What is an Achilles tendon rupture. How does it occur. What are the signs and symptoms. How is it diagnosed. What treatment options are available. How long does recovery take. How can it be prevented.

Understanding the Achilles Tendon: Structure and Function

The Achilles tendon, also known as the heel cord, is a crucial component of the lower leg anatomy. It is a robust band of fibrous tissue that connects the calf muscles (gastrocnemius and soleus) to the calcaneus or heel bone. This tendon plays a vital role in human locomotion, facilitating walking, running, and jumping by helping to raise the heel off the ground.

The Achilles tendon is the strongest tendon in the human body, capable of withstanding forces of up to 1,000 pounds during physical activity. Despite its strength, it is also one of the most commonly injured tendons due to the high stresses placed upon it during everyday activities and sports.

Key Functions of the Achilles Tendon:

• Enables plantarflexion of the foot (pointing the toes downward)
• Assists in push-off during walking and running
• Helps maintain balance and stability during standing
• Absorbs shock during high-impact activities

Achilles Tendon Rupture: Causes and Risk Factors

An Achilles tendon rupture occurs when the tendon is stretched beyond its capacity, resulting in a complete or partial tear. This injury can happen suddenly and often without warning, causing immediate pain and difficulty walking.

What are the common causes of Achilles tendon ruptures? The most frequent causes include:

• Sudden, forceful movements during sports activities
• Abrupt acceleration or deceleration while running
• Unexpected falls or trips
• Direct trauma to the back of the leg

Who is at higher risk for an Achilles tendon rupture? Several factors can increase the likelihood of experiencing this injury:

1. Age: Middle-aged adults, particularly “weekend warriors” who engage in sporadic intense physical activity
2. Gender: Men are more likely to experience Achilles tendon ruptures
3. Certain medical conditions: Conditions like gout or rheumatoid arthritis can weaken the tendon
4. Medications: Some antibiotics and corticosteroids may increase the risk of tendon rupture
5. Previous Achilles tendon injuries: A history of tendinitis or partial tears can predispose individuals to ruptures
6. Lack of flexibility or strength in the calf muscles

Recognizing the Signs and Symptoms of an Achilles Tendon Rupture

Identifying an Achilles tendon rupture promptly is crucial for proper treatment and recovery. The symptoms can be sudden and severe, often occurring during physical activity.

What are the telltale signs of an Achilles tendon rupture?

• A sudden, sharp pain in the back of the ankle or calf, often described as feeling like being kicked or stabbed
• An audible “pop” or snapping sensation at the time of injury
• Swelling between the heel and calf
• Difficulty walking, especially upstairs or uphill
• Inability to stand on tiptoes or push off the injured leg when walking
• A visible gap or indentation in the tendon, just above the heel bone

Is immediate medical attention necessary for an Achilles tendon rupture? Yes, prompt medical evaluation is essential to prevent further damage and determine the most appropriate treatment plan. While waiting to see a healthcare provider, patients should follow the RICE protocol:

• Rest: Avoid putting weight on the affected leg
• Ice: Apply cold packs to reduce swelling and pain
• Compression: Use an elastic bandage to minimize swelling
• Elevation: Keep the leg raised above heart level to decrease swelling

Diagnosing Achilles Tendon Ruptures: Medical Evaluation and Imaging

Accurate diagnosis of an Achilles tendon rupture is crucial for determining the most effective treatment approach. Healthcare providers use a combination of physical examination and imaging studies to confirm the diagnosis and assess the extent of the injury.

Physical Examination

How do doctors diagnose an Achilles tendon rupture through physical examination? The process typically involves:

• Taking a detailed medical history, including how the injury occurred
• Visually inspecting the affected area for swelling, bruising, or deformity
• Palpating the tendon to feel for gaps or abnormalities
• Performing the Thompson test (squeezing the calf muscle to observe foot movement)
• Assessing the patient’s ability to bear weight and perform specific movements

Imaging Studies

What imaging techniques are used to confirm an Achilles tendon rupture diagnosis?

1. Ultrasound: A quick, non-invasive method to visualize the tendon and identify tears
2. Magnetic Resonance Imaging (MRI): Provides detailed images of soft tissues, helping to determine the extent of the injury
3. X-rays: While not typically used to diagnose tendon ruptures, they may be ordered to rule out other injuries like fractures

These diagnostic tools help healthcare providers develop a comprehensive treatment plan tailored to the individual patient’s needs and circumstances.

Treatment Options for Achilles Tendon Ruptures: Surgical vs. Non-Surgical Approaches

The treatment of Achilles tendon ruptures can be broadly categorized into two main approaches: surgical and non-surgical. The choice between these options depends on various factors, including the severity of the rupture, the patient’s age, overall health, and activity level.

Non-Surgical Treatment

When is non-surgical treatment considered for Achilles tendon ruptures? This approach is typically recommended for:

• Older or less active individuals
• Patients with certain medical conditions that increase surgical risks
• Cases of partial tendon tears

What does non-surgical treatment involve?

1. Immobilization: The affected leg is placed in a cast or walking boot for 6-8 weeks
2. Gradual weight-bearing: As healing progresses, patients slowly increase weight on the affected leg
3. Physical therapy: Exercises to improve strength and flexibility
4. Regular follow-up: To monitor healing and adjust treatment as necessary

Surgical Treatment

Why might surgical repair be recommended for an Achilles tendon rupture?

• Potentially faster return to pre-injury activity levels
• Lower risk of re-rupture compared to non-surgical treatment
• Better restoration of tendon length and tension
• Improved push-off strength and ankle function

What are the main surgical techniques used for Achilles tendon repair?

1. Open repair: A large incision is made to directly access and suture the tendon
2. Minimally invasive repair: Smaller incisions are used, potentially reducing complications and improving healing time
3. Percutaneous repair: The tendon is stitched through small incisions, guided by imaging

Post-surgical care typically involves a period of immobilization followed by progressive weight-bearing and physical therapy. The choice between surgical and non-surgical treatment should be made in consultation with a healthcare provider, considering individual patient factors and preferences.

Rehabilitation and Recovery: The Road to Healing After an Achilles Tendon Rupture

Rehabilitation plays a crucial role in the recovery process following an Achilles tendon rupture, regardless of whether the treatment approach is surgical or non-surgical. The goal of rehabilitation is to restore strength, flexibility, and function to the affected leg while preventing re-injury.

Phases of Rehabilitation

What are the typical stages of rehabilitation for an Achilles tendon rupture?

1. Protection Phase (0-6 weeks post-injury/surgery):
   • Immobilization in a cast or boot
   • Non-weight bearing or partial weight bearing as directed
   • Gentle range of motion exercises for toes and ankle
2. Early Healing Phase (6-12 weeks):
   • Gradual increase in weight bearing
   • Removal of cast/boot and transition to supportive footwear
   • Initiation of gentle stretching and strengthening exercises
3. Strength and Conditioning Phase (3-6 months):
   • Progressive strengthening of calf muscles
   • Improvement of balance and proprioception
   • Introduction of sport-specific exercises
4. Return to Activity Phase (6+ months):
   • Gradual return to pre-injury activities
   • Continued strength and flexibility training
   • Monitoring for any signs of re-injury

Physical Therapy Interventions

How does physical therapy contribute to recovery from an Achilles tendon rupture?

• Manual therapy techniques to improve tissue mobility and reduce scar tissue formation
• Customized exercise programs to address individual deficits in strength and flexibility
• Gait training to ensure proper walking mechanics and prevent compensatory patterns
• Modalities such as ultrasound or electrical stimulation to promote healing and manage pain
• Education on proper footwear and activity modification to prevent future injuries

The duration of recovery can vary significantly among individuals, depending on factors such as age, overall health, adherence to rehabilitation protocols, and the severity of the initial injury. Most patients can expect a return to normal daily activities within 4-6 months, while a full return to high-impact sports may take 6-12 months or longer.

Preventing Achilles Tendon Ruptures: Strategies for Maintaining Tendon Health

While not all Achilles tendon ruptures can be prevented, there are several strategies individuals can employ to reduce their risk of injury and maintain overall tendon health.

Proper Warm-up and Stretching

How can warming up and stretching help prevent Achilles tendon injuries?

• Gradually increases blood flow to the muscles and tendons
• Improves flexibility and range of motion
• Prepares the body for more intense activity

Effective warm-up routines should include:

1. Light aerobic activity (e.g., jogging, cycling) for 5-10 minutes
2. Dynamic stretching exercises focusing on the lower leg muscles
3. Sport-specific movements at a low intensity

Strengthening Exercises

What exercises can help strengthen the Achilles tendon and surrounding muscles?

• Eccentric heel drops: Slowly lowering the heel from a raised position
• Calf raises: Both double-leg and single-leg variations
• Resistance band exercises for ankle dorsiflexion and plantarflexion
• Balance and proprioception training on unstable surfaces

Proper Footwear and Training Surfaces

How does footwear and training surface selection impact Achilles tendon health?

• Choose shoes with adequate support and cushioning
• Replace athletic shoes regularly, typically every 300-500 miles of use
• Avoid sudden changes in running or training surfaces
• Gradually transition to minimalist or barefoot-style shoes if desired

Gradual Progression in Training

Why is a gradual increase in training intensity important for preventing Achilles tendon injuries?

• Allows the tendon to adapt to increased loads over time
• Reduces the risk of overuse injuries
• Helps maintain proper form and technique during activities

A general rule of thumb is to increase training volume or intensity by no more than 10% per week.

Listening to Your Body

How can paying attention to your body’s signals help prevent Achilles tendon ruptures?

• Be aware of any pain, stiffness, or discomfort in the Achilles tendon area
• Address minor issues promptly to prevent them from progressing to more severe injuries
• Take rest days as needed and avoid pushing through pain
• Seek medical attention if symptoms persist or worsen

By implementing these preventive strategies, individuals can significantly reduce their risk of experiencing an Achilles tendon rupture and maintain optimal tendon health throughout their active lives.

Achilles Tendon Rupture – Foot Health Facts

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What Is the Achilles Tendon?  

A tendon is a band of tissue that connects a muscle to a bone. The Achilles tendon runs down the back of the lower leg and connects the calf muscle to the heel bone. Also called the heel cord, the Achilles tendon facilitates walking by helping to raise the heel off the ground.

What Is an Achilles Tendon Rupture?

An Achilles tendon rupture is a complete or partial tear that occurs when the tendon is stretched beyond its capacity. Forceful jumping or pivoting, or sudden accelerations of running, can overstretch the tendon and cause a tear. An injury to the tendon can also result from falling or tripping.

Achilles tendon ruptures are most often seen in “weekend warriors”—typically, middle-aged people participating in sports in their spare time. Less commonly, illness or medications, such as steroids or certain antibiotics, may weaken the tendon and contribute to ruptures.

Signs & Symptoms 

A person with a ruptured Achilles tendon may experience one or more of the following:

• Sudden pain (which feels like a kick or a stab) in the back of the ankle or calf—often subsiding into a dull ache
• A popping or snapping sensation
• Swelling on the back of the leg between the heel and the calf
• Difficulty walking (especially upstairs or uphill) and difficulty rising up on the toes
  
   

These symptoms require prompt medical attention to prevent further damage. Until the patient is able to see a doctor, the RICE method should be used. This involves:

• Rest. Stay off the injured foot and ankle, since walking can cause pain or further damage.
• Ice. Apply a bag of ice covered with a thin towel to reduce swelling and pain. Do not put ice directly against the skin.
• Compression. Wrap the foot and ankle in an elastic bandage to prevent further swelling.
• Elevation. Keep the leg elevated to reduce the swelling. It should be even with or slightly above heart level.
  
   

Diagnosis

In diagnosing an Achilles tendon rupture, the foot and ankle surgeon will ask questions about how and when the injury occurred and whether the patient has previously injured the tendon or experienced similar symptoms. The surgeon will examine the foot and ankle, feeling for a defect in the tendon that suggests a tear. Range of motion and muscle strength will be evaluated and compared to the uninjured foot and ankle. If the Achilles tendon is ruptured, the patient will have less strength in pushing down (as on a gas pedal) and will have difficulty rising on the toes.

The diagnosis of an Achilles tendon rupture is typically straightforward and can be made through this type of examination. In some cases, however, the surgeon may order an MRI or other advanced imaging tests.

Treatment

Treatment options for an Achilles tendon rupture include surgical and nonsurgical approaches. The decision of whether to proceed with surgery or nonsurgical treatment is based on the severity of the rupture and the patient’s health status and activity level.

Nonsurgical Treatment

Nonsurgical treatment, which is generally associated with a higher rate of rerupture, is selected for minor ruptures, less active patients and those with medical conditions that prevent them from undergoing surgery. Nonsurgical treatment involves use of a cast, walking boot or brace to restrict motion and allow the torn tendon to heal.

Surgery

Surgery offers important potential benefits. Besides decreasing the likelihood of rerupturing the Achilles tendon, surgery often increases the patient’s push-off strength and improves muscle function and movement of the ankle. 

Various surgical techniques are available to repair the rupture. The surgeon will select the procedure best suited to the patient.

Following surgery, the foot and ankle are initially immobilized in a cast or walking boot. The surgeon will determine when the patient can begin weightbearing. 

Complications such as incision-healing difficulties, rerupture of the tendon or nerve pain can arise after surgery.

Physical Therapy

Whether an Achilles tendon rupture is treated surgically or nonsurgically, physical therapy is an important component of the healing process. Physical therapy involves exercises that strengthen the muscles and improve range of motion in the foot and ankle.

Achilles Tendon Rupture: Symptoms, Treatment, Recovery

The Achilles tendon is a thick tendon located in the back of the leg, just above the heel. It connects the gastrocnemius and soleus muscles in the calf to an insertion point at the calcaneus (heel bone). The Achilles transmits forces from the muscles to the foot, enabling the foot to push off against the ground when walking, running, or jumping. Although the Achilles is the strongest tendon in the body, it has a small but real risk for failure.

Common Achilles tendon injuries include Achilles tendonitis, which can occur due to overuse, a change in activity or sudden increase in activity, or other anatomic causes. This condition typically causes pain and swelling in the main part of the tendon or where the tendon attaches to the heel bone. The most severe acute Achilles tendon injury, however, is an Achilles tendon rupture.

• What is an Achilles tendon rupture?
• What are the symptoms of an Achilles tendon tear?
• What causes an Achilles tendon tear?
• How do you prevent an Achilles tendon rupture?
• How is an Achilles tendon rupture diagnosed?

• How is an Achilles tendon rupture treated?
• What is the recovery time without surgery?
• Should I have surgery for a ruptured Achilles tendon?
• What is the surgery for a ruptured Achilles tendon?

What is an Achilles tendon rupture?

An Achilles tendon rupture is a tear in the tendon at the back of the ankle that spans from the calf muscles to the heel. A rupture occurs when the Achilles is completely torn after a sudden step, jump or movement.

What are the symptoms of an Achilles tendon tear?

The key symptoms are sudden pain and swelling at the back of the ankle. Most people will hear a distinctive popping sound at the time of injury, or they may feel like they were hit in the back of the leg with a hard object. It may be difficult or impossible to bend one’s forefoot downward or effectively push off from the foot with the injury.

What causes an Achilles tendon tear?

Achilles tendon ruptures are most often caused by sudden, strenuous athletic activity that was not preceded by proper stretching, Ruptures usually occur during high-stress activities such as running, cutting or jumping, but sometimes the tendon becomes chronically weakened and can give way during less strenuous activities like walking. About 10% of Achilles tendon ruptures occur in patients who have pre-existing Achilles tendinopathy. Certain medical conditions and some medicines are known to be associated with an increased risk of rupture.

How do you prevent an Achilles tendon rupture?

Stretching and warming up before and cooling down after activity may help prevent an Achilles rupture. Varying your workout and cross-training may help avoid overuse syndromes that can lead to tendon problems.

How is an Achilles tendon rupture diagnosed?

A doctor will ask the patient to describe their injury history and symptoms, and will do a physical examination of the foot and ankle. Usually, a doctor can palpate the back of the ankle and feel a defect in the tendon, therefore identifying the location of the rupture. Doctors will also perform the Thompson Test by squeezing the calf muscle. If the foot does not move downward with this squeeze, this means the Achilles is not attached to the muscle and indicates a ruptured tendon. In some cases, X-ray, ultrasound and/or MRI imaging may be done to confirm the diagnosis or to rule out other injuries.

As soon as a rupture is diagnosed, it should be treated to prevent loss of strength and improper healing. A ruptured Achilles tendon is vulnerable to poor healing because the blood supply to the area of rupture is very limited. If a completely ruptured Achilles tendon is not treated properly, it may not heal or heal with scar tissue in an elongated position, and the person will not regain enough strength in the leg for normal daily activities such as walking, let alone running or other athletic activities.

How is an Achilles tendon rupture treated?

Most people with active lifestyles will need surgery to recover from a complete Achilles rupture. Nonsurgical treatment may be successful for a less athletic individual when the rupture is identified immediately (within 24 hours) and the person is placed in a cast with the toes pointed downward. The goal of casting is to hold the foot and ankle in a position to bring the torn ends of the tendon in proximity, allowing the tendon to slowly heal over time without using invasive surgical techniques. If the rupture is not identified and treated immediately, surgery will offer the best outcome for return to activities and athletics.

What is the recovery time for an Achilles tendon rupture without surgery?

Usually, casting or bracing for up to 8 to 10 weeks is necessary, with four to six months of physical therapy. By avoiding surgery, the risks of skin breakdown or infection are reduced.

Should I have surgery for a ruptured Achilles tendon?

For people who do not engage in athletics, the decision on how to treat these injuries is made on an individual basis. Generally, more active individuals are likely to benefit from surgical intervention while less active persons may be satisfied with nonsurgical treatments.

Surgery for Achilles tendon ruptures ensures that the tendon heals at the appropriate length and tension so that push-off strength in the leg is restored. Without surgery, there is increased chance that the tendon heals in a stretched out fashion and leg strength therefore compromised. High-performance athletes with a torn Achilles tendon are almost always treated with surgery to provide a stronger tendon that is less likely to re-rupture.

Nonsurgical treatment is generally reserved for select patients based on their age, other conditions they may have, and everyday level of activity. Consult a foot-and-ankle orthopedic surgeon to learn which treatment is recommended for you.

What is the surgery for a ruptured Achilles tendon?

An Achilles tendon rupture surgery reconnects the ends of the torn tendon. In revision cases or when the tendon was damaged before the rupture, the tendon may need to be reconstructed using a graft from another tendon in your body. The length of the incision and the surgical approach will depend on location of the rupture. The incision length is about three to four inches long in open surgery and about one inch or less with the minimally invasive approach.

The appropriate surgical approach will depend on location of the rupture. For tears closer to the middle of the tendon or to the muscle, an end-to-end repair will be performed using strong sutures material. For tears very close to the insertion point at the heel bone or when the ruptures caused an avulsion fracture of the calcaneus, suture anchors may be used to repair and reconnect the Achilles directly into the calcaneus bone.

Do I have to stay overnight for an Achilles tendon repair?

Most Achilles tendon repair surgeries are ambulatory (outpatient), with patients leaving about one or two hours after the procedure.

What type of anesthesia is used for Achilles tendon repair?

At HSS, most Achilles tendon surgeries are done with a nerve block (regional anesthesia) and/or a spinal anesthetic while you are in a twilight sleep. An anesthesiologist will perform the regional block in the operating room once you are asleep. This will numb your leg from the knee down and is done for pain control and comfort during and after the procedure. This a long-acting nerve block that may last 24 to 48 hours. In rare instances, it can last as long as three days. For this procedure, anesthesia will also perform an epidural, or “spinal,” in addition to the medication behind the knee. This will numb you from the waist down during the procedure and wears off in the recovery room. You will meet with your anesthesiologist the day of surgery to discuss what type of anesthesia will be performed in more detail.

What are the risks of Achilles tendon surgery?

The concern with surgery is the risk for skin breakdown and infection, which can occur due to swelling and the relatively poor blood supply in the area of the surgery. The risk of infection after Achilles surgery at HSS on the Foot and Ankle Service is less than 1%.

What is the recovery time for Achilles tendon surgery?

The recovery period for Achilles tendon repair surgery is long and requires diligent rehabilitation to restore foot and ankle motion and tendon strength. Typically, after an Achilles tendon repair, patients can expect three to four weeks of immobilization, non-weightbearing (using crutches). It is usually about six to nine months before you return to all activities, such as running or jumping.

Achilles tendon repair recovery benchmarks

After surgery, patients typically wear a splint for two to three weeks until their first post-op appointment.

The splint is removed at the first follow-up appointment. At this time, the healthcare team will evaluate your incisions, remove the sutures and fit you with a lighter removable boot to wear. A prescription for physical therapy will be provided at this time (if not earlier in some cases)

In the CAM boot with heel wedges or a VACOped boot and you can begin to bear weight on your foot at four weeks after surgery. Each week, you will adjust the wedges or VACOped setting to decrease the angle of plantarflexion through your ankle.

You will continue this way for four to six weeks, until you return to the office for another office visit (anywhere from 10 to 12 weeks after your surgery). At this visit, you will be evaluated to determine at what rate you wean out of the boot and into normal sneakers, usually 8 to 10 weeks after surgery.

Is physical therapy necessary after Achilles tendon surgery?

Yes, physical therapy is necessary in order to reduce scarring and swelling, and to promote the strengthening of the Achilles and other soft tissues in the ankle. During rehabilitation, your physical therapist will generally use blood flow restriction techniques to enhance your strength without overloading the newly repaired tendon. Ideally, you will start a PT regimen almost immediately post-op, and will continue it until you have reached your desired activity level. Typically physical therapy continues until six months after surgery.

Updated: 5/18/2022

Authors

Anne Holland Johnson, MD

Associate Attending Orthopedic Surgeon, Hospital for Special Surgery
Associate Professor of Orthopaedic Surgery, Weill Cornell Medical College

Achilles tendon injury – health articles

11/10/2022

Achilles tendon injury is one of the most common closed soft tissue injuries of the lower leg. It is a complete or partial rupture of the junction of the heads of the triceps muscle of the leg and its transition to the calcaneus. It is more often observed in people aged 30 to 50 years, often leading an active lifestyle or in the past involved in sports.

Unlike injuries to most other tendons, damage to the Achilles tendon is almost always complete.

Symptoms of rupture of the Achilles tendon include: sharp pain, swelling, limitation of movement in the foot, palpation detection of “failure” in the area of ​​the Achilles tendon. Diagnosis is carried out mainly on the basis of the results of the examination by a traumatologist. An MRI or ultrasound may also be performed. Treatment – surgical or percutaneous suturing of the tendon with immobilization of the foot for 1 month.

Causes

There are two types of injury in which rupture is possible: direct and indirect injury.

Direct injury. It implies a directed blow to a stretched muscle, for example, when playing sports, in particular football. Possible injury with a sharp object or intentional injury. In this case, the rupture belongs to the category of open injuries, all the rest are closed cases (subcutaneous).

Indirect injury. In case of an unsuccessful fall from a height onto the toe of the foot or a jump.

In addition, the causes of destruction or weakening of the tendon may lie in hereditary predisposition.

Symptoms

External manifestations of tendon rupture, and it is usually sharp and complete, are almost similar in all patients. They are characterized by sharp pain, as if someone behind had struck a muscle with a blunt object or slashed with a razor. In this case, the mobility of the leg completely disappears, the triceps muscle can no longer pull the foot due to a torn tendon. A bluish edema appears, starting from the injury site and ending with the fingertips. It is almost impossible to step on the foot, lameness appears, the mobility of the foot itself is paralyzed.

In some cases, a depression can be felt on the gastrocnemius muscle, indicating a complete rupture of the tendon. In a successful case, the resulting injury may be just a sprain, the treatment of which is much faster and easier.

Diagnostics

Radiography with a rupture of the Achilles tendon gives practically no results. The fact is that tendon tissue does not delay x-rays. However, in some cases, an x-ray may indirectly indicate an injury to this tendon, for example, when a fracture of the leg bone is detected.

Ultrasound and/or magnetic resonance imaging is used to diagnose an Achilles tendon rupture. An MRI will also help in diagnosing an Achilles tendon sprain.

Treatment

conservative way. The essence of this method is immobilization (immobilization) of the lower leg with the help of a plaster splint with an extended toe of the foot for 6-8 weeks. The elongated toe allows you to bring the torn ends of the tendon to each other, ensuring their gradual fusion.

Conservative treatment is possible only in the first hours after the injury. In the future, it will be simply impossible to match the ends of the tendon.

Surgical treatment for Achilles tendon rupture is much more effective than conservative treatment.

In case of an open injury, the tendon is sutured end to end (if there is no defect and rupture of the ends). The ends of the tendon are connected and stitched with interrupted and U-shaped lavsan sutures or chrome-plated catgut. Sometimes a wire is used, which is removed after 6 weeks.

If there is a tendon defect, the first step is plastic correction.

In case of closed injuries, the skin is first cut, then both ends of the tendon are brought to each other, after which they are sutured. Plastic restoration is possible. For this, flaps of the proximal and distal end of the tendon are used.

After surgical treatment, the leg is immobilized with a plaster or polymer bandage, which after 3 weeks is changed to a “boot”. The foot is placed in a flexion position at a slight angle (5-10 degrees). A heel is attached to the plaster cast, which allows you to fully load the leg. After another 3 weeks, the bandage is removed altogether.

After the end of immobilization, the lower leg is fixed with an elastic bandage, therapeutic exercises, massage, swimming, etc. are prescribed. Within a month after the removal of the cast, it is necessary to wear shoes with a heel of at least 2.5 cm.

Ankle recovery after Achilles tendon injuries company blog

Description. Terms and stages of rehabilitation.

Rupture of the Achilles tendon is a complete or partial tear of the junction of the heads of the triceps muscle of the leg and its transition to the calcaneus. It is the most powerful tendon, functionally holds the ankle joint, gives it strength and mobility. Often these injuries are found in athletes, and it does not have to be about professional sports.

Rehabilitation

Tendon rupture occurs in domestic injuries, especially when walking on a slippery surface. Road traffic injuries rarely result in such damage except for direct impact, blunt or sharp objects. Rehabilitation of an Achilles tendon rupture directly depends on therapeutic measures. If conservative therapy, for example, with incomplete ruptures, is effective, the rehabilitation plan is based on it. With surgical treatment, rehabilitation has its own differences.

Terms of rehabilitation

As mentioned above, the terms of rehabilitation depend on the method of treatment (conservative or surgical), as well as on the individual characteristics of the body, physical condition and lifestyle before the injury. If we are talking about professional athletes who want to return to competitive loads, then the recovery period will be approximately 4 months. In other cases, about 6 months.

Stages of rehabilitation

Stage 1 target:
Relief of inflammatory edema and pain by performing physiotherapy and therapeutic massage, prophylactic administration of anti-inflammatory drugs, usually in the form of ointments and gels. The general goal of the first stage can be called the preparation of the joint and muscles for further rehabilitation in the exercise therapy room. And the same exclusion of the risk of the appearance of a contracture of the being from immobility.

Stage 2 target:
Regain muscle control through exercise. Special emphasis on coordination exercises and joint stretching exercises. Achieving a state in which it will be possible to walk without additional support, i.e. without crutches.

Stage 3 target:
Achieving a full range of motion in the ankle joint, restoring strength and endurance close to the initial values. Gradually there is a return to the usual way of life.

Complications

Speaking about the pathogenesis of trauma, rehabilitation and recovery procedures, it is important to talk about complications that develop just when the treatment plan is not followed. If the patient again loads the injured leg and ankle in particular, often new injuries can occur during ruptures against the background of an existing defect that has not yet fully healed. Failure to follow medical recommendations often leads to the development of inflammation at the site of injury, called tendinitis.