Achilles tendon repair postop rehabilitation protocol. 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. As such, it should be stressed that this is only a protocol and should not be a substitute. It can occur at any age but is most common between the ages of 30 and 50. Achilles tendon repair and rehab pdf anterior cruciate ligament more about uw health sports rehabilitation acl rehabilitation. Rehabilitation protocols ohio state sports medicine. Pad placement medial and lateral gastrocnemius 2,500 hz modulated at 75 bursts per second 2 second ramp time 10 on 50 second off 1015 contractions. For best outcomes, the achilles tendon repair is typically performed within 2 weeks of the injury and. Rom should be measure in both open and closedchain methods. If it does, rest the patient until pain level is clearly decreasing. Achilles tendon repair postop protocol penrose physical. Below we outline the steps that we have our patients take to recover from achilles tendon repair surgery. It is designed for rehabilitation following post operative achilles tendon repair.
This protocol for achilles tendon repair work is developed to supply the rehab professional with a basic standard for patient care. Early weight bearing and an accelerated rehab has been shown to result in improved functional outcomes after achilles tendon repairs. The sports physical therapy service is an integral part of the sports medicine center and the department of. This was shown effective with patellar tendinopathy and further research is required into other tendinopathies. Massage the tendon with your figers achilles tendonitis. Achilles tendon repair is performed after injury occurs to the achilles tendon. 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 and elevation. Nonoperative treatment of achilles tendon ruptures phase. We provide our patients with comprehensive, coordinated care from experts who understand the unique needs of women in sports. Oct 2012 general the rehab protocol for repaired and nonsurgical repaired achilles tendon ruptures are very similar. 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. 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.
As with any muscle or tendon in the body, the achilles tendon can be torn if there is a high. The surgically repaired achilles will typically be removed from a cast and switched to a. Achilles repair rehabilitation protocol key considerations. Rehab practice guidelines for achilles tendon repair. This rehabilitation protocol was developed for patients who have had a repair of an acute achilles tendon rupture. Sports medicine physical therapy rehabilitation protocols. Achilles tendon rupture nonsurgical and surgical protocol. Find pdfs of our most common rehabilitation protocols. Kaar, md department of orthopaedic surgery sports medicine and shoulder service achilles tendon repair rehab protocol prescription. They are provided as an educational resource, are not intended to replace the advice of a medical professional, are the property of the ohio state university wexner medical center and should not be copied. 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. Also, heel lift removal is also md dependent and communication with the md should be made to. 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. Accelerated achilles protocol time frame activity 02 weeks posterior slabsplint.
Over time the tendon may become thickened causing constant or recurring pain and stiffness. Achilles insertional repair and retrocalcaneal exostectomy postoperative protocol total 10 weeks of immobilization nonweightbearing x 4 weeks weightbearing in boot x 6 weeks first postoperative follow up cast application within 25 days after surgery nonweightbearing in a cast in equinus toes pointed down for 2 weeks. Achilles tendon repair rehabilitation protocol this rehabilitation protocol was developed for patients who have had a repair of an acute achilles tendon rupture. Nonoperative treatment of achilles tendon ruptures phase 1. Achilles tendon rupture atr is a common sports injury, with a rising incidence and significant impairments. Specific intervention should be based on the needs of the individual and should consider exam findings and clinical decision making. Achilles tendon rupture repair return to sport protocol. Modifications to this guideline may be necessary dependent on physician.
As such, it must be stressed that this is just a protocol and needs to not be a substitute for expert clinical decisionmaking regarding a patients development. Achilles tendon rupture accelerated functional rehabilitation. Rehabilitation protocol achilles tendon repair alterg. Achilles tendon repair rehab guidelines brian grawe, md. The primary goal of this protocol is to protect the repair while steadily progressing towards and ultimately achieving preinjury level of activity. Depending on the severity of your injury, you may be required to wear a cam boot or removable cast for four to six weeks. Avoid all passive motion into df for 1st 6 weeks postop 3. Department of physiotherapy department of sport and. Rehabilitation guidelines after surgery, sports medicine. Avoid creating pain discomfort is okay but pain should not occur and persist 3 days in a row. This leads to repeated small amounts of damage within the tendon fibres, and results in the tendon trying to heal itself in response to the strain.
These rehabilitation recommendations are based upon the guidance of content experts and evidence. These care protocols provide a synopsis of guidelines for individuals recovering from sportsrelated surgery with ohio state sports medicine. Insertional achilles tendon repair rehabilitation protocol home. Table e1 achilles tendon rupture rehabilitation protocol time frame activity 02 weeks posterior slabsplint. What causes achilles tendinopathy is still not completely understood, but we know tendinopathy occurs when a tendon is unable to adapt to the strain being placed upon it. Achilles tendon repair postop 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.
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. Specific changes in the program will be made by the. Achilles tendon rupture accelerated functional rehabilitation protocol 0 2 weeks aircast boot with 2 cm heel lift nwb with crutches 2 6 weeks aircast boot with 2 cm heel lift protected weightbearing with crutches as required active plantar and dorsi flexion to neutral, inversion eversion below neutral. Achilles tendon repair rehab protocol below we outline the steps that we have our patients take to recover from achilles tendon repair surgery. It attaches the calf muscles soleus and gastrocnemius to the heel bone calcaneus. Acute versus chronic, as well as, concomitant procedures, and physiologic age of the patient. The achilles tendon usually rupt ures without warning. These protocols are listed by diagnosis, so clinicians who are providing patient care may reference the applicable protocol to help rehabilitate their patient. Achilles tendon repair phase i postoperative period weeks 01 nonweight bearing splint immobilization daily icing, compression and elevation home program phase ii weeks weightbearing. Table e1 achilles tendon rupture rehabilitation protocol. In the late rehab phase after achilles tendon rupture repair you should focus more closely on proprioception. Kaar, md, william mitchell, md and lauren smith,pac department of orthopaedic surgery sports medicine and shoulder service.
Department of physiotherapy department of sport and exercise. The tendon transmits force from the contracting calf muscles to the calcaneus to cause the foot action of plantar flexion foot pointed down. Achilles tendon repair rehabilitation protocol the following is a protocol for postoperative patients following achilles tendon repair. Rehabilitation guidelines for achilles tendon repair. 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. Calf girth, plantar flexor strength and ankle rom are all keys to full recovery. In general, you can expect to be immobilized initially after your achilles tendon tear. Rehabilitation guidelines for achilles tendon repair the achilles tendon is the strongest and thickest tendon in the body. The information contained in these standards of care or protocols is not intended in any way to be used as primary medical advice or to replace medical advice offered by physical, occupational, speech therapists or other health care professionals. The intent of posting these standards of care and protocols is to provide clinicians and patients. Mar 15, 2016 this protocol for achilles tendon repair work is developed to supply the rehab professional with a basic standard for patient care. Achilles tendon rupture non surgical and surgical protocol last modified.
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. You may learn more about how the stone clinic repairs achilles tendon ruptures without open surgery in our explanation of achilles tendon injury. 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. Amol saxena, dpm, facfas achilles insertional repair and. Rehabilitation protocol for achilles tendon repair this protocol is intended to guide clinicians and patients through the postoperative course for an achilles tendon repair.
The following tips will help you treat your symptoms. Insertional achilles tendon repair rehabilitation protocol. The injury is often accompanied by an audible and palpable pop with limited ability to push off of the injured limb. 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. Achilles tendon rupture accelerated functional rehabilitation protocol 0 2 weeks aircast boot with 2 cm heel lift nwb with crutches 2 6 weeks aircast boot with 2 cm heel lift protected weightbearing with crutches as required active plantar and dorsi flexion to. Physical therapy standards of care brigham and womens.
Achilles tendon repair rehabilitation postoperative guideline this rehabilitation program is designed to return the individual to their activities as quickly and safely as possible. Rest gives the tendon time to heal and repair itself. Achilles tendon rupture non surgical and surgical protocol. Rehabilitation protocols southeast georgia health system. Achilles tendon repair rehabilitation postoperative guideline. Accelerated achilles protocol indiana total therapy. Achilles tendon rupture affects about 1 in 15,000 people at any one time, increasing to 1 in 8,000 in competitive athletes.
The tendon transmits force from the contracting calf muscles to. Rehabilitation protocols the protocols listed below were developed by southeast georgia health system physicians and therapists and are intended for use by clinicians and patients alike. The ideal is to achieve full symmetry in all 3 areas. This protocol has been developed for the patient following achilles tendon repair. The area that the flap was harvested from is then stitched together figure 3. The tendon transmits force from the contracting calf muscles to the calcaneus to cause the foot action of plantar. Achilles tendon rupture nonoperative rehabilitation protocol. 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. It is hypothesized that this lack of consensus and guidelines leads to suboptimal recovery and higher societal costs.
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