Orthopedic Rehabilitation
Conditions We Treat
Browse the conditions we specialize in
Achilles Tendinitis
What is Achilles Tendinitis? Achilles tendinitis is an inflammation of the Achilles tendon — the largest tendon in the body, connecting the calf muscles to the heel bone — caused by overuse or repetitive loading. Runners, athletes in jumping sports, and individuals who suddenly increase their activity level are particularly prone to this condition. Pain in the heel or along the tendon, morning stiffness, and symptoms that worsen with activity are typical signs. If not treated correctly in the early stages, it can lead to complications such as chronic degeneration (tendinosis) or tendon rupture. What Causes It? Sudden increase in training load Running on hard or uneven surfaces Inappropriate footwear Tight and shortened calf muscles Excessive pronation (inward rolling of the foot) Decreased tendon flexibility with age Achilles Tendinitis Treatment at ROMMER At ROMMER, Achilles tendinitis treatment is carried out with an evidence-based approach aimed at relieving pain and strengthening the tendon to prevent recurrence: Eccentric Exercise Programme: Eccentric calf exercises — the gold standard in Achilles tendinitis treatment — reorganise tendon collagen and reduce pain. Load Management: The load on the tendon is controlled through activity modification; controlled loading is preferred over complete rest. Manual Therapy: Soft tissue mobilisation and fascial release improve the structures surrounding the tendon. ESWT (Shockwave Therapy): In chronic cases, high-energy sound waves stimulate healing in tendon tissue. Orthosis and Heel Raise: Appropriate insoles and heel raises are selected to reduce the tension on the tendon. Return-to-Sport Plan: A safe return to activity is achieved through a graded loading protocol. Treatment Process In acute Achilles tendinitis, the vast majority of patients achieve full recovery with a 6–12 week regular programme. Chronic cases may take longer; however, successful outcomes are achieved without surgery through correct exercise and load management.
Joint Calcification (Osteoarthritis)
What is Osteoarthritis? Osteoarthritis (OA) is a degenerative joint disease that develops as a result of gradual cartilage wear, causing pain, stiffness and restricted movement. The knee, hip, hand and spinal joints are the most commonly affected areas. Ageing, excess weight, a history of joint injury and genetic predisposition are the main risk factors. Although osteoarthritis is a progressive disease, symptoms can be significantly controlled with appropriate treatment and exercise programmes, and joint longevity can be extended. Symptoms of Osteoarthritis Joint pain that increases with activity and eases with rest Morning stiffness (usually less than 30 minutes) Creaking or grating sensation in the joint (crepitus) Swelling and warmth around the joint Reduced range of motion Joint deformity in advanced stages Osteoarthritis Rehabilitation at ROMMER Rehabilitation is the primary approach in osteoarthritis treatment, to be applied before or alongside pharmacological treatment. At ROMMER, an individual programme is created for each patient based on their joint condition, pain level and functional capacity: Strengthening Exercises: Muscles around the joint are strengthened, reducing the load on the joint and increasing stability. Quadriceps strengthening is critically important in knee osteoarthritis. Aerobic Exercise: Low-impact activities such as swimming, cycling and walking reduce pain, improve general fitness and support weight management. Manual Therapy: Joint mobilisation and soft tissue techniques improve range of motion and reduce pain. Physical Therapy Modalities: TENS, ultrasound, laser and heat-cold applications are used for pain control. Load Reduction Strategies: Body weight management, appropriate footwear selection and, when necessary, use of knee braces or walking aids. Joint Protection Education: Ergonomic techniques that reduce joint load during daily activities are taught. Pre- and Post-Surgical Rehabilitation For patients planning joint replacement surgery due to advanced osteoarthritis, a "prehabilitation" programme is implemented at ROMMER; pre-operative strengthening accelerates post-operative recovery. A comprehensive rehabilitation programme is also provided after prosthesis placement, aiming for functional independence in the shortest possible time.
Tennis Elbow (Lateral Epicondylitis)
What is Tennis Elbow? Tennis elbow (lateral epicondylitis) is an overuse injury that develops when the forearm extensor muscles, which attach to the bony prominence on the outside of the elbow (lateral epicondyle), are damaged through excessive use. As the name suggests, it is common among tennis players, but computer users, musicians, painters and people in occupations requiring manual dexterity are also frequently affected. Typical symptoms include pain on the outer side of the elbow and forearm, difficulty gripping and weakness. Causes of Tennis Elbow Repetitive wrist extension and gripping movements Use of a racket or tool with incorrect technique Sudden increase in activity Weakness and reduced flexibility in forearm muscles Inappropriate equipment (heavy or stiff racket, wrong grip size) Tennis Elbow Treatment at ROMMER The vast majority of tennis elbow cases heal without surgery with correct conservative treatment. The programme at ROMMER includes: Load Management and Activity Modification: Activities that trigger pain are identified and the load is gradually reduced; controlled loading is preferred over complete rest. Eccentric and Isometric Exercises: An exercise programme that strengthens and stimulates healing of the extensor muscle-tendon junction is applied. Manual Therapy: Elbow and wrist mobilisation, soft tissue techniques and myofascial release relieve pain and movement restrictions. ESWT (Shockwave Therapy): In chronic cases, high-energy sound waves stimulate remodelling in tendon tissue. Taping and Epicondylitis Brace: Kinesio taping or a special elbow brace is used to reduce the load on the lateral epicondyle. Technique and Equipment Assessment: For athlete patients, movement technique and equipment suitability are evaluated and corrections are made. What to Do in Chronic Tennis Elbow? In chronic cases that do not respond to 6 months of conservative treatment, PRP (Platelet Rich Plasma) injection or surgical options are considered. At ROMMER, the most appropriate treatment plan is determined in coordination with orthopaedics.
Heel Spur
What is a Heel Spur? A heel spur is a bony outgrowth that develops on the heel bone (calcaneus), usually forming at the point where the plantar fascia meets the bone. It is often seen together with or confused with plantar fasciitis; however, incidentally detected spurs without symptoms on imaging are also quite common. Sharp, stabbing pain in the heel upon the first steps in the morning, and discomfort felt when starting to walk again after long periods of sitting, are typical signs. Causes of Heel Spurs Prolonged excessive stretching of the plantar fascia Short and tight Achilles tendon and calf muscles Excess weight and obesity Standing on hard surfaces for long periods Footwear with insufficient support and sole thickness High foot arch (pes cavus) or flat foot (pes planus) Heel Spur Treatment at ROMMER The aim of heel spur treatment is to reduce tension in the plantar fascia, heal the tissue and eliminate pain. The evidence-based conservative approach at ROMMER includes: Plantar Fascia and Calf Stretching Exercises: Stretching the plantar fascia and gastrocnemius/soleus muscles is one of the most effective methods of reducing pain. Stretching exercises performed before getting out of bed in the morning significantly alleviate first-step pain. Manual Therapy: Manual mobilisation of the plantar fascia and ankle eliminates tissue restrictions. ESWT (Shockwave Therapy): A non-invasive treatment with a high success rate in chronic plantar fasciitis and heel spurs. Orthopaedic Insoles: Specialised insoles with heel cushioning and arch support reduce the load on the plantar fascia. Night Splint: A night splint that keeps the plantar fascia stretched during sleep dramatically reduces morning pain. Appropriate Footwear Selection: Guidance is provided on choosing footwear with adequate heel support, cushioning soles and appropriate width. Treatment Response More than 90% of patients recover with 6–12 months of conservative treatment. In resistant cases, PRP injection or surgery is rarely considered. At ROMMER, early intervention enables most patients to return quickly to daily life and sport.
Anterior Cruciate Ligament Tear
What is an ACL Tear? The anterior cruciate ligament (ACL) is one of the four main ligaments that ensure the stability of the knee joint, and specifically prevents the tibia from sliding forward. ACL tears occur as a result of sudden changes in direction, incorrect landing after a jump, or a direct blow to the knee. They are common in sports requiring high speed and sudden manoeuvres such as football, basketball, skiing and volleyball. A "pop" sound at the moment of injury, rapid swelling and knee instability are typical signs. Conservative or Surgical Treatment? The choice of treatment for an ACL tear is determined by the person's age, activity level, the presence of other ligament and meniscal injuries, and functional goals. Arthroscopic ACL reconstruction is often preferred in competitive athletes and those performing pivoting activities, while comprehensive conservative rehabilitation may be sufficient for low-activity individuals. ACL Rehabilitation at ROMMER At ROMMER, ACL rehabilitation is conducted with evidence-based, specific phase protocols for both conservative and post-surgical cases: Acute Phase (Weeks 0–2): Control of swelling and pain, quadriceps activation, achieving full knee extension and initiating weight-bearing. Subacute Phase (Weeks 2–6): Completing range of motion, proprioception and neuromuscular control exercises, progressive increase in muscle strengthening. Strengthening Phase (Weeks 6–16): Quadriceps and hamstring strengthening, single-leg balance work, foundation for sport-specific movements. Return-to-Sport Phase (Months 4–9): Retraining of running, cutting and jump-landing mechanics; return-to-sport criteria are evaluated with biomechanical testing. Neuromuscular Training: Risk of re-injury is reduced through proprioception, balance and coordination work for knee stability. When is Return to Sport Possible? For safe return to sport after ACL reconstruction, functional tests must be passed (quadriceps strength symmetry index ≥90%, single-leg hop tests). At ROMMER, the return-to-sport decision is made according to these objective criteria — functional-based progression is the principle, not calendar-based.
Bone Loss (Osteoporosis)
What is Osteoporosis? Osteoporosis is a metabolic bone disease in which bone density and quality decrease, making bones brittle, and which progresses silently. It usually develops asymptomatically, and the first sign is often a fracture following low-energy trauma such as a fall. The hip, spine (vertebral fractures) and wrist are the most common fracture sites. Post-menopausal women, older adults, individuals with low bone density and those using corticosteroids constitute the high-risk group. Risk Factors for Osteoporosis Menopause and oestrogen deficiency Advanced age Insufficient calcium and vitamin D intake Physical inactivity and sedentary lifestyle Smoking and excessive alcohol use Long-term corticosteroid therapy Family history and slender bone structure Osteoporosis Rehabilitation at ROMMER Osteoporosis rehabilitation aims to increase bone density, reduce the risk of falls and protect against fractures. The comprehensive programme at ROMMER includes: Weight-Bearing Exercises: Activities performed against gravity such as walking, light jogging and dancing stimulate bone formation. These exercises are among the most effective natural treatments for osteoporosis. Resistance Exercises: Muscle strengthening both increases bone density and reduces the risk of falls. Balance and Proprioception Training: A special programme targeting balance loss — the most important determinant of fall risk in older individuals — is applied. Posture Training: Posture correction exercises are applied for kyphosis (hunchback) developing after vertebral fractures. Fall Prevention Programme: Home safety assessment, footwear selection and environmental modification recommendations are provided. Vertebral Fracture Rehabilitation: Functional independence after vertebral fracture is targeted through back strengthening exercises and pain management. Integration with Medical Treatment At ROMMER, osteoporosis rehabilitation is planned in coordination with endocrinology or rheumatology, alongside medical treatment (bisphosphonates, denosumab, etc.) and calcium-vitamin D supplementation. Exercise is the most powerful complementary treatment supporting the effect of medications in increasing bone density.
Meniscus Tear
What is a Meniscus Tear? The menisci are C-shaped cartilage structures located between the femur (thigh bone) and tibia (shin bone) in the knee joint, functioning as shock absorbers and load distributors. Each knee has two menisci: medial (inner) and lateral (outer). A meniscus tear occurs either suddenly (acute tear) from twisting, bending or a blow to the knee, or gradually from repetitive stress and tissue degeneration with age (degenerative tear). Knee pain, swelling, a locking sensation and restricted movement are typical signs. Types of Meniscus Tears Longitudinal Tear: Parallel to the long axis of the meniscus; a "bucket handle" tear falls into this group and can cause the knee to lock. Radial Tear: Running across the meniscus, significantly reducing its shock-absorbing capacity. Horizontal Tear: Divides the meniscus into upper and lower parts; commonly seen in degenerative cases. Complex Tear: A tear present in more than one plane. Meniscus Tear Rehabilitation at ROMMER Treatment decisions for a meniscus tear are determined by the type, size, location of the tear and the patient's age and activity level. At ROMMER, comprehensive rehabilitation is offered for both conservative and post-arthroscopic repair/partial meniscectomy cases: Pain and Swelling Management: Acute symptoms are controlled with cold application, TENS and manual techniques. Regaining Range of Motion: Knee flexion-extension is progressively developed within safe limits. Quadriceps and Hamstring Strengthening: A muscle strengthening programme is created to provide knee stability and balance the load on the meniscus. Neuromuscular Training: Proprioception and balance work minimise knee instability and the risk of re-injury. Functional and Sport-Specific Exercises: A graded loading protocol is applied for return to daily activities and sport. Lifestyle and Activity Guidance: Strategies for avoiding activities that place excessive load on the meniscus and joint protection are taught. Conservative or Surgical Treatment? Tears located in the outer 1/3, which is rich in blood vessels, can heal spontaneously and respond well to conservative treatment. Avascular tears in the inner 1/3 have low healing capacity, making surgery frequently necessary. At ROMMER, the most appropriate approach is determined on a patient-by-patient basis in coordination with orthopaedics.
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