Post-operative rehabilitation program for acute Achilles tendon rupture

  Re-rupture of the Achilles tendon after surgery sometimes occurs. The postoperative cast should be firmly fixed at the ankle joint, and the Achilles tendon suture should be edematous and under high tension in the early postoperative period to avoid re-rupture of the Achilles tendon caused by dorsal extension of the patient’s foot; when holding the crutches, attention should be focused to prevent accidental injury and avoid walking off the crutches; functional exercises should follow the principle of gradual progress and be carried out under the guidance of medical personnel, and jumping exercises should be prohibited for 3 months to avoid ankle joint Injury.  Training of crutches: To prevent re-injury after surgery, the patient should be taught the correct way to use crutches before surgery, told to concentrate on using crutches, look forward with eyes, do not hold the crutches with head down, wear comfortable and light shoes when walking with crutches, the width of both crutches should be slightly wider than both shoulders, support the crutches by force with both upper limbs, do not use axillary support, avoid damage to the brachial plexus nerve by axillary pressure, and do not walk when the ground is slippery.  1.1-3 weeks after surgery The active extension and flexion exercises of the metatarsophalangeal and interphalangeal joints and the isometric contraction exercises of the quadriceps muscle will be carried out on the first day after surgery to prevent quadriceps atrophy. On the second postoperative day, patients can practice muscle strength of both upper limbs and the healthy lower limbs in bed, while practicing straight leg raising on the affected limb at least three times a day for 15-20 min in 3-5 sets, and actively moving the toe joints to facilitate blood and lymphatic fluid return. On the third postoperative day, the affected limb can be elevated in bed under plaster fixation, and the affected limb can be walked on the ground with the help of crutches under non-weight-bearing conditions.  2.The fourth week after surgery, the long leg plaster posterior support will be sawed short to 3cm below the fibular tuberosity, gradually restore the range of motion of the knee joint, remove the plaster support daily, immerse the Achilles tendon area in warm water or Chinese medicine soup, then massage the Achilles tendon, and increase the mobility of the ankle joint appropriately.  3.5th week after surgery In addition to the rehabilitation content in the 4th week, increase the exercise with foot roller, the roller should be sitting on a bed or chair with suitable height, the length of the cylinder is 30-40cm, the diameter is 10-15cm, the feet step on the roller and roll back and forth, use the healthy side to assist the affected side to complete the exercise, 1-2 times a day, 20-30 minutes each time.  4. 6-8 weeks after surgery Remove the cast and walk in shoes, put a heel pad of 2.5-3cm thickness composed of 10 layers of thin plates between the heel and the shoe, remove one piece every 2 days, and when there are 3 pieces left, remove one piece every 3 days until it is finished, 23 days in total. At this time, the flexion and extension activities of the ankle joint are close to normal, and office workers can participate in work, but care should be taken to avoid falls and sudden stomping movements, otherwise the Achilles tendon will be easily re-ruptured.  5.9-12 weeks after surgery Further practice ankle joint range of motion, start calf triceps muscle strength exercise, start to perform bipedal heel raising exercise, gradually increase the burden of the affected limb, and finally transition to single foot heel raising, at this time, those engaged in light work can start to work, but should still pay attention to prevent falls or sudden stomping action on the post-operative Achilles tendon strain.  6, 13-24 weeks after surgery Continue to practice the single-footed heel, completely restore the range of motion of the ankle joint, start jogging exercises, gradually improve the flexibility of the ankle joint and the muscle strength and coordination of the calf triceps, athletes can resume small-motor training, medium physical laborers can work.  7.After 24 weeks postoperatively, athletes can participate in formal training and heavy manual workers can participate in work.