I. Early flexion 30 degree long leg cast fixation period (0-3 weeks)
Purpose: To reduce pain, swelling; early muscle strength exercises to avoid muscle atrophy as much as possible.
1. On the day of surgery.
After anesthesia subsides, start to move toes; if pain is not obvious, try to contract quadriceps (i.e. anterior thigh muscle tensing and relaxation).
2.One day after surgery.
Move your toes, hard, slowly and as widely as possible. But never cause the ankle joint to move! 5 minutes / group, 1 group / hour. (Important for promoting circulation, decreasing swelling, and preventing deep vein thrombosis) Quadriceps (anterior thigh muscles) isometric exercises, i.e. thigh muscle tensing and relaxation. Do as many as possible without increasing pain. (More than 500 times/day)
3.2 days after surgery.
(1) Continue the above exercises.
(2) You can walk with your feet off the ground with the help of crutches, but only to go to the toilet but necessary for daily activities.
(3) Start to try leg lifts – leg lifts to heel 15M above bed, hold until exhaustion. 10 reps/set, 2-3 sets/day (may not be completed due to heavy cast rest.) .
According to the characteristics of the injury and surgery, in order to make the Achilles tendon heal firmly, the plaster cast for the long leg should be worn for about 3 weeks, and after 3 weeks, it should be changed to plaster cast for the short leg for 3 weeks. During the fixation period, only the above mentioned exercises can be performed without the doctor’s permission, blind activity is likely to cause injury!
Second, the middle period – mobility and muscle strength exercises period (6-12 weeks)
1.3 weeks after surgery: (Depending on the situation, the doctor will decide to start joint mobility exercises.)
(1) Start lateral leg raising exercises, 30 times/group, 2-4 groups/day, 30 seconds rest between groups.
(2) Begin knee flexion exercises (because knee mobility will decrease with prolonged immobilization, so there may be pain at the beginning of the exercises, which will improve with persistent practice.)
(3) Start extension exercises (seated suspension): put a pillow at the heel, make the affected leg leave the bed completely, relax the muscles to make the knee joint extend naturally. 30 minutes/time, once a day, until the affected leg can be straightened and the healthy leg is the same.
(4) Start leg muscle exercises: to restore the atrophied thigh muscles during the plaster fixation period.
2.6 weeks after surgery: remove the plaster rest
(1) Cut cardboard into the size of the heel of the shoe, pad in the heel of the shoe about 3 cm, start walking with crutches, about 2-3 days to remove a layer of cardboard, 2-3 weeks to remove, transition to walking in flat shoes.
(2) Begin front-to-back and side-to-side striding exercises. Note: No excessive pulling sensation at the Achilles tendon!
3. 7 weeks after surgery.
Start static squatting or sliding exercises against the wall to strengthen the legs.
4.8 weeks after surgery.
(1) Strive to achieve normal gait walking within one to two weeks.
(2) Strengthen the intensity of pedaling exercises, gradually transition to and gradually increase the load to 30 times/group, 4 groups/day.
(3) Strengthen the muscle strength, and start the knee exercises of 45° single leg semi-squatting flexion and extension on the affected side. 5 minutes/time, 4 times/day.
III. Late stage: (3 months)
Objective: Strengthen the joint mobility until it is flexible and the same as the healthy side. Strengthen muscle strength and improve joint stability. Resume daily life and gradually regain motor ability.
1. Fixed bicycle exercises, no load to light load, no obvious pulling sensation at the Achilles tendon. 30 minutes/time, 1-2 times/day.
2 .Start pedaling exercises.