RTS Post Achilles Tendon Rupture

best way to treat an achilles tendon rupture

depends on the pts anatomy, goals, and rehab but studies agree that early mobilization results in better outcomes

length of controlled mobilization phase of achilles rehab

6-8 weeks

length of early achilles rehab phase

3 months

length of RTS phase of achilles rehab

4 - 12 months

obstacles to full recovery

fear of re-rupture, calf muscle weakness, tendon elongation during healing

how to address the fear of movement post-reconstruction

education starting day 2 about how exercise actually helps prevent re-rupture

amount of calf strength deficit post reconstruction

10-30%

amount of heel-rise endurance deficits post reconstruction

20-30%

percentage of pts that can perform a SL heel rise at 3 months

50%

primary goals of early achilles tendon reconstruction rehab

minimize tendon elongation and passive insufficiency, minimize muscle atrophy, avoid re-rupture, avoid DVT

when is weight bearing initiated

week 1

when is exercises/ROM initiated

week 2

exercises in controlled mobilization phase

isometric PF in boot, seated heel rise, tband PF

goals of early rehabilitation

avoid re-rupture, avoid further elongation, increase cross sectional area, overcome fear of loading, recover calf strength

when is the greatest risk of re-rupture

weeks 6-11

exercises in early rehabilitation phase

bilateral standing heel rise, gait training, walking backwards

goals of later rehabilitation phase

recover tendon strength, muscle endurance, function, progress to running/jumping

milestone that must be reached to start running/jumping

5 SL heel rises at 90% available height

exercises in later achilles rehabilitation phase

quick rebounding heel rises, bilateral hopping, jogging in place

function of testing to return to sport

helps the PT and athlete know if they are ready, helps motivate the athlete on what to work on

why do older adults report less problems

they want to get back to activities that are less demanding so they don’t need as much function