Achilles tendon rupture injuries are a very common type of athletic injury to the foot and ankle, and the pain that exists during functional exercises is, in many cases, unavoidable. If the pain can subside to the original level within half an hour after the exercise is stopped, it usually does not cause damage to the tissue and should be tolerated.
I. Early flexion 30 degree plaster fixation period (0-3 weeks)
Purpose: To reduce pain, swelling; early muscle strength exercises, avoid muscle atrophy as far as possible.
(i) On the day of surgery.
After anesthesia subsides, start to move the toes; if pain is not obvious, try to contract the quadriceps muscle (i.e. anterior thigh muscle tensing and relaxation).
(ii) The day after surgery.
1. Move the toes – forcefully, slowly and as widely as possible, but never cause ankle movement! 5 minutes/group, 1 group/hour. Important for promoting circulation, decreasing swelling and preventing deep vein thrombosis
2. Quadriceps (anterior thigh muscle group) isometric exercises – i.e. thigh muscle tensing and relaxation, as much as possible without increasing pain, >500 times/day.
(iii) 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 for necessary daily activities (such as going to the toilet).
3.Start to try leg lifts – raise the leg to the heel 15M above the bed and hold it until exhaustion. 10 times/group, 2-3 groups/day.
4.Lateral leg lift exercise: 30 times/group, 30 seconds rest between groups, 4-6 groups in a row, 2-3 exercises/day; posterior leg lift exercise: prone, the affected leg straight backward lift until the toe is 5 cm from the bed for 1 time, 30 times/group, 30 seconds rest between groups, 4-6 groups in a row, 2-3 exercises/day.
According to the characteristics of the injury and surgery, the plaster brace should be worn for about 3-4 weeks in order to make the Achilles tendon heal firmly. During the fixation period, only the above exercises can be performed without the doctor’s permission, blind activity is likely to cause injury!
Second, medium-term mobility and muscle strength exercises period (4-12 weeks)
Review, and depending on the situation, the doctor will remove the cast brace to below the knee joint at 3 or 4 weeks. It must be worn for the rest of the time, except during exercises!
Purpose: To start mobility exercises and strengthen the leg muscles; to start weight-bearing exercises and gradually return to normal gait walking.
”Roller” exercises
1, choose a solid cylinder (such as wine bottles, cans, etc.), repeated exercises no more than 5 minutes. Before the exercise, you can soak your feet in hot water for 15 minutes to increase the temperature of the tissue to improve the ductility and strengthen the practice effect. After soaking the feet, sit on a chair, bend the knees, step on the cylinder with the affected foot and roll the cylinder back and forth, gradually increase the force and increase the activity, once a day. In this exercise, the pulling induction of the Achilles tendon is controlled to a lesser extent;
2.Start knee flexion exercises, because of the long time fixed knee mobility will be reduced, so the exercise may have pain at the beginning, persistent practice can be improved;
3.Start knee straightening exercises (prone suspension): put a pillow at the heel, make the affected leg leave the bed completely, relax the muscles so that the knee joint extends naturally. 30 minutes / time, 1 time / day, until the affected leg can be straightened and the same as the healthy side;
4.Start leg muscle exercises to restore atrophied thigh muscles during the cast fixation period: resistance to knee flexion, resistance to knee extension, leg lift in all directions, etc;
5.Week 7 after surgery: remove the cast, wear custom-made orthopedic shoes, about 3 cm heightened in the heel of the shoe; walk with crutches, about 2-3 days to remove part of the heightened thickness, until about 3 months after surgery, completely transition to walking in flat shoes;
6, 10 weeks after surgery, start passive Achilles tendon pulling exercises: the affected limb bending knee position, hold the affected side of the foot with both hands, pull inward with gentle force, 1-2 minutes / time, interval 5 seconds, 3-5 times / group, 1-2 groups / day, this exercise, the Achilles tendon pulling induction control in the medium degree, that is: pulling feeling is more obvious but can openly bear.
7.10 weeks after surgery, start squatting exercises to strengthen the leg strength;
8, 10 weeks after surgery, start resistance hook foot: during this exercise, pay attention not to feel the pulling sensation of Achilles tendon.
9, 10 weeks after surgery, start resistance foot straining: during this exercise, pay attention not to feel the pulling sensation of Achilles tendon.
Third, late (3 months later)
Purpose: to strengthen the joint mobility in all directions until it is as flexible as the healthy side; to strengthen the muscle strength and improve the joint stability; to resume daily life and gradually restore the movement ability.
Strengthen pulling the Achilles tendon with the affected limb bending the knee, lifting the foot, leaning forward, relying on the weight down to pull the Achilles tendon, pay attention to the strength must be controlled, avoid excessive pulling, avoid violent pulling.
Fixed bicycle exercise
From no load to light load, no obvious pulling sensation at the Achilles tendon. 20 minutes/time, 1-2 times/day. At the beginning of the exercise, the pedal of the bicycle should be placed after the arch of the foot, and pay attention to the force of the foot.
The sutured tendon is not strong enough during this period, so all exercises and training should be gradual and not forced or blindly adventurous. You should also strengthen your muscles to ensure the stability of the ankle joint in sports, and pay attention to safety and avoid falling!
Fourth, the recovery period (5-6 months later)
Purpose: Resume sports or strenuous activities; strengthen muscle strength and start running and jumping exercises.
1.After 3 months, you can start to walk slowly
2, 5-6 months to start heel lifting exercises, double foot heel lifting gradually transition to single foot heel lifting (not less than 5 months after surgery).
Heel lifting exercises – that is, standing on the tips of the feet, including the feet stand apart and shoulder width, the tips of the feet are forward; “outer eight” standing; “inner eight” standing three positions, in order to practice different muscles and different parts of the muscles. 2 minutes / time, rest 5 seconds, 10 times / group, 2-3 groups / day. During this exercise, be careful not to feel the pulling sensation of Achilles tendon.
3.Start front-to-back and side-to-side striding exercises: the striding range should not be too large! The Achilles tendon should not have excessive pulling sensation!
4.Progressive step by step! According to their own practice gradually fast walking – jogging – fast running – jump.
5, 10-12 months to resume the confrontational sports.