Postoperative rehabilitation strategies for acute Achilles tendon rupture

  To ensure safety, it is recommended to carry out rehabilitation training under the guidance of the rehabilitation physician and surgeon according to local conditions: ①Phase 1 (1-3 weeks): Absolutely no weight-bearing in the first week, protect the surgical site, remove external fixation, and actively perform plantarflexion/ dorsiflexion for 5 times; in the second week, plantarflexion/ dorsiflexion, internal and external rotation and circular motion for 20 times each; in the third week, gradually start to walk slowly with partial weight-bearing under the protection of a cast. In the third week, partial weight-bearing walking on the ground was gradually started under the protection of a cast, and 20 repetitions of gentle passive traction plantarflexion and internal/external rotation with a rubber band and non-weight-bearing activities in water were performed 3 times a day before continuing to increase active training.  Phase 2 (4-6 weeks): gradual change from partial to full weight-bearing, with the knee in 35 or 40° of flexion and increasing intensity of passive ankle flexion; full extension of the knee from week 5; internal and external rotation, plantarflexion/dorsal extension with a rubber band 20 times, 3 times daily; walking exercises with full floating in the water. Gentle lateral massage of the Achilles tendon and ultrasound therapy (mobile method, frequency 800-1000 KHz, speed 3-6 cm per second) were combined.  Phase 3 (6-12 weeks): Full weight-bearing was allowed and the limb was further stretched. The movement of the ankle joint in all directions was enhanced with a rubber band, hammer lifting was practiced within the weight-bearing range, and walking exercises were performed with complete floating in water; bicycle or walking machine training was performed. Adjunctive treatment as before.  Phase 4 (after 12 weeks): Increase the weight-bearing of the foot to normal weight, start jogging, treadmill training and trampoline training; outdoor exercise, etc.