# @thelewinclinic on Instagram

- **Type:** Image
- **Original URL:** https://www.instagram.com/p/CaHzDblIaAV
- **Gondola URL:** https://gondola.cc/posts/16038516-thelewinclinic-instagram
- **Thumbnail:** https://img.gondola.cc/tr:w-,h-,fo-auto/postThumbnails/dccf22d874.jpg
- **Posted:** 2022-02-18T14:22:31.000+00:00
- **Account Owner:** The Lewin Sports Injury Clinic (@thelewinclinic) — https://gondola.cc/thelewinclinic

## Caption

It's been a busy week for Achilles injuries in-clinic, with six different presentations. 

There are plenty more, but it's interesting to look at the background and rehab pathways - and how they can differ.

Patient #1 - Cause: a sudden increase in their load, playing three games of football a week and more running on hilly roads Plan: Isometrics /pain modulation/stop stretching!

Patient #2 - Cause: Carrying a chronic tendinopathy for months after being clipped by a car in a pit lane. Ignored but it's flared it up recently with an increase in walking Plan: settle it/slow heavy strength once we have established calf capacity and pain scores/stop stretching!

Patient #3 - Cause: Many months of Achilles pain, assumed it would clear it. Plan: address underlying strength issues/get on the long road of a slow/heavy loading programme/stop stretching!

Patient #4 - Cause: Football injury and very efficient ultrasound scanning established only a 1cm retraction and so the decision was made to immobilise in a boot Plan: week 16 and has managed a single leg calf raise to a good height/should progress well over next two months of strength/power/plyo work

Patient #5 - Cause: Another football injury. Retraction of 4cm and so the decision was made to repair it surgically Plan: Week 10 now and just out of boot. In the 'vulnerable' stage where patients get a little complacent being free of the boot. Gradually increasing the tendon load with a target of single leg calf raise to full height in next 6-8 weeks

Patient #6 - Cause: Re-repaired using FHL as the graft. Plan: Week 11 now and going very well. Little bit more focus here on chasing ankle dorsiflexion/strength as the knee-to-wall limitation is a bit more stubborn after the surgery

#lsic #essexsportsrehab #physioclinic #sportsrehab #sportsphysioterapy #gymrehab #orthopaedics #footandankle

## Stats

- **Views:** 0
- **Likes:** 37
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## Tags

lsic, physioclinic, footandankle, 5, gymrehab, 1, orthopaedics, essexsportsrehab, 4, sportsphysioterapy, 6, 3, sportsrehab, 2

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