Commentary

P Kannus

Professor of Injury Prevention, Department of Surgery, Tampere University Medical School and University Hospital, Tampere, Finland

see also page 329

Increasing plantarflexion of the ankle decreases the stress on the Achilles tendon during ambulation in an ankle immobiliser, but how much stress is optimal in the various phases after an Achilles injury?

The atrophying effects of immobilisation and the strengthening effects of training and exercise on all musculoskeletal tissues (bone, cartilage, ligament, muscle, and tendon) are well known, and therefore much effort has been expended during recent decades on studies to clarify whether the old concept of post-traumatic immobilisation could be safely replaced by rehabilitation programmes using early controlled mobilisation. The controlled experimental and clinical trials have yielded convincing evidence that early controlled mobilisation is superior to immobilisation for musculoskeletal soft tissue injuries.1 2 This holds true not only in primary treatment of acute injuries, but also in their postoperative management. The superiority of early controlled mobilisation is especially apparent in producing quicker recovery and . . . [Full text of this article]

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Relevant Article

The relative stress on the Achilles tendon during ambulation in an ankle immobiliser: implications for rehabilitation after Achilles tendon repair

K H Akizuki, E J Gartman, B Nisonson, S Ben-Avi, M P McHugh
Br. J. Sports Med. 2001 35: 329-333. [Abstract] [Full Text] [PDF]