Physiotherapy
Many conditions affecting the lower leg or foot can be successfully treated with physiotherapy. It is common to commence a programme of treatment for such problems and only come on to surgical therapies if the problem persists despite physiotherapy. If surgery is needed, physiotherapy is often very important to gain the full benefit of the surgical procedure. People are generally familiar with the idea that physiotherapy can stretch tight tissues and strengthen weak muscles. However less known is the great importance of training the muscles to function correctly and to regain the subconcious sense of how the limb and joints are positioned from one movement to the other, so that the reflexes, for example, react to stop an ankle going over on an uneven surface. This process is called proprioception and becomes out of condition very quickly after an injury or operation thereby leaving the person prone to further injury even if the muscle strength is actually quite good.
Physiotherapists also treat inflammation with many different therapies including heat, cold, ultrasound and massage. Painful swollen tendons (eg Achilles tendon) improve with deep firm massage (deep friction treatment) which is quite painful but appears to stimulate healing of the tendon fibres. The same tendons also benefit from a specific type of stretching exercise (eccentric stretches) which the physiotherapists spend time teaching their patients.