Acute Achilles Tendon Rupture
A complete Achilles tendon rupture commonly occurs in athletes aged between 30 and 40 and is 10 times more likely to occur in male athletes.
- Ice and use of crutches
- Over the counter pain relief
- There is a debate regarding complete immobilisation vs some movement as a non-surgical option. Research now suggests that early mobilisation for conservatively treated patients decreases the re-rupture rate compared with use of a rigid cast. Research suggests that simple, early movement whilst in a functional brace improves long-term outcomes compared to no loading in the first 6-8 weeks.
- No stretching of the calf should occur in the first 4 weeks of the rehabilitation period.
- Professional Medical Treatments
- Both surgery and conservative treatments are usually successful. Surgical repair is often advised in young patients and active patients (especially elite athletes). Older patients and inactive patients are usually recommended to conservatively manage, with some form of immobilisation.
- After removal of brace / cast, treatment aims to restore normal walking, optimal strength of the calf muscle (and muscles of the affected lower limb). It is important to minimise the chance of re-rupture during this time. Very slow and controlled movements are recommended particularly in the first 4 weeks of this period.
- Another important aim is to restore ankle range, usually with a combination of exercises and manual therapy.
Physical Therapy Exercises
- Ankle mobilisation to ensure joints restore to full range of motion
- Soft tissue massage through muscles that become tight as a compensation mechanism
- Exercises to prevent DVT (Deep Vein Thrombosis)
- Strength and proprioception (joint position awareness) exercises to restore function / strength and prevent re-injury (these often include calf raises, squats, resisted ankle TheraBand exercises, single-leg balance exercises, stretches and mobility exercises to self-manage. Calf strengthening usually starts in sitting, with progression into standing double leg and later standing single-leg. Resistance bands are used to strengthen muscles around the ankle also. Strengthening should be advised by a professional and should be extremely well-monitored.
- Eventual return to high level exercises including bounding / jumping / directional changes and sports drills
- Exercise techniques to prevent injury
- Dynamic balance training
- Ankle mobility exercises
- Lower limb proprioception and strength exercises