Achilles Tendon Rupture
Dr Jeff Ling & Dr David LunzSydney Orthopaedic Specialists: Foot & Ankle Institute
The Achilles tendon is the strongest tendon in the body. It is vitally important for walking and for any sporting activities.
Achilles tendon problems are very common and range from tendinitis and tendinosis (inflammation and degeneration of the tendon itself) to complete ruptures of the tendon.
Achilles tendon ruptures most commonly occur during sports such as a racquet sport or basketball. Patients feel a pop and often feel like someone has kicked them in the back of the leg. The treatment of an Achilles tendon rupture has been shown to be most successful with surgical treatment. Patients are more likely to return to their pre- rupture level if they have a surgical repair rather than non-operative management. This is because they are more likely to return to function earlier, maintain more power, strength, and endurance, and are exposed to a lower re-rupture rate.
Achilles rupture rehab protocol post surgical repair
- Non weight bearing for 2 wks in front plaster slab
- Wound review in office and sutures out 10-14 days post surgery
- Vacoped boot applied, weightbearing commenced in plantarflexion,
ROM exercises but no dorsiflexion past neutral (90°)
- Gradually reduce plantarflexion to 0° by 6 wks post op
- Change from wedge heel to flat heel at 8 wks
- Wks 8 - 12 in flat heel with hinge at neutral
- Wk 13 boot removed
Start physio at 6 weeks post-op
- ROM exercises continue
- Full plantarflexion permitted
- Dorsiflexion to no more than 10° past neutral for 4-6 wks
- After 12 wks, full dorsiflexion allowed
- Calf strengthening exercises including:
- Double stance heel raises progressing
to single leg heel raises and toe walking, leg curls
- Swimming is resumed at 3 months
- Jogging can be resumed at 5-6 months and running/cutting/pivoting sports at 7-8 months