This can lead to possible tendon rupture with forceful pushing off during activities such as basketball, tennis or racquetball. Achilles rupture nonop orthopaedic medical group of. Turn your face in a wall and twist your two legs so. See a doctor urgently if you think that you may have. Your achilles tendon is the biggest and strongest tendon in the body. Static balance exercises begin in 2 foot stand, then 2 foot stand on balance board. The yearly incidence of achilles tendon rupture is up to 37 per 100,000 individuals.
Achilles tendon repair rehabilitation postoperative guideline this rehabilitation program is designed to return the individual to their activities as quickly and safely as possible. As with any muscle or tendon in the body, the achilles tendon can be torn if there is a high. Achilles tendon rupture diagnosis, causes, treatment. Your pt can show you which exercises to doand when to do themto fully recover. 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. Dependent upon the patient and quality of the repair, weight bearing status postoperatively as well as the intensity and time frame of initiation of functional activities will vary. American academy of orthopaedic surgeon, 188, 503510. Achilles tendon repair rehabilitation postoperative guideline. Due to the lack of treatment guidelines, there is no consensus about diagnostic methods, primary treatment nonsurgical or surgical and rehabilitation. Treating an achilles tendon rupture requires surgery or. Achilles tendon repair rehabilitation protocol this rehabilitation protocol was developed for patients who have had a repair of an acute achilles tendon rupture. An achilles tendon rupture is a complete or partial tear that occurs when the tendon is stretched beyond its capacity. Eversion sit in a chair with your feet flat on the floor. An achilles tendon tear or rupture can be a difficult injury to come back from.
Nonoperative treatment of achilles tendon ruptures phase. 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. It attaches the calf muscles soleus and gastrocnemius to the heel bone calcaneus. This is because the tendon is damaged and weaker than usual. Rehabilitation guidelines for achilles tendon repair uw health.
Defining components of early functional rehabilitation for. Most achilles tendon ruptures are treated surgically, especially with young athletes or active people. Avoid creating pain discomfort is okay but pain should not occur and persist 3 days in a row. 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. If reducing your repetitions does not help, try resting for 25 days.
Department of physiotherapy department of sport and. The chronic form of achilles tendinopathy is not an. Promoting health through exercise treating inflammation. The calf muscle is squeezed and, if there is a rupture of the achilles tendon, the foot will not plantarflex push downwards. There is a risk of rupturing your achilles tendon if you have achilles tendinitis. It is designed for rehabilitation following post operative achilles tendon repair. The combination of achilles tendon pain, swelling, and impaired performance indicates the clinical diagnosis of achilles tendinopathy. Any closedkinetic chain therapeutic exercises can be performed in the alterg antigravity treadmill to decr.
Severe pain around the achilles tendon that develops suddenly may be a sign of tendon rupture. The achilles tendon is made up of two separate muscles. Rehabilitation guidelines for achilles tendon repair. This video is about rehabilitation of an achilles tendon rupture after surgery and progession to return to play status. This is purely an educational video designed by students for a. 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. 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 runningcutting at 16 weeks. 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. Exercise program for achilles tendon rupture verywell health.
The diagnosis of an achilles tendon rupture is made from clinical history, physical exam and diagnostic testing. By doing the right exercises for your condition, you can quickly and safely get back to your normal lifestyle. Consider taking a more conservative approach to range of motion, weight bearing, and. As tolerated in cam walker boot with heel wedges in place first wedge removed at 4 weeks, second wedge removed at. All patients had sustained achilles tendon rupture during sports activities. The tendon transmits force from the contracting calf muscles to the calcaneus to cause the foot action of plantar. 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.
Achilles tendon rupture has been reported with the use of corticosteroids, taken either by mouth or after injection near the tendon area. Forceful jumping or pivoting, or sudden accelerations of running, can overstretch the tendon and cause a. The achilles tendon is the strongest and largest tendon in the body, but it is also the most commonly ruptured tendon. Rerupture excessive laxity in the achilles tendon andor excessive.
Achilles tendon exercises after injury, rupture exercises and easier exercises should be done in the first days after surgery. Torn achilles rehabilitation following surgery and non. Best achilles tendon exercises, rehab exercises to avoid. Avoid all passive motion into df for 1st 6 weeks postop 3. The pain is often described as being struck physically on the back of your ankle by an object or implement. 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. Place one end or the band around the inside ball of your foot. Diagnosis and treatment of acute achilles tendon rupture.
Achilles repair rehabilitation protocol key considerations. You may hear a loud snapping noise or bang at the time of injury. 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. This protocol is designed to assist you with your rehabilitation after surgery and should be followed. Achilles tendon repair postop rehabilitation protocol. 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.
If youre physically active and put a lot of pressure on your feet and legs, you need to take care of your achilles tendon. Exercises painfree active ankle range of motion rom, including ankle. Achilles tendon rupture affects about 1 in 15,000 people at any one time, increasing to 1 in 8,000 in competitive athletes. The following is an example of a rehabilitation and exercise program for a complete achilles tendon rupture. 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. The ideal is to achieve full symmetry in all 3 areas. When the walker brace is removed, no weightbearing or dorsal extension of the foot is allowed. Physical therapy guideline for achilles rupture repair. This protocol for achilles tendon repair is designed to provide the. In the late rehab phase after achilles tendon rupture repair you should focus more closely on proprioception. Achilles tendon rupture most commonly occurs in middle age ages 3050, and may be associated with repeated strain and inflammation. If the achilles tendon is torn, this is called an achilles tendon rupture.
Achilles tendon rupture repair return to sport protocol. On exam, there is a palpable divot or gap in the area of the rupture along. 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. A complete rupture of the achilles tendon may make a pop sound, followed by pain and swelling of the lower leg. This will result in weakness and loss of athletic ability. Therefore, we recommend two different exercises to stretch each. The achilles tendon usually rupt ures without warning. Rehabilitation protocol for achilles tendon repair this protocol is intended to guide clinicians and patients through the postoperative course for an achilles tendon repair. Achilles tendon exercises invesion sit in a chair with your feet flat on the floor. Rehabilitation guidelines for achilles tendon repair the achilles tendon is the strongest and thickest tendon in the body.
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 involves degeneration of the tendon and is common in men. The calf muscle is a major muscle we use for running, jumping and climbing. If it does, rest the patient until pain level is clearly decreasing. 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. It is hypothesized that this lack of consensus and guidelines leads to suboptimal recovery and higher societal costs. A sudden sharp pain in the achilles tendon at the back of your ankle. The achilles tendon is the thick tendon above the heel that attaches the calf muscles to the heel bone. Place the other end of the other band around a stable object. Achilles tendon rupture repair return to sport protocol keys for achilles tendon rehabilitation. Exercises will help the healing process by improving the strength of the tendon and help align scar tissue. Rom should be measure in both open and closedchain methods. We recommend seeking advice from your own surgeon before attempting any rehabilitation exercises.
Calf girth, plantar flexor strength and ankle rom are all keys to full recovery. Rehabilitation protocol achilles tendon repair alterg. Achilles tendon rupture conservative treatment protocol. Modifications to this guideline may be necessary dependent on physician. Treatment options for an achilles tendon rupture include surgical repair and conservative nonsurgical rehabilitation.
Accelerated rehabilitation following achilles tendon repair after acute rupture development of an evidencebased treatment protocol. The achilles tendon is a strong tendon attaching the two major calf muscles gastrocnemius and soleus to the heel bone calcaneus. Working with a pt is a good idea to help you get back to normal. In all cases, aatr was identified by evaluating patients. The surgical approach to repair the torn tendon requires postoperative.