Rom should be measure in both open and closedchain methods. Rehabilitation guidelines for achilles tendon repair uw health. On exam, there is a palpable divot or gap in the area of the rupture along. Achilles tendon rupture accelerated functional rehabilitation protocol 0 2 weeks aircast boot with 2 cm heel lift nwb with crutches 2 6 weeks aircast boot with 2 cm heel lift protected weightbearing with crutches as required active plantar and dorsi flexion to. As with any muscle or tendon in the body, the achilles tendon can be torn if there is a high. This can lead to possible tendon rupture with forceful pushing off during activities such as basketball, tennis or racquetball. Consider taking a more conservative approach to range of motion, weight bearing, and. See a doctor urgently if you think that you may have.
Rehabilitation guidelines for achilles tendon repair the achilles tendon is the strongest and thickest tendon in the body. Most patients who sustain an achilles tendon rupture report a pop and a feeling of being kicked or shot in the back of the leg. It involves degeneration of the tendon and is common in men. If reducing your repetitions does not help, try resting for 25 days. Achilles rupture nonop orthopaedic medical group of. Nonoperative treatment of achilles tendon ruptures phase. Achilles tendon rupture affects about 1 in 15,000 people at any one time, increasing to 1 in 8,000 in competitive athletes. Your pt can show you which exercises to doand when to do themto fully recover.
This protocol for achilles tendon repair is designed to provide the. Your achilles tendon is the biggest and strongest tendon in the body. Rehabilitation protocol achilles tendon repair alterg. Nonoperative treatment of achilles tendon repairs 2020 riverside drive 4 p a g e green bay, wi 54301 9202885555 phase 4 terminal stretching and progressive strengthening 812 weeks goals immobilizationweight bearingfor phase 4 protect integrity of achilles due to highest risk of rerupture wean out of boot over 25 days. Most achilles tendon ruptures are treated surgically, especially with young athletes or active people. Achilles tendon rupture most commonly occurs in middle age ages 3050, and may be associated with repeated strain and inflammation. The calf muscle is a major muscle we use for running, jumping and climbing. The calf muscle is squeezed and, if there is a rupture of the achilles tendon, the foot will not plantarflex push downwards. The chronic form of achilles tendinopathy is not an. We recommend seeking advice from your own surgeon before attempting any rehabilitation exercises. This video is about rehabilitation of an achilles tendon rupture after surgery and progession to return to play status.
A complete rupture of the achilles tendon may make a pop sound, followed by pain and swelling of the lower leg. There is a risk of rupturing your achilles tendon if you have achilles tendinitis. Achilles tendon repair rehabilitation postoperative guideline. All patients had sustained achilles tendon rupture during sports activities. The overall incidence of achilles tendon rupture is on the rise recently 1,2 because of the aging of the population, growing prevalence of obesity, and. Severe pain around the achilles tendon that develops suddenly may be a sign of tendon rupture. Avoid creating pain discomfort is okay but pain should not occur and persist 3 days in a row. As tolerated in cam walker boot with heel wedges in place first wedge removed at 4 weeks, second wedge removed at. The achilles tendon is made up of two separate muscles. A sudden sharp pain in the achilles tendon at the back of your ankle.
The following is an example of a rehabilitation and exercise program for a complete achilles tendon rupture. This is purely an educational video designed by students for a. Any closedkinetic chain therapeutic exercises can be performed in the alterg antigravity treadmill to decr. Treatment options for an achilles tendon rupture include surgical repair and conservative nonsurgical rehabilitation.
Exercise program for achilles tendon rupture verywell health. Best achilles tendon exercises, rehab exercises to avoid. Therapeutic exercises o standing heel raises o single leg eccentric lowering o stepups, side steps o proprioception exercises balance board phase iv months 36 o progress with strengthening, proprioception and gait training activities o begin light jogging at 1214 weeks o runningcutting at 16 weeks. The pain is often described as being struck physically on the back of your ankle by an object or implement. You may hear a loud snapping noise or bang at the time of injury. The yearly incidence of achilles tendon rupture is up to 37 per 100,000 individuals. Achilles tendon rupture conservative treatment protocol. Defining components of early functional rehabilitation for. By doing the right exercises for your condition, you can quickly and safely get back to your normal lifestyle.
Considerations for the postoperative achilles tendon repair program many different factors influence the postoperative achilles tendon rehabilitation outcomes, including type and location of the achilles tear and repair. The achilles tendon is the strongest and largest tendon in the body, but it is also the most commonly ruptured tendon. In all cases, aatr was identified by evaluating patients. It can occur at any age but is most common between the ages of 30 and 50. Achilles tendon rupture atr is a common sports injury, with a rising incidence and significant impairments. Achilles tendon rupture has been reported with the use of corticosteroids, taken either by mouth or after injection near the tendon area. The surgical approach to repair the torn tendon requires postoperative. Department of physiotherapy department of sport and.
Treating an achilles tendon rupture requires surgery or. Achilles tendon repair postop rehabilitation protocol. When the walker brace is removed, no weightbearing or dorsal extension of the foot is allowed. This will result in weakness and loss of athletic ability. Forceful jumping or pivoting, or sudden accelerations of running, can overstretch the tendon and cause a. Achilles repair rehabilitation protocol key considerations.
An achilles tendon rupture is a complete or partial tear that occurs when the tendon is stretched beyond its capacity. Rehabilitation guidelines for achilles tendon repair. Rehabilitation protocol for achilles tendon repair this protocol is intended to guide clinicians and patients through the postoperative course for an achilles tendon repair. Exercises for achilles tendinosis rehabilitation your injury achilles tendonosis is a condition that affects the lower end of your achilles tendon which connects your calf muscle to your heel. Torn achilles rehabilitation following surgery and non. The combination of achilles tendon pain, swelling, and impaired performance indicates the clinical diagnosis of achilles tendinopathy.
An achilles tendon tear or rupture can be a difficult injury to come back from. Promoting health through exercise treating inflammation. The achilles tendon is the thick tendon above the heel that attaches the calf muscles to the heel bone. The achilles tendon is a strong tendon attaching the two major calf muscles gastrocnemius and soleus to the heel bone calcaneus. Ensure patient understands that tendon is still very vulnerable and patients need to be diligent with activities of adl and exercise any sudden loading of the achilles e. Specific intervention should be based on the needs of the individual and should consider exam findings and clinical decision making. Therapeutic exercises o standing heel raises o single leg eccentric lowering o stepups, side steps o proprioception exercises balance board phase iv months 36 o progress with strengthening, proprioception and gait training activities o begin light jogging at 1214 weeks o.
This protocol is designed to assist you with your rehabilitation after surgery and should be followed. Achilles tendon rupture diagnosis, causes, treatment. Modifications to this guideline may be necessary dependent on physician. Exercises will help the healing process by improving the strength of the tendon and help align scar tissue. Exercises painfree active ankle range of motion rom, including ankle. It can take up to a year to make a full recovery, and it is not unusual to have intermittent pains and aches during that time. The tendon transmits force from the contracting calf muscles to the calcaneus to cause the foot action of plantar. If it does, rest the patient until pain level is clearly decreasing. It is hypothesized that this lack of consensus and guidelines leads to suboptimal recovery and higher societal costs. Working with a pt is a good idea to help you get back to normal. Eversion sit in a chair with your feet flat on the floor.
Achilles tendon repair rehabilitation postoperative guideline this rehabilitation program is designed to return the individual to their activities as quickly and safely as possible. Achilles tendon exercises invesion sit in a chair with your feet flat on the floor. Karas md, and the entire sports medicine planning committee, emory university school of medicine and continuing medical education, thank you for your commitment to emory university and interest in attending th annual emory sports medicine symposium due to increased covid19 coronavirus activity and the rapidly evolving. Due to the lack of treatment guidelines, there is no consensus about diagnostic methods, primary treatment nonsurgical or surgical and rehabilitation. Instructions and videos guide you through achilles tendon stretches and exercises that you can use to speed your recovery from injury, improve mobility, and prevent future injuries. Place one end or the band around the inside ball of your foot. Therefore, we recommend two different exercises to stretch each. If youre physically active and put a lot of pressure on your feet and legs, you need to take care of your achilles tendon.
The diagnosis of an achilles tendon rupture is made from clinical history, physical exam and diagnostic testing. Pdf on dec 1, 2000, nicola maffulli and others published rupture of the achilles tendon find, read and cite all the research you need on researchgate. Rerupture excessive laxity in the achilles tendon andor excessive. Physical therapy guideline for achilles rupture repair. Diagnosis and treatment of acute achilles tendon rupture. Achilles tendon rupture repair return to sport protocol keys for achilles tendon rehabilitation. It is designed for rehabilitation following post operative achilles tendon repair.
Achilles tendon exercises after injury, rupture exercises and easier exercises should be done in the first days after surgery. Turn your face in a wall and twist your two legs so. This is because the tendon is damaged and weaker than usual. Place the other end of the other band around a stable object. Avoid all passive motion into df for 1st 6 weeks postop 3.
The thompson test, which is typically positive with an acute achilles rupture, is a clinical test performed while affected patients lie on their stomachs. It attaches the calf muscles soleus and gastrocnemius to the heel bone calcaneus. Achilles tendon rupture repair return to sport protocol. In the late rehab phase after achilles tendon rupture repair you should focus more closely on proprioception. American academy of orthopaedic surgeon, 188, 503510. The achilles tendon usually rupt ures without warning. Static balance exercises begin in 2 foot stand, then 2 foot stand on balance board. Calf girth, plantar flexor strength and ankle rom are all keys to full recovery. The ideal is to achieve full symmetry in all 3 areas. Accelerated rehabilitation following achilles tendon repair after acute rupture development of an evidencebased treatment protocol.733 23 1551 821 317 855 1125 93 1157 359 1231 891 1313 790 432 55 114 1065 986 615 1171 921 953 485 1108 1147 1411 1508 1182 1162 512 783 24 1418 1343 1470 288 1379 507 1429 1036 1486 1331