Achilles Tendon Rupture (Physiotherapy Practice)

Achilles Tendon Rupture
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ACHILLES TENDON RUPTURE
Jane Achilles tendon injury and rehabilitation case is described in Phyllis Carolyn Leppert (2003, 670-680). Jane is a female patient aged 40s. She engages in recreational sport such as squash, badminton and athletics. One afternoon as she was playing badminton she felt as sharp pain at the back of the legs. She stated to the doctor that she had landed heavily on her left foot as she was trying to defend a score. Later on she played for 3-4 minutes before the pain and swelling become uncomfortable. By the time she arrived at the accident and emergency department her heel was slightly swollen. On further interview she claimed that she had stopped her exercises for month and the day she injured herself was when she had resumed.
The doctor used the Thomson test as decribed by Nunley (2008, 142) to examine te patinet. The patient was told to lie down on the examination table facing downwards. The doctor squeezed the calf muscles and this action caused the foot to point like a ballerina. Though the foot ability was decreased it did show partial pointing and thus the diagnosis was made for partial Achilles tendon rupture.
What follows from diagnosis is deciding on the best option to ensure the tendon does not lengthen. The doctor analyzed the three options for treating a ruptured tendon as described in Nunley (2008, 150). He discussed the traditional conservative treatment with the patient. This type of treatment the leg is put into the plaster-of Paris. They also discussed the surgery option and finally the active rehabilitation. The doctor and the patient agreed to settle on active rehabilitation since it allows a patient return to the normal activity earlier than the other option. This kind of rehabilitation uses a removable cast to protect the tendon length.
Treatment was started immediately after the injury happened. The removable cast was put in the leg and taped so as to hold the foot in the correct position (Phyllis Carolyn Leppert, 2003, 675). The patient was advised to use crutches at first but was advised to shift the weight in the injured leg. After patient was comfortable to walk without the crutches she got rid if them after 2 weeks. Physical treatment and self help measures were initiated right away. Massage was the most recommended and it was conducted after every two days to help circulatory flow and also to maintain activity in the muscles which were not involved in the rupture. During the massage the taping is removed but the therapist has to ensure he supports the foot in the downward pointing position so as to prevent the broken ends of the tendon from separating whenever the patent changes position on the couch.
The method although not very popular is supported by (Elattrache, 2007, 382) who lists several advantages. During the massage there is minimal loss of neuromuscular function in the injured muscles of the leg. By usin...