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Musculo-Tendinous Injuries
The spectrum of tendon injuries ranges from acute tendonitis (inflammation of the tendon and surrounding paratenon), through to degenerative changes within the substance of the tendon (tendonosis) and potential tendon disruption (partial or complete). The pathophysiology is usually related to an intrinsic mechanism of injury - gradual, sustained overload, or sudden, severe overload. The most commonly involved tendons in sports injuries are: Achilles, peroneal, hamstring, iliotibial band, rotator cuff, common extensor origin and wrist extensors. The principles of rehabilitation are similar whether the Hydrotherapy is addressing a post-surgical repair or chronic tendonosis. The application of the principles varies according to the initial level of loading (reduced load tolerance of a surgical repair relative to a tendonicis) and the duration of each phase of rehabilitation.
Once the inflammatory responses have settled during an acute trauma, Hydrotherapy is an ideal means of rehabilitation. Athletic fitness can be maintained by swimming and deep water running supported by a buoyancy aid.
Some Hydrotherapy authorities consider exercising the smaller joints of the body - the ankle and wrist joints to be difficult in water. However, the use of Bad Ragaz patterns and hydrodynamic exercise negates this argument, and there the ankle tendons are involved, activity taking place in a buoyancy neutral situation will help disperse swelling (Pascal's law).
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