What is an Achilles tendon rupture?
Achilles tendon rupture is a common condition that usually occurs during sports or when you fall and are unprepared. A violent muscle contraction causes the tendon to tear. Patients usually experience a sensation as if someone or something has hit the muscle in the back of the calf, followed by a sudden onset of pain, although they can walk, and weakness in the leg.
Although it is possible to treat the ruptured tendon non-surgically, this approach is not the ideal solution because the maximum contraction of the muscle and Achilles tendon is not restored with non-surgical treatment. Therefore, surgery is necessary to repair the ruptured tendon. Surgery is performed to restore the maximum contraction of the Achilles tendon as well as the normal propulsive force of the affected foot. The contractile force of the muscle depends on the precise construction of the proper tension between the muscle and the tendon, and this can only be achieved by precise repair of the tendon stump.
After tendon repair, walking is not allowed for 14 days, after which you can start walking in a removable boot. The design of the boot is very important and it is important to control the movement of the foot in the boot after surgery. Previously, a cast was used for immobilization, which often resulted in severe and permanent muscle weakness and atrophy.
About 15 years ago, with the application and expansion of new Achilles tendon surgery techniques and new post-operative rehabilitation methods, there has been a dramatic change in the recovery of the Achilles tendon after surgery, allowing for maximum recovery of the tendon and rapid restoration of muscle strength.
After surgery, a removable boot was worn in place of a cast and walking was soon possible without the need for crutches. This treatment has yielded excellent results in the rehabilitation process, and therapy and exercise can begin shortly after surgery.
General recovery
The goal of the surgery is to achieve complete healing and full recovery of muscle strength in as short a time as possible. After surgery, the patient will need to use a brace for 10-14 days, and then the patient will begin walking in a removable boot. The boot has a hinge that allows the foot to move downward (plantarflexion), but will restrict upward movement (dorsiflexion). Post-operative walking and exercise are very important.
Special post-operative rehabilitation process
Day 1
The foot is bandaged and then temporarily immobilized in a plaster splint.
Apply cold compresses, elevate the foot, and take pain medication.
The foot may be numb for 4-12 h, followed by pain, which may be relieved by intravenous pain medication.
Do not drop the affected foot.
Stimulate the gastrocnemius muscle by moving the toes as much as possible.
Day 14
The first follow-up visit is performed in the outpatient clinic.
The dressing is changed and the boot is put on and kept in a mild horseshoe position.
The affected foot can be moved downward (plantarflexion).
Full weight bearing is started with the boot on.
May drop the affected foot until week 3.
Weeks 2 – 6
The boot may not be set to a neutral position until the end of week 6.
More vigorous exercises are done under the guidance of a physical therapist.
The boot can be removed after 8 weeks.