Achilles tendon injury
Listed below we describe the steps that we have our patients take to recuperate from Achilles tendon repair work surgery. To find out more about how we repair Achilles tendon ruptures without an open surgery, please describe our description of Achilles tendon injury, medical diagnosis and treatment.
General considerations
Timespan pointed out in this protocol ought to be thought about approximate with real development based upon clinical discussion. Physician consultations, in addition to continued evaluation by the treating specialist, should dictate progress.
- Prevent strong active and passive variety of motion of the Achilles for 10-12 weeks
- Carefully keep track of the tendon and lacerations for movement and signs of scar tissue development.
- Regular soft tissue treatments (i.e. scar mobilization and friction massage) to decrease fibrosis
- All exercises must be thoroughly observed for any signs of payment or safeguarding
- No running, jumping, or ballistic activities for 6 months
- Aerobic and basic conditioning throughout the rehabilitation process
- MD visits at Day 1, Day 14 nurse visit for suture removal, MD follow up at 1 month, 2 months, 4 months, 6 months, and 1 year post-op
Rehab Protocol for Achilles Tendon Rupture
0 – 3 Weeks:
- Adjustable boot locked out at 30 ° of plantar flexion
- Non-weightbearing for 3 weeks– no push off or toe-touch walking
- Pain and edema control (i.e. cryotherapy, electrical stim, soft tissue treatments).
- Toe curls, toe spreads, gentle foot motion in boot, straight leg raises, knee flexion/extension.
- Well-leg biking, weightlifting, and swimming for cardiovascular conditioning.
3 – 8 Weeks:
- Slowly enhance weight bearing from toe-touchdown to partial as tolerated. After 6 weeks, all right to advance to full weightbearing.
- Walking orthosis changed 5 ° a week up until 10 ° of plantar flexion. After 8 weeks, okay to wear shoes with a heel (i.e. cowboy boots, 1/4″ heel lift in shoes).
- Isometrics of uninvolved muscles, light active dorsiflexion of the ankle until mild stretch of Achilles.
- Slowly enhance the strength and varieties of isometrics of Achilles within the range of the boot.
- Gradually increase passive range of movement and stretch on the Achilles after 6 weeks.
- Proprioception exercises, intrinsic muscle strengthening, PNF patterns (not to Achilles).
- At 6 weeks, all right to add fixed cycling with heel push only. Deep water exercises.
- Soft tissue treatments daily.
8 – 12 Weeks:
- Full weightbearing with heel lift as tolerated, gait training.
- Wean into a regular shoe over a 2-4 week duration.
- Begin and progressively increase active/resistive exercises of the Achilles (i.e. submaximal isometrics, careful isotonics, Theraband).
- Handbook full passive range of motion of the Achilles– absolutely nothing powerful.
- Development to biking in shoe, swimming.
3 – 6 Months:
- Wean off heel lifts (if not currently).
- Closed chain exercises: controlled squats, lunges, bilateral calf raise (development to unilateral), toe raises, controlled sluggish eccentrics vs. body weight.
- Cycling, VersaClimber, rowing machine, NordicTrack (progressively).
- Unless extreme fibrosis is present, need to be released into a home program.
6 – 7 Months:
Development training jogging/running, jumping, and eccentric loading exercises, noncompetitive sporting activities, sports-simulated exercises.
8 – 9 Months:
Return to physically requiring sport and/or work.
NOTE: All progressions are approximations and should be utilized as a guideline only. Progression will be based upon specific patient discussion, which is examined throughout the treatment procedure.
This protocol for Achilles tendon repair is developed to provide the rehabilitation professional with a general standard for patient care. As such, it ought to be stressed that this is just a protocol and ought to not be an alternative to expert medical decision-making concerning a patient’s progression.
