For best outcomes, the achilles tendon repair is typically performed within 2 weeks of the injury and recovery is expected to take between 6 to 9 months. Rehabilitation protocols ohio state sports medicine. The path to regaining range of motion, strength and function can require a sustained and coordinated effort from the patient, his or her family, the ohio state sports medicine physical therapy team and sometimes, other healthcare providers. It is designed for rehabilitation following postoperative achilles tendon repair.
A multicenter randomized trial using accelerated functional rehabilitation kevin willits, annunziato amendola, dianne bryant, nicholas g. Rehabilitation protocol the boot vacoped the boot can be removed when seated, for bathing, but when off, no weight through foot the boot must remain on at all other times. This was shown effective with patellar tendinopathy and further research is required into other tendinopathies. Rehabilitation guidelines for achilles tendon repair uw health. Specific intervention should be based on the needs of the individual and should consider exam findings and clinical decision making. Calf girth, plantar flexor strength and ankle rom are all keys to full recovery. This protocol for achilles tendon repair is designed to provide the rehabilitation professional with a general guideline for patient care with the. Surgery is only the beginning of a long rehabilitation. It is designed for rehabilitation following post operative achilles tendon repair. This is generally in the weekend warrior, recreational athlete, in his late 20s to early 40s.
To learn more about how we repair achilles tendon ruptures without an open surgery, please refer to our explanation of achilles tendon. The ideal is to achieve full symmetry in all 3 areas. Accelerated rehabilitation following achilles tendon. The optimal postoperative rehabilitation protocol after surgical repair of an achilles tendon rupture is unknown. Postoperative rehabilitation protocols for achilles tendon.
Achilles tendon rupture nonsurgical and surgical protocol. Inv, ev, pf light theraband, light manual resistance. Soft tissue mobilization to anklefooteffleurage for edema. Rom should be measure in both open and closedchain methods.
Achilles tendon rupture, march 2018 1 achilles tendon rupture. The area that the flap was harvested from is then stitched together figure 3. Achilles tendon repair rehabilitation postoperative guideline this rehabilitation program is designed to return the individual to their activities as quickly and safely as possible. The primary goal of this protocol is to protect the repair while steadily progressing towards and ultimately achieving preinjury level of activity. Sports medicine center for musculoskeletal care 333 east 38th street new york, ny 10016 tel.
The doctor or his associate will do a preoperative history and physical examination and complete the necessary. 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 repair surgery rehabilitation protocol preoperative instructions here are guidelines that will help you in preparing for surgery to repair your achilles tendon. The injury is often accompanied by an audible and palpable pop with limited ability to push off of the injured limb. Achilles tendon repair rehabilitation protocol the following is a protocol for postoperative patients following achilles tendon repair.
Achilles tendon repair and rehab pdf anterior cruciate ligament more about uw health sports rehabilitation acl rehabilitation. Rehabilitation guidelines for distal biceps tendon repair. Achilles tendon repair rehab protocol below we outline the steps that we have our patients take to recover from achilles tendon repair surgery. Define the protocol to be followed for all patients referred from northwestern orthopedics after the above procedure has been performed. Modifications to this guideline may be necessary dependent on physician. Achilles tendon repair protocol the following protocol is subdivided into four general phases. Here are guidelines that will help you in preparing for surgery to repair your achilles tendon. The tendon transmits force from the contracting calf muscles to. After open repair, early functional rehabilitation improves outcome, but there are risks of infection and poor wound healing.
Acute versus chronic, as well as, concomitant procedures, and physiologic age of the patient. Manual resistance exercises, but cautious with df resistance. Patellar tendon debridement patellofemoral rehabilitation pcl reconstruction single leg exercise progression. Cole,md,mba weight bearing brace rom exercises phase i 02 weeks as tolerated with crutches and brace locked in full extension for sleeping and all activity off for exercises and hygiene 02 weeks. Rehabilitation guidelines for achilles tendon repair. Achilles tendon repair postop protocol penrose physical. David gordon, consultant orthopaedic surgeon achilles tendon repair post operative accelerated rehabilitation protocol. Achilles tendon rupture atr is a common sports injury, with a rising incidence and significant impairments. Sports medicine physical therapy rehabilitation protocols. What is the effect of the early weightbearing mobilization without using any support after endoscopyassisted achilles tendon. The achilles tendon usually rupt ures without warning.
Consequently, physicians may have reservations about adopting. Historically it has been thought that a surgically repaired achilles tendon offered a significantly smaller risk of rerupture rate and increased strength in. Please use extreme caution when using assistive devices such as crutches, walker or rollabout. Achilles tendon rupture affects about 1 in 15,000 people at any one time, increasing to 1 in 8,000 in competitive athletes. Achilles tendon repair rehabilitation postoperative guideline. Achilles tendon rupture repair return to sport protocol.
Uw health s sports medicine sports rehabilitation physical therapists and athletic trainers in madison, wisconsin, help injured athletes return to health and return to sport. The rehab protocol for repaired and nonsurgical repaired achilles tendon ruptures are very similar. You may learn more about how the stone clinic repairs achilles tendon ruptures without open surgery in our explanation of achilles tendon injury, diagnosis and. Adductor release rehab protocol hamstring strain proximal hamstring repair. It is not intended to be a substitute for ones clinical decision making. Tendon neuroplastic training uses strengthbased training with external cues as a strategy to optimise neuroplasticity. Peroneal tendon repair south carolina sports medicine. Accelerated rehabilitation has been advocated after achilles tendon repair, but it produces significant forces at the repair site. Achilles tendon repair protocol sheet for clinicians alterg. We provide our patients with comprehensive, coordinated care from experts who understand the unique needs of women in sports.
Achilles repair protocol northwestern medical center. The surgically repaired achilles will typically be removed from a cast and switched to a removable cast boot a little sooner than the nonsurgical achilles tendon rupture. As such, it ought to be stressed that this is just a protocol and ought to not be an alternative to expert medical decisionmaking concerning a patients progression. Achilles tendon repair is performed after injury occurs to the achilles tendon. Rehabilitation guidelines after surgery, sports medicine. As with any muscle or tendon in the body, the achilles tendon can be torn if there is a high. Postop days 1 10 bracesplint watch for skin breakdown crutches non weight bearing nwb active motion arom hip and knee wiggle toes straight leg raise slr x 4 lower extremity le stretches hamstring, quads, itb, hip flexors ice. Rehab practice guidelines for achilles tendon repair. Avoid all passive motion into df for 1st 6 weeks postop 3. Begin weight bearing with the castboot when walking activities 1. Insertional achilles tendon repair rehabilitation protocol. Although a 6week cast immobilization is common, many early functional.
Rehabilitation protocol general principles this protocol for achilles tendon repair is designed to provide the rehabilitation professional with a general guideline for patient care with the alterg antigravity treadmill. Insertional achilles tendon repair rehabilitation protocol home. Avoid creating pain discomfort is okay but pain should not occur and persist 3 days in a row. Treatment options for an achilles tendon rupture include surgical repair and conservative nonsurgical rehabilitation. Sep 26, 2015 surgical repair after acute achilles tendon rupture leads to lower rerupture rates than nonsurgical treatment. Long term results of acute achilles repair with triplebundle technique and early rehabilitation protocol. If it does, rest the patient until pain level is clearly decreasing. 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.
Accelerated rehabilitation following achilles tendon repair after acute rupture development of an evidencebased treatment protocol. Achilles tendon repair postop rehabilitation protocol. It connects the calf muscles gastrocnemius and soleus to the heel calcaneus. The path to regaining range of motion, strength and function can require a sustained and coordinated effort from the patient, his or her family, the ohio state sports medicine physical therapy team and. It is hypothesized that this lack of consensus and guidelines leads to suboptimal recovery and higher societal costs. It attaches the calf muscles soleus and gastrocnemius to the heel bone calcaneus.
Achilles tendon rupture rehabilitation surgical repair evidencebased treatment protocol weight five bearing ankle full mobilization immobilization functional treatment a b s t r a c t the acute rupture of the achilles tendon is a protracted injury. When the walker brace is removed, no weightbearing or dorsal extension of the foot is allowed. Table e1 achilles tendon rupture rehabilitation protocol time frame activity 02 weeks posterior slabsplint. The achilles is the largest tendon in the human body and transmits the powerful contractions of the calf muscles that are required for walking and running. Rehabilitation guidelines for achilles tendon repair the achilles tendon is the strongest and thickest tendon in the body. You may learn more about how the stone clinic repairs achilles tendon ruptures without open surgery in our explanation of achilles tendon injury, diagnosis and treatment. Nov 25, 2019 the yearly incidence of achilles tendon rupture is up to 37 per 100,000 individuals. It can occur at any age but is most common between the ages of 30 and 50.
Achilles tendon repair phase i postoperative period weeks 01 nonweight bearing splint immobilization daily icing, compression and elevation home program phase ii weeks weightbearing. If at any time after surgery you notice increasing pain, redness. Rehab protocols southeast georgia rehabilitation program. Operative versus nonoperative treatment of acute achilles tendon ruptures. This protocol for achilles tendon repair is designed to provide the rehabilitation professional with a general guideline for patient care with the alterg antigravity treadmill.
Specificity of sport or activity each of these phasesread more. Development of an accelerated functional rehabilitation. Brian grawe, md progression is based on healing constraints and functional progression specific to the patient. Elbow strengthening exercises golfers elbow tennis. Table e1 achilles tendon rupture rehabilitation protocol. Maintain independent ambulation pain and oedema control protection of operated foot in a shortleg nonweightbearing cast in a plantarflexed.
Defining components of early functional rehabilitation for. Phases and time frames are designed to give a general sense of progression. Haglunds lesion resection and achilles tendon reattachment postoperative rehabilitation protocol phase 1 weeks 14. This protocol provides you with general guidelines for initial stage and progression of rehabilitation according to specified time frames, related tissue tolerance and directional preference of movement. The tendon transmits force from the contracting calf muscles to the calcaneus to cause the foot action of plantar. Brace locked at 0 degrees for ambulation for 68 weeks with use of bilateral axillary crutches. As tolerated in cam walker boot with heel wedges in place first wedge removed at 4 weeks, second wedge removed at 6. Achilles tendon rupture repair return to sport protocol keys for achilles tendon rehabilitation. Rehabilitation protocol the boot vacoped the boot can be removed when seated, for bathing, but when off, no weight through foot. The yearly incidence of achilles tendon rupture is up to 37 per 100,000 individuals. Ohio state physicians and physical therapists work collaboratively to develop best clinical practices for postsurgical rehabilitation. Postoperative protocol peroneal tendon repair please note these are general guidelines and may change for various reasons on a casebycase basis. However, it does occur less commonly in the highlevel competitive athlete.
This protocol provides you with general guidelines for initial stage and progression of rehabilitation according to specified. Achilles tendon repair phase i postoperative period weeks 01 nonweight bearing splint immobilization daily icing, compression and elevation home program phase ii weeks. Specific changes in the program will be made by the. Find pdfs of our most common rehabilitation protocols. Achilles tendon repair rehabilitation protocol this rehabilitation protocol was developed for patients who have had a repair of an acute achilles tendon rupture. Insertional achilles tendon repair rehabilitation protocol this protocol provides you with general guidelines for initial stage and progression of rehabilitation according to specified time frames, related tissue tolerance and directional preference of movement. Development of an accelerated functional rehabilitation protocol following minimal invasive achilles tendon repair. As such, it should be stressed that this is only a protocol and should not be a substitute. Also, heel lift removal is also md dependent and communication with the md should be made to.