Intermediate Achilles Tendon Rupture Repair Rehab
The Achilles tendon is the biggest and strongest tendon in the human body and is formed by the tendons of the soleus and gastrocnemius muscles which both insert at the calcaneus. We mostly see ruptures of the Achilles tendon in high-impact sports predominantly in the male athlete.
While a scientific review from the year 2017 showed no significant differences in the outcomes of surgical and conservative management the re-rupture rate of conservatively managed tendons was higher and conservative management might not be suitable for every injury depending on its severity. However, there is a clear benefit of an accelerated rehab program including early mobilization versus immobilization as has been researched by Brumann et al. (2014).
In another post, we covered what the first two weeks of rehab could look like. Having no pain at rest and no increase in swelling the patient may progress to more ankle mobility. In the second phase which can last up to three weeks, your goal should be to obtain a neutral ankle position and full plantarflexion range of motion. Make sure that the wound is healing properly and swelling continues to decrease, as well as work on restoring a normal gait pattern. You can continue to load the exercises from phase 1. But in phase 2 we are going to focus more closely on the ankle.
Continue exercises with an increase in load from the acute stage which is:
- Toe flexion & extension
- Straight Leg Raise
- Clam Shells with and without resistance bands
- Side-lying abductions with or without resistance bands or ankle weights
- Move the ankle/foot into full plantar flexion and move back to neutral
- Ankle/foot movement into supination and pronation (avoid dorsiflexion)
- Use resistance from a theraband for the first two exercises
In order to progress to the third stage, the patient should be pain-free at rest, achieve neutral ankle dorsiflexion and any remaining swelling or inflammation should be gone.
If you are interested in early and late phase rehab exercises for Achilles tendon rupture repair, check out the posts below:
Brumann M, Baumbach SF, Mutschler W, Polzer H. Accelerated rehabilitation following Achilles tendon repair after acute rupture–development of an evidence-based treatment protocol. Injury. 2014 Nov 1;45(11):1782-90.
Deng S, Sun Z, Zhang C, Chen G, Li J. Surgical treatment versus conservative management for acute Achilles tendon rupture: a systematic review and meta-analysis of randomized controlled trials. The Journal of Foot and Ankle Surgery. 2017 Nov 1;56(6):1236-43.
- Adam Stewart14/11/23The Big 3 - Advanced Rehabilitation of Hamstring, Quadriceps, and Calf Muscle- and Tendon Injuries VERY THOROUGH AND EXCELLENT JOB USING EVIDENCE BASED PRACTICE
Enda does a great job with this course and dives into as much detail as you would like throughout. Excellent job of keeping the most up-to-date information in the presentation. Takes time to get through it all, but very worth itOlivier Gouvernet11/10/23The Big 3 - Advanced Rehabilitation of Hamstring, Quadriceps, and Calf Muscle- and Tendon Injuries BIG §
The course is very well structured, the anatomical reminders are relevant, each stage of rehabilitation is well detailed and the videos of the exercises make it easy to see and understand what needs to be monitored and done.
In my opinion, the last phases of rehabilitation are the most interesting, as they are rarely covered. This helps to reduce the gap between the load at the end of treatment and the load of a return to sport.Jeremy Beyer05/09/23The Big 3 - Advanced Rehabilitation of Hamstring, Quadriceps, and Calf Muscle- and Tendon Injuries An excellent course on the rehabilitation and management of lower extremity muscle & tendon injuries! Enda covers serious range in this course with lessons on muscle & tendon physiology all the way to late stage rehab and discussions around power & reactive strength development. This course is comprehensive and covers many of the overlooked aspects of muscle and tendon rehab. Enda highlights foundational rehabilitation concepts in an easy to digest manner that is guaranteed to influence the way you practice.
- Beppeke Molenaar04/05/23The Big 3 - Advanced Rehabilitation of Hamstring, Quadriceps, and Calf Muscle- and Tendon Injuries EXCELLENT COURSE, INCREDIBLY KNOWLEDGEABLE
This is a fantastic course, with loads of information that is very applicable to daily practice.
I think this course has offered me the most in terms of learning and professional development out of all the courses I’ve done so far.
The set-up of the course is really well-structured. The videos are clear, the information in the text is evidence-based, very in-depth, and at the end of each unit, you can find further readings for anyone who wants to dive even deeper into the material.
I would highly recommend this course!Badrinath31/03/23The Big 3 - Advanced Rehabilitation of Hamstring, Quadriceps, and Calf Muscle- and Tendon Injuries The presentation is quite evidence based and evidence informed. It is presented in a structured manner. The author has put lots of effort. It is an application based course.Frederik Adriaensens30/12/22The Big 3 - Advanced Rehabilitation of Hamstring, Quadriceps, and Calf Muscle- and Tendon Injuries VERY NICE OVERVIEW OF ALL THE INFLUENCIAL MECHANICS AND REHAB OPTIONS
Thanks for the excellent refresher!
- Aemy den Hollander04/05/22The Big 3 - Advanced Rehabilitation of Hamstring, Quadriceps, and Calf Muscle- and Tendon Injuries AWESOME
the amazing amount of detail Enda gives was a huge Eye opener for me.
Not the regular elearning i was used to. love this!Nicolo16/01/22The Big 3 - Advanced Rehabilitation of Hamstring, Quadriceps, and Calf Muscle- and Tendon Injuries USEFUL AND INSPIRING
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If you really can learn all the notions , you’ll be a better physiotherapist for sure.Zico Verhaegen01/01/22The Big 3 - Advanced Rehabilitation of Hamstring, Quadriceps, and Calf Muscle- and Tendon Injuries GREAT COURSE
As a recently graduated physiotherapist working with athletes regularly, this course helped me a lot from assessing to building a rehab program for every individual.
- Lynn26/12/21The Big 3 - Advanced Rehabilitation of Hamstring, Quadriceps, and Calf Muscle- and Tendon Injuries Really good course. Much better understanding in Pathomechanics, risk factors and management of rehabilitation.Conall27/10/21The Big 3 - Advanced Rehabilitation of Hamstring, Quadriceps, and Calf Muscle- and Tendon Injuries EXCELLENT, PRACTICAL AND BACKED WITH INNOVATIVE METHODS FOR INJURY PREVENTION AND REHABILITATION
This course was excellent at breaking down the rehabilitation process of the big 3 (Quadriceps, Hamstrings and lower leg injuries). The content is very practical and applicable to advance your methods of rehabilitation and also to to develop robust methods for injury prevention and building resilience with your athletes. I particularly liked the progression of rehab shown from the acute stage right through to the return to training and performance phase. The exercises and rehab techniques highlight the importance of building structural strength and their progression and integration into more dynamic exercises as they relate to the phases of gait, running cycle and specific movement patterns in multiple planes . All material is supported with evidence based research, a list of further references and practical video demonstrations for you to practice.Paul Scurfield27/08/21The Big 3 - Advanced Rehabilitation of Hamstring, Quadriceps, and Calf Muscle- and Tendon Injuries BRILLIANT COURSE
This course was one of the best professional development courses I have ever been involved in.
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The level of detail in this course is amazing.
I would recommend this course to anyone who works in rehabilitation.
- Simone Ondoso21/06/21The Big 3 - Advanced Rehabilitation of Hamstring, Quadriceps, and Calf Muscle- and Tendon Injuries very nice course!