What Are the Different Achilles Tendon Rupture Treatments?
The Achilles tendon is located behind the calf, starting in the middle of the calf and ending at the midpoint behind the calcaneal tubercle. The tendon gradually thickened and narrowed from top to bottom, and gradually widened from 100px above the calcaneal tubercle to the attachment point. The Achilles tendon has a good blood supply at the beginning and the attachment point, but the lower part is 2-150px above the Achilles tendon attachment point. The blood supply is poor, the tendon is malnourished, and tendon degenerative degeneration and breakage occur .
Achilles tendon rupture rehabilitation
- Rehabilitation after Achilles tendon repair should begin 2-6 weeks after surgery. In order to protect the repaired Achilles tendon, the rehabilitation doctor must explain some precautions. For example, passive traction of the Achilles tendon should be prohibited for 12 weeks after surgery. In addition, the weight-bearing process should be performed step by step under the guidance of the surgeon. The therapist must identify the four phases of Achilles tendon healing (inflammation, hyperplasia, plasticity, and maturity) during the entire postoperative rehabilitation process. The Achilles tendon is most vulnerable during the first 6 weeks of healing (inflammation and hyperplasia), and gradually increases in intensity during the next 6 weeks to 12 months (plastic and mature). Patient rehabilitation is a standard functional recovery process.
Achilles tendon rupture recovery stage 1
- Protection and healing period (1 to 6 weeks)
- Goal: Protect the repaired Achilles tendon
- Control of edema and pain
- Reduce scar formation
- Improve dorsiflexion activity to neutral position
- Increase the muscle strength of the proximal lower limbs to 5/5
- Progressive weight bearing under the guidance of a doctor
- Complete the home training program independently
- Note: Avoid passively stretching the Achilles tendon
- Active ankle dorsiflexion at 90 ° knee flexion should be limited to neutral position (0 °)
- Avoid hot packs
- Avoid prolonged sagging
- Treatment measures: When using the armpit or cane under the guidance of a doctor, wear a roulette fixed boots to gradually load
- Active ankle dorsiflexion / plantar flexion / varus / valgus
- Massage scar
- Joint loosening
- Proximal muscle exercises
- Physiotherapy
- Cold therapy
- Promotion criteria: pain and edema are controlled
- Weight-bearing under the guidance of a doctor
- Neutral ankle dorsiflexion
- Proximity of lower limb muscle strength reaches 5/5
Achilles tendon rupture rehabilitation stage 2
- Early joint activity (weeks 6-12)
- Goal: return to normal gait
- Restore sufficient functional joint activity to meet normal gait (15 ° ankle dorsiflexion) and upper step requirements (25 ° ankle dorsiflexion
- Restores ankle dorsiflexion, varus and varus muscle strength to normal level 5/5
- Note: Avoid pain during therapeutic exercises and functional activities
- Avoid passive stretching of the Achilles tendon
- Treatment measures: under protection, you can carry your hands to full weight to practice gait, and you can abduct when you are painless
- Gait for underwater treadmill system
- Heel pads inside shoes help restore normal gait
- Proprioceptive training
- Isometric / Isotonic Strength Exercises: Ankle Eversion / Eversion
- 6 weeks after operation: 90 ° knee flexion progressive ankle plantar flexion / dorsiflexion exercise
- 8 weeks after operation: Knee straight 0 ° progressive resistance ankle plantar flexion / dorsiflexion exercise
- Leg flexion and knee extensions for plantar flexor strength exercises
- Bicycle exercise
- Lettering on a pedal multi-axis device
- Reverse treadmill
- Physiotherapy
- Scar massage
- Step forward
- Promotion criteria: normal gait
- Sufficient passive ankle dorsiflexion angle (20 °)
- Ankle dorsiflexion, varus, valgus muscle strength reaches 5/5
Achilles tendon rupture recovery stage III
- Early strength exercises (weeks 12 to 20)
- Goal: Restore full range of active joint activity
- Ankle plantar flexor strength to normal 5/5
- Ability to restore normal balance (assessed with NeuroCom or Biodex balance system
- Restore painless functional activities
- Ability to step down
- Note: Avoid pain during therapeutic exercises and functional activities
- Avoid high Achilles tendon load (i.e. excessive dorsiflexion of the ankle or jumping over the entire body weight)
- Treatment measures: isotonic / isokinetic varus / valgus exercises
- Fixed-line driving, training stairs, Versa climbing exercises
- Proprioceptive training: proprioceptive tablet / BAPS / foam roller / spring pad / NeuroCom
- Strengthen ankle plantar flexion with progressive resistance to exercise (emphasis on eccentric exercise)
- Sub-Extreme Specific Motor Skills
- Progressive proprioceptive exercises
- Underwater treadmill system running exercise
- Lower Extremity Proximal Strength Exercises (Progressive Resistance Exercise)
- Isokinetic exercises
- Flexibility needed during the activity
- Step forward and down
- Promotion criteria: complete daily activities without fear
- Normal flexibility
- Enough muscle strength, the watch is new to be able to lift one leg 10 times
- Ability to step back and forth
- Symmetrical lower limb balance
Achilles tendon rupture rehabilitation stage 4
- Late muscle strength exercises (weeks 20-28)
- Goal: Freely complete forward running on the treadmill
- Isokinetic average peak torque reaches 75%
- Able to meet the maximum muscle strength and flexibility required for daily activities
- Resume unlimited functional activities
- Ability to complete higher levels of physical activity without fear
- Note: Avoid pain and fear during activities
- Avoid running and physical activity before reaching enough strength and flexibility
- Treatment: Start running and step forward
- Isocratic assessment and training
- Continue to lower limb muscle strength and flexibility exercises
- Advanced proprioceptive training under disturbance
- Mild functional reciprocating motion (two-foot jump exercise)
- Sub-Extreme Sports Skills Practice
- Continue cycling, training stairs, Versa climbing exercises
- Continue to strengthen the proximal lower limb muscle exercises (progressive resistance exercise)
- Promotion Standard: Painless Running Ability
- Isokinetic average peak torque reaches 75%
- Normal flexibility
- Normal muscle strength (all ankle muscle strength is 5/5)
- Perform sports-specific exercises without fear
Achilles tendon rupture recovery stage 5
- Full recovery of sports skills (week 28 to 1 year)
- Goal: Play sports without fear
- Ability to meet the maximum muscle strength and flexibility required for personal sports activities
- Vertical jump assesses 85% of affected limbs up to healthy limbs
- Isometric muscle strength determination of 85% of the affected limb (plantar flexion / dorsiflexion / varus / valgus)
- Note: Avoid pain during therapeutic, functional, and physical activities
- Avoid all sports until you have enough muscle and flexibility
- Treatment: more advanced functional training and flexible exercises
- Functional reciprocating motion
- Physical exercise
- Isokinetic evaluation
- Functional evaluation, such as vertical jump evaluation
- Discharge Standard: Achieve the muscle strength and flexibility required for sports
- Ability to complete sports without fear
- Functional evaluation of 85% of affected limbs
- Isokinetic strength determination of 85% of the affected limb (plantar flexion / dorsiflexion / varus / valgus)
- Ability to complete gym / home training programs independently