoms the fastest. For example, if using a keyboard is generally when you feel your symptoms start โ€“ the therapist may observe you performing the very task to examine your overall posture.

Referral to scans or nerve conduction tests may be arranged by your doctor or therapist depending on the severity or complexity of your symptoms.

Scans

Referral to scans or nerve conduction tests may be arranged by your doctor or therapist depending on the severity or complexity of your symptoms.

  • Xray โ€“ provides key information on bone health, when dealing with a potential injury, or arthritis
  • Ultrasound โ€“ can examine potential soft tissue injury or inflammation compressing the median nerve
  • MRI โ€“ this advanced imaging provides in depth review of your wrist and hand. Usually arranged by your doctor or a specialist
  • Nerve conduction study โ€“ studies the electrical activity of the median nerve. This test will help you doctor examine the severity of your problem.

Treatment

In most cases, carpal tunnel syndrome will progressively worsen overtime. So, the key is early intervention!

Conservative management

Mild symptoms can be easily managed with a conservative approach.

  • Wearing splints or braces โ€“ keeps your wrist straight to prevent repetitive use of hands, thus reducing pressure or inflammation in the carpal tunnel.
  • Non-steroidal anti-inflammatory medications โ€“ such as celecoxib and ibuprofen as prescribed by your doctor may decompress the median nerve by reducing the inflammation in your body and wrist.
  • Activity modification: your physiotherapist will play an important role in providing you with advice around to modifying your activities to reduce your symptoms. They will also prescribe you with effective stretches and exercises to help manage your symptoms while safely aiding your recovery.
  • Steroid injections: your physiotherapist or doctor may recommend a โ€˜cortisoneโ€™, also known as a โ€˜corticosteroid’ injection to control your symptoms. It contains an anti-inflammatory substance that is injected into your carpal tunnel. The effects of the steroid injection may be temporary and can vary person to person depending on many factors (cause of symptoms, stage of your condition).

In mild to moderate cases, the effects of injection may last between 3-6months.

Surgical intervention

If non-surgical approaches have failed to relieve your symptoms, surgery may be required.

By this stage you would have consulted an orthopaedic surgeon. Your surgeon will thoroughly examine your overall health, symptoms, results from the scans and the nerve conduction study to help you decide on the best treatment approach.

If you decide to undergo surgery โ€“ the surgical procedure your surgeon will perform is called โ€˜carpal tunnel releaseโ€™.

Recovery and outcomes

  • After your surgery you may be given a splint or a brace for a period of time specified by your surgeon. While in the splint or brace you will be encouraged to move your fingers to prevent stiffness and swelling.
  • Expect to experience minor pain, stiffness and swelling for a couple of weeks to months after your surgery. Pain medications provided by your surgeon must be taken as prescribed.
  • You may be encouraged to see your physiotherapist, who will work closely with your surgeon to help meet post-operative outcomes.
  • You will have regular 6-8 weekly follow ups with your surgeon as required to assess your healing and discuss gradual return to light activities and return to work.
  • If you have underlying medical conditions such as arthritis, except that your recovery may be slower than otherwise expected. It is important that you follow post-operative protocols your surgeon, doctor and physiotherapist recommend.

We Want You To Understand Your Pain

What is pain?

Pain is the brain giving out a message to protect you . It is part of our bodies natural defense system.

When an event occurs that we need protecting from, our brains response is to increase our pain. Living things detect and respond to stimulus. | Characteristics of living  things, Natural hairstyles for kids, Characteristics

Example: Putting a hand on a hot pan. You feel pain, which is the brain giving you a warning signal to move your hand away.

Pain is all about protection, never about measuring the condition of the tissues in the body.

In this instance we experience a high level of pain to prevent a bigger injury eg. causing a burn.

This is our bodies way of protecting us

So what is happening in our brain?

  • We as human beings are amazingly adaptable. The longer we have pain, the longer our brains learn to produce pain.

  • It hurts in the tissues (back, knee, hand), but the problem is in the nervous system. There is an adaptation within our nervous system.

Long term pain or Chronic pain

Chronic pain is defined as persistent or recurrent pain lasting longer than 3 months

If you have had pain for more than 3 months, your system is now overprotective. Your nervous system and immune systems have learnt.

 

Movement is medicine: why exercise therapy reduces chronic pain - Hinge  Health

 

  • With chronic pain the buffer size is increased- therefore pain comes on quicker than before.

  • You get pain when you are not anywhere near being in danger.

Management of chronic pain:

  • Identify why your brain is protecting you – fear, anxiety, quality of movement, posture, injury

  • Reduce the size of your buffer – desensitization, reassurance, progressive load management

  • Understand your pain- know that it may not go completely, but can become more manageable

Medication:

  • Depending on the type of pain you are experiencing, painkillers/NSAIDโ€™s may be beneficial in the short term – speak to your GP/pharmacist

  • Note: the research does not show good outcomes for the long-term use of medication to treat chronic pain.

Occupational Therapy:

  • If you have been off work because of your pain – try to return to work asap. An OT can discuss and plan a gradual return to work plan for you

  • They can also assist by providing aids to helps with daily tasks such as getting out of bed, or putting on shoes.

Physiotherapy:

  • There is no quick fix for persistent pain. We can help guide you along your journey to recovery

  • With persistence and hard work you can learn to adapt and cope with your pain

  • Movement is king – it is critical for retraining the system

  • Movement gradually suppresses the pain system.

  • Finding any form of exercise or movement that you enjoy and gradually increasing the volume over time

  • Moving regularly- on your good days and your bad days

Self Help:

  • Meditation or mindfulness – Apps such as Headspace or Calm are easy to use and will guide you through the process

  • The Pain ToolKit

Pressure on the Spine in Different Posture

Did You Know?

 

Low back pain is a common health problem which affects up to 80% of the population at some stage in their life.

 

In New Zealand ACC spends in excess of $130 million a year treating back pain related injuries.

Most back pain occurs between the ages of 25 and 60, and most typically in the 40s.

 

 

 

In an era of smart devices, posture has never been more important or harder to achieve. As technology continues to grow, sitting at a desk on a computer or on our phones is becoming more prevalent at work. Having a sedentary desk job can result in sitting for around 8 hours a day. This position actually increases the load on your spine more than standing. Spinal pressure โ€œsitsโ€ around 140mm pressure. This pressure usually does not hurt the back right away however, builds up over time and can even change the structure structure of your spine. So, if you slouch then spinal pressure increases to 190mm; add some weight and youโ€™ve put 275 pounds of pressure on your spine.

 

A compromised spine constricts your blood vessels and nerves, causing problems with your muscles, discs, and joints. And all of these problems can lead to headaches, fatigue, and even breathing problems. Your back is a delicate machine. When one part falls out of alignment, it can affect everything setting off a domino effect and wreak havoc throughout your back and body.

 

 


Below is a graph showing different postures and the pressure it exerts on the spine;


But, remember: While you may feel comfortable and supported in your chair and find a perfect sitting posture, staying in the same position for long periods is not healthy for your spine. Varying your postures by occasionally standing and moving around for at least a few minutes each half hour will help keep your spinal joints, muscles, tendons, and ligaments loose and pain free.

 

Stand Up for Your Spine

If you donโ€™t have a sit-stand desk, you can still combat โ€œsitting diseaseโ€ and protect your spine. Consider these tips:

  • Do some work standing at a high table or counter.

  • Use a lumbar roll behind your back when sitting to improve seated posture

  • Set a timer on your computer for a stand-and-stretch break every 30 minutes.

  • Exercise to assist in improving body weight to lessen additional load on the spine

  • Strengthen the core to provide additional support

The focus is simple: Reduce your sitting throughout the day. But, remember that varying postures is best for your back and neck, so do not go the opposite extreme and never sit. Alternating sitting, standing and movement throughout your day is the best way you can keep your spine safe and body healthyโ€”at work and beyond

 

Still having back pain?

Schedule an initial assessment with one of our Physiotherapists so they can determine the root of the problem.  During this assessment your physiotherapist will be able to decide whether your pain is a source of nerve root irritation, discogenic, postural related, or musculoskeletal.  After arriving with the consensus of the problem, we will be able to use many techniques to relieve the back pain.  These include: manual therapy, therapeutic exercise, and postural recommendations.

 

To find your nearest Physio Fusion clinic and book an appointment call 09 6266186 or visit our website https://physiofusion.co.nz

Do You Have a Healthy Work Station Set Up?

An ergonomically correct workstation has all the best practices to help maintain a healthy posture and improve your health and productivity.

Here are a few helpful tips;

1. Set up your screen

Adjust the monitor height so that the top of the screen is atโ€”or slightly belowโ€”eye level. Your eyes should look slightly downward when viewing the middle of the screen. Position the monitor at least 20 inches (51 cm) from your eyesโ€”about an arm’s length distance. If you have a larger screen, add more viewing distance.


2. Set up your chair

  • Height โ€“ You should be able to sit with your feet flat on the floor and your thighs roughly parallel to the floor. If you require a taller chair in order to reach the floor you can use a foot rest to ensure you achieve the right angle.

  • Backrest Recline and Tilt โ€“ Research has shown that a reclined seat (at least 135 degrees back)  significantly reduces the pressure on your back, and is particularity beneficial for people with back

  • Lumbar support โ€“ the shape of the backrest should have a natural curve to support your lower back.

  • Arm rests โ€“ Look for armrests that are not just height adjustable and support the entire length of the forearms.


3. Adjust your Desk Height

  • Your legs should fit comfortably under the desk if you are sitting with your feet flat on the floor: you should have enough space to cross your legs.

  • The angle between your forearm and upper arm should be between 90 degrees and 110 degrees while your arms are at rest on the desk.

  • Make your desk organized using storage accessories i.e. Document holders

  • Use an ergonomic mouse pad; to keep your wrists supported.


4. Organizing your Desk space

Organize all the items on the workstation according to their priorities and assign them to the proper ergonomic reach zones.

  • Primary Zone: High use items, easiest access

  • Secondary Zone :Medium use items, comfortable reach

  • Third Zone: Low use items, reduction in efficiency

:sparkles: MOVEMENT IS KEY :sparkles:

Its a simple action step, but mighty! Get up out of your chair and take frequent posture breaks!

When we sit in one position for hours without moving, our performance slowly starts to deteriorate, our body slows down, static loading takes over our muscles and we actually get fatigued even when we arenโ€™t putting in any physical effort. However, when you consciously integrate these microbreaks into your day, youโ€™re giving your body a much-needed refresher and an opportunity to wake up your muscles and replenish blood flow. Research has shown that movement can also help with creativity, or get you โ€˜unstuckโ€™ so you can approach your work with a different or fresh perspective and energy.

If you think your desk set up could be better, or want us to have a quick look we can do this via a video call. Book in for an appointment www.physiofusion.co.nz or give us a call on (09) 626 6186

Do you experience Cervicogenic Headaches?

What on Earth is a cervicogenic headache??

Headaches happen for lots of reason and can be cause by several sources- both primary and secondary. Once major โ€œred flagsโ€ are ruled out, understanding the type of headache is important in order to have it properly addressed.

A cervicogenic headache is a secondary headache arising from a musculoskeletal dysfunction within the cervical spine, and is a disorder that many physiotherapists treat. The main players that are typically involved in generating the pain are the joints, discs, ligaments, nerves and/or muscles found in the upper portion of the neck.

Characteristics of a Cervicogenic Headache:

:sparkles: Pain usually one sided or one side dominant

:sparkles: Pain originates from the back of the neck and radiates along the forehead, orbits around the eye, temple area and ear.

:sparkles: Steady ache or dull, diffuse pain that travels into shoulder region

:sparkles: Limited neck movement especially when turning head

:sparkles: Tenderness to touch at the muscles at the base of the head.

Here are some exercises that would help alleviate your pain:

  1. Cervical side flexion with chin tuck

  • Sit upright in a chair.
    With your shoulders relaxed, relax one arm to your side.
    Drop your opposite ear to your shoulder until a stretch is felt.
    Using your fingers, tuck your chin in, as to resemble a double chin.
    Gently release pressure with your fingers and hold this position.
    Relax and repeat

2. Levator stretch Neck stretch – levator scapula

  • Start in a seated position.
    Place the hand of the side you want to stretch down by your side.
    Tilt your head forwards and to the opposite side at an angle, as if you are trying to
    look at your armpit.
    Keeping your back straight and upright, continue to tilt your head down until you
    feel a stretch from the base of your skull down into your shoulder blade.

3. Neck stretching (Upper trapezius)

 

  • Stand up straight.
    Take the hand on the symptomatic side and place it behind your back.
    Take your other hand and place it on your head.
    Tilt your ear directly down towards your shoulder and hold this position.
    You should feel a stretch down the side of your neck.

If you believe you experience Cervicogenic Headaches get in touch with us https://physiofusion.co.nz/ for an in-depth assessment and lets knock out those headaches and decrease you dependence on pain meds

Disorders of the Achilles Tendon

Basic Anatomy

The Achilles tendon is the largest tendon in the human-body. It is a band of tissue that connects your calf muscles to your heel bone (calcaneus). This tendon primarily facilitates general mobility such as walking, running, climbing stairs, jumping, and standing on your tip toes, by helping to raise the heel off the ground.

 

 

Common Achilles Pathology

Achilles tendinitis and tendinosis are two common disorders and are typically classified as overuse injuries.

Achilles tendonitis involves inflammation of the Achilles tendon. Inflammation is the body’s natural response to injury or disease, and often causes swelling, pain, or irritation. This inflammation is typically short-lived. Over time, if this is left resolved, the condition may progress to degeneration of the tendon- Achilles tendinosis, in which case, the tendon loses its organized structure and is likely to develop microscopic tears.

There are two types of Achilles tendonitis and it is based on which part of the tendon is inflamed:

  • Insertional Achilles tendonitis affects the lower portion of your tendon where it attaches to your heel bone.
  • Non-insertional Achilles tendonitis involves fibres in the middle portion of the tendon and tends to affect younger people who are active.

In both non-insertional and insertional Achilles tendinitis, damaged tendon fibres may also calcify (harden) and often bone spurs (extra bone growth) develop with insertional Achilles tendinitis. Achilles tendonitis may also increase your risk of sustaining an Achilles tendon rupture (tear).

Causes

Typically referred to as “overuse” conditions, Achilles tendonitis and tendinosis are often caused by the sudden increase in repetitive activity involving the Achilles tendon. This can put too much stress on the tendon too quickly, that can then lead to micro-injury of the tendon fibres. Because of this ongoing stress on the Achilles, the body is not able to repair the injured tissue. The structure of this tendon is then modified, resulting in continued pain and other symptoms. The Achilles tendon also has poor blood supply that makes it more susceptible to injury and may make recovery from injury slow.

Common factors that may lead to the development of disorders of the Achilles tendon include:

  • Weak and/or tight calf muscles
  • Rapidly increasing the amount or intensity of exercise within a short span of time
  • Hill climbing or stair climbing exercises
  • Presence of bony spurs in the back of your heel
  • Changes in footwear – especially changing from wearing high-heeled shoes to flat shoes
  • Wearing poor fitting, inappropriate, or worn out shoes during sporting activities
  • Exercising without adequate warm-ups and stretching
  • A sudden sharp movement which causes the calf muscles to contract and the stress on the Achilles tendon to be increased. This can cause the tendon fibres to tear.
  • Excessive mobility
  • Poor feet positioning and biomechanics (excessive pronation and flattening of the arches of the foot)

 

Symptoms

Achilles tendon pain: Causes. when to see a doctor, and treatment

 

Common symptoms include:

  • Pain and stiffness along the Achilles tendon especially first thing in the morning
  • Pain along the tendon or back of the heel that worsens with activity
  • Severe pain the day after exercising
  • Visible thickening of the tendon
  • Tenderness to touch
  • Bone spur
  • Swelling that is present all the time and gets worse throughout the day with activity

If you have experienced a sudden “pop” in the back of your calf or heel, you may have torn your Achilles tendon. Please seek urgent medical attention if you think you may have torn your tendon.

Diagnosis

If Achilles tendonitis or tendinosis is suspected, please deter from any activity or exercise which causes the pain. It is advisable to see your doctor or physiotherapist as soon as possible so that an accurate diagnosis may be made and appropriate treatment recommended.

You will be asked about the nature and duration of your symptoms and the medical professional assessing you will have a look at your foot and ankle. Ultrasound scanning may be used to evaluate the damage to the tendon and/or surrounding structures.

An MRI may be recommended if symptoms persist. X-rays may also be taken to rule out other disorders which may cause symptoms like Achilles tendonitis and tendinosis.

Achilles Tendonitis - Ankle - Conditions - Musculoskeletal - What We Treat  - Physio.co.ukHow to Treat Achilles Tendinopathy with Physical Therapy -  prohealthcareproducts.com

Treatment

Treatment will depend on the nature, severity, and length of the injury. Generally speaking, the longer the symptoms are present before treatment commences, the longer the timeframe until full recovery is attained.  Full recovery may take between three and nine months.

Initial treatment options in the early stages may include:

  • Rest – to avoid further injury to the area
  • Ice – to reduce inflammation
  • Elevation – to reduce swelling
  • Non-steroidal anti-inflammatory drugs to reduce pain and inflammation.

 How physiotherapy can help:

Physiotherapy typically focuses on two main areas: treatment and rehabilitation. Treatment may entail massage, shockwave therapy, acupuncture, gait re-education, and gentle stretching, whereas, rehabilitation predominantly entails strengthening of the Achilles and surrounding musculature.

Strengthening of the muscles surrounding the Achilles tendon facilitates healing in the tendon itself. Strengthening is attained through the utilization of specific exercises, that will be taught by your physiotherapist. It is common for the rehabilitation programme to take up to three months.

 

Exercises