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Your first step to recovery

Piriformis Syndrome

Piriformis syndrome refers to the dysfunction of the piriformis muscle which irritates the sciatic nerve. It is characterized by deep buttock region pain that radiates down leg and foot often accompanied by pins and needles and numbness traveling along the path of the sciatic nerve.

The simplistic reason for this widely distributed pain comes down to the piriformis muscle itself – Their close proximity means that direct trauma to the buttock region or the supporting structures can result in inflammation and muscle dysfunction which can compress and irritate the sciatic resulting in referred symptoms.

Piriformis syndrome symptoms may include:

  • Localised deep buttock region pain
  • Pain with continuous sitting or standing for 15 mins or over
  • Pins and needles along the leg down to the outer foot
  • Numbness in outer leg or foot (often resolves on movements)
  • Deep squatting or bending
  • Pain on direct palpation

Anatomy

 

The piriformis muscle originates from the outer surface of a large fused bone of our pelvis called the sacrum. It travels adjacently and inserts into the top of the hip joint. The piriformis muscle is a very active muscle involved in stabilizing the hip and pelvis during majority of our activities (walking, running, standing, sitting or standing, turning in bed). When the piriformis muscle contracts it helps the hip rotate outwards (external rotation) and lift thigh out and up (abduct).

The sciatic nerve originates from where the very base of the spine and the sacrum join known as the lumbosacral region (lower back and saddle region). In this region five separate branches of nerves travel outside of the bony openings of the spine called the nerve roots and connect into a single large nerve – the sciatic nerve. It then travels through the pelvis deep into the buttock region close proximity the piriformis and gluteal muscles. In some individuals the piriformis muscles can travel through the piriformis muscle subjecting them to piriformis syndrome.

Diagnosis

There are no specific tests to diagnose piriformis syndrome. Diagnosis of piriformis syndrome is made by the report of symptoms and by physical exam using a variety of movements to elicit pain to the piriformis muscle. In some cases, a contracted or tender piriformis muscle can be found on physical exam.

In cases where there is underlying pathology (such as disc injury, arthritis, sacroiliac dysfunction or hip injury) resulting in true sciatica – piriformis syndrome may develop to become an additional muscular dysfunction that is required to be addressed. Because symptoms can be similar in other conditions, radiologic tests such as MRIs may be required to rule out other causes of sciatic nerve compression, such as a herniated disc.

Consultation with a physiotherapist in this case is highly recommended as they will perform a comprehensive clinical examination to identify the root cause of your symptoms.

Exercises for piriformis syndrome

Corrective exercises with a combination of strength and flexibility regimen is an essential way to treat true piriformis syndrome (without involvement of other underlying pathologies).

The exercises outlined below follow a phase-by-phase progressive regimen to strength key muscles of the hip, buttock and legs.

As you work through these exercises expect to feel some pain during and after your exercise. Pain you may feel during the exercise is an expected sign of muscle activity. Pain you may feel after the exercises is an expected sign of muscle healing and recovery. However, if you are unable to participate in the exercises due to symptom deterioration – it is highly recommended you consult your physiotherapist to rule out other potential causes.

Otherwise, to help you gauge the correct amount of pain you should expect during exercise – use this scale. The ideal range should be 2 to 5. If your baseline pain is over 6 or 7 – it is recommended that you consult your doctor for pain relief appropriate to manage your pain, followed by a consult with a physiotherapist. Your physiotherapist will be able to modify the following exercises or prescribe alternative exercises best suited based on your current level of function and symptoms.

Symptom noting – is a great way to keep track of your progress and symptom behaviour.

  • Take a diary
  • Note down pain before you begin the exercise.
  • Note down the pain rating after each exercise.
  • Note down pain at the end of the day
  • Repeat the pain recording process for the next 4-5 days
  • Examine the trend in your symptoms.

Interference with everyday tasks – Your participation or level of exertion with everyday activities may interfere with your symptoms impacting your exercise tolerance. It is therefore important to note any of these interferences’ contributory to your pain.

Phase 1 – is a beginner stage.

This phase is intended for gently priming muscle activation. It will demand your concentration on technique and compliance to change the possible compensation your body has been used to as a result of pain. This phase can last between 1-2 weeks.

Instructions:

3 sets of 10 repetitions. Hold each repetition for 8-10 seconds. Rest 10-15 seconds between sets, 30 seconds between exercises. Do this exercise 1-2 times per day.

Bridges

 

Lie on your back.
Bend both knees and place your feet flat on the bed.
Lift your buttocks from the bed.
Place your buttocks back on the bed.
Repeat this exercise and remember to continue to breathe properly.


Clam shells

 

 

 

 

 

 

Lie on your side with your feet, ankles and knees together.
Bend the legs a little and tighten your core stability muscles.
Keeping the feet together, lift the top knee up.
Make sure you don’t roll your body back with the movement.
Control the movement as you bring the knee back down to the starting position.


Phase 2 – intermediate stage

The intermediate phase is similar to the beginner stage with the difference of using changing elements of progression to challenge the muscles capacity further. In this stage you may choose to progress the exercises by choosing to change ONE factor:

  • Increase repetitions
  • Increase hold time
  • Increase sets
  • Add appropriate resistance

Instructions:

  • 3 sets of 10-15 repetitions. Hold each repetition for 10-15 seconds.
  • Rest 10-15 seconds between sets, 30 seconds between exercises.
  • Do this exercise 1-2 times per day.

Bridges with resistance

 

 

 

 

 

 

 

Tie a resistance band around both thighs, just above your knees.
Lie on your back with your knees bent and legs hips width apart.
There should be tension in the band.
Raise your hips up into a bridge, keeping the knees hips width apart.
Control the movement back down to the start position, maintaining constant tension on the band.


Clams with resistance

Lie on your side and place a band above your knees, approximately an inch or two above the knee joint.
Bend your legs a little, keeping the feet in line with your back.
Use your core stability muscles to keep the body stable.
Keeping your feet together, lift the top knee up against the resistance of the band.
Ensure you stay on your side and do not roll your hips and your body back with the movement.
Lower the knee back down, controlling the resistance.


Phase 3 – advance stage

Body weight squats

Start position is standing straight with the arms out in front and bent at the elbows, the fists should be clenched and the palms facing inwards.
Move downwards into a squat position so that the knees are aligned over the toes and the heels are in contact with the floor, make sure the back is straight.
Keep the head and chest upright and the gaze horizontal.
Hold for 2 seconds and return to the start position.


Lunges

Stand straight with your arms to the side or on your hips.
Take a large step forwards on your affected leg, then drop your hips directly down between both feet, bending your hips and knees to a 90 degrees.
Push back up to the starting position, and repeat.
Make sure you take a large enough step that your front knee does not travel over your foot, and ensure your knee travels directly forwards.
Keep your body up straight throughout the movement.


Crab walks

Place a band around your ankles and gather some tension.
Side-step keeping constant tension on the band.
Make sure you do not bring your feet too close together and keep your toes and knees pointing forwards.


Phase 4 – return to activities

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Stretching

Do you always need to stretch the muscle? The answer is NO. While stretching is an important tool to improve muscle elasticity. You may not always need to stretch a muscle if it is NOT tight. Thus, stretching is recommended to be limited to areas you feel are TIGHT when you perform a given movement. Check the affected side and unaffected side – don’t need to stretch a muscle that doesn’t need to be stretched.

Seated piriformis stretch 

Start in a seated position.
Cross the symptomatic leg your ankle is resting on, to the opposite knee.
Apply gentle pressure to the knee as you lean forward, increasing the depth of the stretch.
Hold this position, you should feel a comfortable tension with no pain.


Pigeon stretch

 

Start on your hands and knees.
Cross the symptomatic leg underneath you, then lower your hips down to the ground.
Rest your body forwards on your arms.
You should feel a stretch across the buttock.

 

 

 

 

 

 

Managing your Medial Knee Pain: MCL injuries

What is it?

Although your knee has free movement going forwards and backwards, its’ sideward movements are restricted by the robust collateral ligaments on either sides of your knee. The medial collateral ligament (MCL) is situated on the inner part of your knee, but on the outside of your joint. The MCL connects the top of your shinbone (tibia) to the bottom of your femur (thighbone). It helps hold your bones together, provides stability and prevents your knee from bending sideways away from your body.

Injuries to the MCL are from the result of a direct blow to the outer part of your knee- and is most commonly seen in contact sports such as football and soccer. These injures may either over-stretch or cause a tear in the ligament. Whilst surgery may be needed in some severe cases, it is not always the go-to form of management.

Read on to know how physiotherapy can help manage your MCL related-knee pain.

 

 

Mechanism of Injury

Injury to the MCL typically occurs when a force drives the lower leg in a sideward direction away from your upper leg and body. Awkwardly landing from a height, twisting of your knee with your foot fixated to the ground, or from a direct blow to the outer part of your knee- most commonly seen in contact sports, are frequent causes of injury to the MCL.

 

 

Grading of MCL Injuries

MCL injuries are often graded using the system below:

Grade 1: Regarded as a minor injury- means that the MCL has been overstretched but not torn

Grade 2: Regarded as a moderate injury- means that there is a partial tear in MCL, and presents with some degree of instability in the knee

Grade 3: Regarded as a severe injury- means that the MCL has completely ruptured/torn, and presents with noticeable joint instability

 

Often 3 MCL injuries are associated with concurrent medial meniscus and ACL ligament damage, which may need surgical intervention. But, the good news is that most MCL injuries may be treated well with conservative physiotherapy management. It usually takes between 2-8 weeks for Grade 1 and 2 MCL injuries to heal, and a graduated rehabilitation programme is highly commended for prevention of future injury.

 

 

Signs and Symptoms

Because injury to the MCL may present with similar symptoms as with other knee injuries such as ACL damage, it is vital to have a medical professional such as your physiotherapist evaluate your injury.

Common symptoms of an MCL injury may include:

  • Tenderness and pain along in the inner part of your knee
  • Swelling in the knee
  • Experience catching and locking sensations in the knee joint
  • A ‘pop’ sound at the time of injury
  • Actual or feeling of giving way of the knee (often indicate grade 2 or 3 injury)

 

 

Diagnosis

Your physiotherapist will discuss your injury and its presenting symptoms, past medical history (including a history of any prior knee injuries) and will also undertake a thorough physical examination. During the physical examination, your physiotherapist will assess the structures of your injured knee and compare them to the non-injured side. The range of motion, strength and stability of your knee will be assessed. You may be referred on for imaging such as X-rays and Ultrasounds to help aid the diagnosis. For more severe MCL injuries, and if your symptoms do not resolve with conservative physiotherapy management, you may be referred onto a specialist who may consider referring you for an MRI to get a deeper look at your knee.

 

Management

The management options for MCL injuries will be dependent on the severity of the injury. In the initial stages of injury, management is focused on controlling swelling and pain, whilst allowing your body to initiate healing processes via inflammation. This is typically achieved through the P.O.L.I.C.E. principles (Protect, Optimal Loading, Ice, Compression and Elevation).

Over the counter medication such as ibuprofen and paracetamol may be taken to reduce pain. Other stronger painkillers and NSAIDs may be prescribed by your doctor to help reduce swelling and inflammation as well.

After assessing your knee, your physiotherapist will frame a rehabilitation programme with exercises tailored to your needs. The purpose of physiotherapy is to help restore your knee’s range of motion, stability and strength, which in turn will then allow you to safely return to your usual day-to-day and sporting activities as soon as possible.

Management of most MCL injuries usually only involves knee bracing and physiotherapy treatment. However, in some cases, surgery may be recommended. Particularly if there is damage to more than one ligament or structure in your knee or if you continue to experience instability in spite of physiotherapy.

EASY STRETCHES DESK STRETCHES

Sitting at a desk working, studying or surfing the net for long hours at a time makes it extremely difficult to maintain proper posture. That’s because our bodies are not designed for hours of idle sitting. So as the clock gets ticking many of us have the tendency lean forward, slouch our shoulders and hunch our backs.

Unfortunately, this increases pressure on multiple areas in your body. This explains why most of us experience pain and stiffness in our neck, shoulders, back and in some cases your tailbone!

So what do I need to do you ask?

The answer is simple, STAND, MOVE AND STRETCH!

It sure does sound easier said than done, especially if you are pressed with time to complete set work tasks. BUT the good news is that stretching or moving is a buildable habit that can be easily implement as you work. It doesn’t take long!

For starters set an alarm to take micro 2–3-minute break for every 20-30 minutes. Use this time to stand up, walk over to a colleague, go for a toilet break, drink water or make yourself tea or a coffee.

Or try out these simple easy stretches while you sit or stand at your desk

So let’s get started!

SPINAL TWIST:

  • Sit up tall, relax your shoulders
  • Cross one leg over the other, then place your opposite elbow on your top thigh.
  • Take a deep breath and as you exhale slowly twist your body (not your neck) and look over your shoulder.
  • Hold for 10 seconds.
  • Slowly return to resting position and repeat on the other side.

BACK ARCHES

  •  Sit tall, set your feet flat on the ground hip-width apart.
  • Rest your hands behind your hips, then slowly arch your back as you gently tilt your head back.
  • If you experience pain or discomfort in your neck or tingling in your arms – do this stretch without head tilt.
  • Hold for 10 seconds, return to start and repeat

ARM REACHES 

  • Sit up tall with your feet flat on the ground.
  • Interlace your fingers and stretch your arms straight as you turn your palms up to the ceiling.
  • Hold this position for 10 seconds and repeat

SHOULDER CIRCLES

  • Sit or stand up tall, feet hip width apart
  • Relax your arms and shoulder, begin by rolling your shoulder backward in a circular motion.
  • Do this 5 times, repeat forward circles

NECK CIRCLES

  • Sit or stand up tall, with feet planted flat on floor
  • Slowly begin to roll your head in a clockwise position
  • Do this 20 seconds, then repeat in a counterclockwise direction

CHEST STRETCH

 

  • Stand close to wall or a door frame
  • Place your forearm in a 90-degree angle at shoulder height.
  • Take one step forward on the leg closest to the wall and slowly rotate your chest away until you feel a stretch across your chest.
  • Do not hunch or round your shoulders.
  • Hold the stretch for 20 seconds, repeat
  • Do this both for both sides

BACK EXTENSIONS

  • Stand with your legs at hip width apart and straight.
  • Place your hands on your hips.
  • Lean your body backwards, trying to arch in the lower back as much as you can, lifting your chest up towards the ceiling.
  • Try to avoid allowing your hips to swing forwards too far.
  • Hold this position for 10 seconds, return to start position & repeat 5 times.

 FLOOR REACHES

  • Sit on a chair with upright posture
  • Slowly bend forward to plant your hands on the floor.
  • Hold for 10 seconds, return to start

SHOULDER BLADE SQUEEZE

  • Start in an upright position.
  • Practice bringing your shoulder blades back and down.
  • Picture gently drawing your shoulder blades towards the centre of your lower back.
  • This is a subtle movement, ensure you do not over strain your shoulder blades when performing this action.
  • Hold for 10 seconds, repeat 3-5 times

SHOULDER BLADE STRETCH

  • Clasp your hands together and hold them in front of your body.
  • Push your arms as far forward as you can whilst rounding your shoulder blades.
  • Gently drop your chin down to your chest.
  • Hold this position while you feel a stretch between your shoulder blades.

 WRIST STRETCHES

  • Stretch out your arm straight in front of you with your palm facing away
  • Use your opposite hand to gently pull your palm back
  • Hold for 5 seconds, repeat with your palm facing your body

How to stay Healthy and Sane during Lockdown

 

The restrictions and change brought by the outbreak of COVID-19 has resulted in a great deal of control being taken from our hands; this has been anxiety provoking for many of us. Nevertheless, it’s important to re-evaluate, acknowledge and place focus upon the matters that we DO have control over so that we can gain our personal power back!

 

Lockdown Productivity Tips

 

 

Check in with yourself: how is your body and mind feeling. Embrace your emotions and give yourself permission to feel the way toy do.

:large_blue_diamond: Stay connected: Social connection is inevitably limited at the moment but catching up with people via text or facetime will help prevent feelings of isolation.

:large_blue_diamond: Maintain some form of routine: Maintaining a routine helps provide some structure do days which often all seem to merge into one.

:large_blue_diamond: Get fresh air where possible: Daily fresh air can provide an easy change of scenery when we are stuck at home most of the day.

:large_blue_diamond: Gentle exercise is a MUST!

:large_blue_diamond: Stay Hydrated: Drinking enough water is important to keep your body hydrated and makes sure your body functions properly.

:large_blue_diamond: Eat well- You’d be surprised how your diet can affect how you feel. Gut health in particular is linked to mental health.

:large_blue_diamond: Get to that “thing” you’ve been delaying for months

:large_blue_diamond: Pick up a good book

:large_blue_diamond: Learn new habits or rediscover old ones

:sparkles: These may seem like simple strategies but sometimes it’s the simple things that are most effective :sparkles:

“One day this will all be over and we will be grateful for life in ways we never felt possible”

The gratitude we will have for the things we once took for granted will be unmeasurable- getting on a plane, an impromptu visit to the cinema, a shopping spree, going to the gym, even meeting a friend for lunch at a café. Keep going, nothing lasts forever and we have so much to look forward to. In the mean time take each day as it comes, be kind, support those who are struggling and keep going! You are stronger and more resilient than you know!

Lifting Mechanics

IS IT DANGEROUS TO LIFT WITH A BENT BACK?

One common belief about lifting is that rounding your back when lifting an object is considered dangerous while lifting with a straight back is considered safe…

 

 

However, there is a lot of misinformation circulating around lifting mechanics and what is deemed “good technique” versus “bad technique.”

Here are some key myths and misinformation that you may have heard:

 

A ROUNDED BACK WHILE LIFTING OVER STRESSES THE BACK MUSCLES AND LIGAMENTS

  • Research has shown that regardless of lifting position, whether you’re stooped, squatting or weightlifting, your back has to produce the same amount of force. Statistically speaking, it’s not significantly different.

 

 

FLEXING THE SPINE WHILE LIFTING INCREASES THE LOAD ON THE LUMBAR DISCS

  • Under heavy loads, discs are unlikely to fail unless >95% flexion is achieved (which is near impossible)

  • With low loads, the disc is unlikely to fail unless you do thousands of repetitions continuously

  • Your body is an amazing adapter, this includes discs! Your discs can adapt and become more and more able to handle loads when stressed appropriately

 

THESE COMPOUND TO CAUSE INJURIES AND PAIN TO THE BACK MUSCLES AND DISCS

  • Resistance training has demonstrated through countless studies the ability to increase bone mineral density (BMD) of the lumbar spine. BMD is actually positively associated with the strength of the spinal discs and ligaments at that level. With appropriate loading and training, disc, ligament, bone and muscles are going to adapt favourably

 

A NEUTRAL SPINE IS SAFER, STRONGER, MORE EFFICIENT AND BETTER TO LIFT WITH

  • There is no significant difference between activities that encourage more spinal flexion and one’s that do not in the long term

  • Lifting with lumbar flexion is not a risk factor for low back pain

  • Research has shown lifting with a bent back is more metabolically and neuromuscularly efficient

  • When the spine is in extension during bent over activities, the hip is actually flexed to a greater degree – decreasing the ability for the glutes and hamstrings to create as much internal torque. Flexing the spine reduces this effect and reduces the moment arm for the hip extensors

 

STOP BACK PAIN & INJURIES BY LIFTING WITH A NEUTRAL SPINE

  • Your lumbar spine flexes every time your hip flexes! It is impossible to isolate one versus the other. It is also impossible to not flex while doing common movements

  • Extreme flexion however (>/=100%), may pose an increased risk under heavy loads, but not at light loads

 

You may still be wondering why you have back pain (stay tuned for our next blog!). Your pain may not be directly related to your lifting strategy.

 

 

Could you have pain with forward bending? Absolutely.

Is bending at the lumbar spine an increased risk for pain or injury? In the vast majority of situations, no.

If I have pain with forward bending, is it bad to temporarily limit doing so? Not at all.

Should I fear bending at the spine with or without pain or injury? No. Being fearful of flexing/moving your spine is actually a stronger predictor of disability and back pain.

 

Work on moving through your spine, after all it’s what it is designed to do! Choose comfortable movements and gain confidence over time, then build up your strength gradually with resistance training – try and not to push too fast, we want nice, healthy adaptation! Give your body time to adapt, back pain is not quick fix sometimes but you are resilient and with healthy, normal movements and some patience, you will be okay.

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