Issue link: https://www.massageandbodyworkdigital.com/i/72103
FOR ACCESS TO FREE VIDEOS AND ARTICLES AND THE LATEST NEWS ON UPCOMING TRAININGS, JOIN BEN ON FACEBOOK AT FACEBOOK.COM/DRBENBENJAMIN. Friction of the posterior surface. severe strain, the person will be able to push your hand away, but will also feel some pain. If the tendon is ruptured, absolutely nothing will happen because you cannot plantarflex the foot without your Achilles tendon. When a rupture occurs, the person usually goes to a hospital immediately, so it is very rare for a massage therapist to see someone with a ruptured tendon. If you happen to see someone who cannot plantarflex the foot, run your finger gently down the tendon. Your finger will drop into a small space where the tendon used to be. This person needs to go to the hospital immediately for a surgical repair. Friction of the medial and lateral surfaces. TREATMENT CHOICES SELF-TREATMENT It can help to wear a shoe with a moderate (1–11 ⁄2 Friction of the posterior surface. Have the client lie prone, with the injured foot hanging off the edge of the table. Stand at the foot of the table and place your hand or thigh against the sole of the foot, creating a right angle at the ankle. Maintain this position throughout the treatment. Use your thumb pad or thumb tip to friction the affected area of the back portion of the tendon. inch) heel, which Friction of the anterior surface. have the client repeat the test while standing on the injured leg only. If the tendon is injured, the location of the pain tells you the location of the injury, because this tendon doesn't refer pain to any other areas. If the client feels pain only after strenuous activity, have the person perform a strenuous activity and then do the test again. If the Achilles tendon is injured, the pain will increase with the test. TEST 2 If the person cannot walk, it may be because the tendon is severely inflamed or ruptured. In these cases, have the client lie supine while you place the palm of your hand under the metatarsal area of the foot. Now place the client's foot in dorsiflexion and ask the person to push your hand away, bringing the foot into plantarflexion. In cases of takes the pressure off the tendon when walking. It's also important to avoid any activity that causes pain. Unless the strain is very mild, an Achilles injury is difficult to self-treat. If the pain comes and goes and is not resolved in a few weeks, the person should seek professional treatment. MYOFASCIAL THERAPY Sometimes the fascia that covers the Achilles tendon contains scar-tissue adhesions. If this is the case, performing myofascial therapy on the tendon is the first therapeutic step, provided that you have the appropriate training. FRICTION THERAPY This treatment modality is often effective in breaking up pain-causing adhesive scar tissue. With two to three friction therapy treatments a week, healing generally takes about 4–6 weeks for recent injuries, and 8–12 weeks for chronic injuries. Unfortunately, this treatment can be fairly uncomfortable for the client. To see a video clip of friction therapy on the Achilles tendon, visit the digital edition of Massage & Bodywork magazine (www.abmp.com). Friction of the medial and lateral surfaces. Start from the same position you used for the posterior surface. Grasp the affected part of the tendon between your middle finger and thumb. Now, friction by drawing your hand backward, moving your fingers from the anterior toward the posterior aspect of the tendon. To friction only one surface at a time, squeeze the tendon with your thumb to perform the friction, while curling your index finger on the opposite side for support. Friction of the anterior surface. Have the client lie prone with the foot resting on the table, fully plantarflexed. This puts the tendon in a relaxed position so you can reach the anterior portion. Sitting at the foot of the table, forcefully push the tendon sideways with the thumb or fingers of one hand, and place the index finger of your other hand on the tendon's anterior surface. Support this finger with the middle finger of the same hand. Perform friction by alternately supinating (with pressure) and pronating (without pressure) your forearm and hand. This action rotates the index finger, causing a friction movement. Throughout the movement, hold your finger, hand, and forearm in a straight line with the elbow bent. Take care not to use too much pressure; this treatment is a bit uncomfortable for the client. After you've performed the technique on one side of the anterior surface, repeat on the other side (you can only reach about half of the surface from each side). earn CE hours at your convenience: abmp's online education center, www.abmp.com 99