Achilles Tendon Rupture:
Surgical or non-surgical care involves physical therapy for reduction of swelling, healing of the damaged or repaired tendon, and restoring normal strength and ROM. Non-surgical treatment involves at least 8 weeks of casting with the foot in maximum plantar flexion (pointing of the foot), to bring the ends of the torn tendon to less than 5 mm apart for optimal results. After, ROM, strength, and functional Weight Bearing (WB) training begins, similar to post-operative protocols.
Post-surgical treatment protocols can differ widely from surgeon to surgeon and depend on the long-term goals of the patient relative to individual activities (i.e., serious athlete vs. week-end warrior) or general level of activity. What is generally agreed upon, however, is the need for conservative non-weight bearing (NWB) in the initial few weeks to allow the tissues to start mending and healing, in addition to ROM exercises for the lower leg inclusive of the knee, ankle, and foot. Progressive weight bearing (WB) as tolerated is encouraged to increase function as well as to increase the tensile strength of the tendon itself. It is interesting to note that when an aggressive approach to treatment was undertaken, findings included less pain, earlier return to work, and higher Achilles tendon strength.
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