Rehabilitation program after Achilles tendon rupture suture:
1.0-4 weeks after surgery
On the day of surgery.
After the anesthesia subsides, start moving your toes; if the pain is not obvious, try to contract the quadriceps muscle i.e. thigh muscle tensing and relaxation. Do as much as possible without increasing pain. Greater than 500 times/day.
1 day after surgery.
(1) Movement of the toes.
Move the toes vigorously, slowly and as widely as possible. But never cause movement of the ankle joint! 5 times/group, 1 group/hour.
(2) Continue and strengthen the quadriceps isometric exercises.
2 days after surgery.
(1) Continue the above exercises.
(2) Walk with the affected foot without touching the ground, but only to the toilet but necessary daily activities.
(3) Start straight leg raising exercises, including upward, inward lateral leg raising and abducted lateral leg raising, backward posterior leg raising exercises to strengthen the muscles of the anterior and posterior medial and lateral thighs to avoid excessive atrophy and weakness. 30 times/group, 30 seconds rest between groups, 4-6 groups in a row, 2-3 exercises/day. It is possible that the exercise cannot be completed due to the excessive weight of the plaster rest.
2.4-12 weeks after surgery
The cast is usually removed at 4 weeks to below the knee joint. 4 weeks after surgery: (Start joint mobility exercises according to the doctor’s decision.)
(1) Ankle passive mobility exercises
Passive flexion, extension and internal and external rotation of the ankle joint, slowly, with force, to the maximum. However, it must be within the range of no or minimal pain! Because early tissue healing is not yet strong enough, excessive stretching may cause undesirable consequences. 10-15 minutes/time, 2 times/day. Soak feet in hot water for 20-30 minutes before practice to increase tissue temperature to improve extension and enhance the practice effect.
(2) Start knee flexion exercises.
15-20 minutes/time, 1-2 times/day. Because the mobility of the knee joint will decrease after a long time of fixation, there may be pain at the beginning of the exercise, which can be improved by persistent practice.
(3) Start knee extension exercises
15-20 minutes/time, 1-2 times/day. Because the mobility of the knee joint will decrease after a long time of fixation, there may be pain at the beginning of the exercise, which can be improved by perseverance.
(4) Start leg strength exercises
To restore the atrophied thigh muscles during the plaster fixation period. Exercise the absolute strength of the leg, choose a medium load (the amount of load to complete 20 movements that feel fatigue), 20 times / group, 2-4 groups of continuous exercises, rest 60 seconds between groups, until fatigue.
5 weeks after surgery.
(1) Start passive ankle flexion and extension exercises, gradually increase the force and mobility, 10-15 minutes/time, 2 times/day. The mobility exercises should be performed gradually, so that the mobility of the ankle joint (i.e. the range of motion) is the same as that of the healthy side within 2-3 months.
(2) Internal and external ankle joint mobility exercises
Slowly, forcefully and maximally turn the ankle joint inward and outward. It must be within the range of no or minimal pain, and gradually increase the angle and strength of movement! Excessive stretching may cause adverse consequences because the tissue healing is not strong enough yet. 10-15 minutes/time, 2 times/day.
You can soak your feet in hot water for 20-30 minutes before the exercise to increase the tissue temperature to improve ductility and enhance the exercise effect.
6 weeks after surgery.
Remove the cast and begin to wear shoes with a padded heel to gradually bear weight and resume walking.
(1) Cut cardboard into the size of the heel of the shoe, put it inside the heel of the shoe about 3 cm, start walking with the help of crutches, remove the cardboard layer in about 2-3 days, and finish it in 2-3 weeks, and transition to walking with a flat shoe.
(2) Begin front-to-back and side-to-side striding exercises.
Forward striding exercises
20 times/group, 30 seconds interval between groups, 2-4 groups in a row, 2-3 times/day. Requires slow, controlled movements and no swaying of the upper body.
Backward stride exercise
20 times/group, 30 seconds interval between groups, 2-4 groups in a row, 2-3 times/day. Requires slow, controlled movements and no swaying of the upper body.
Lateral straddle exercise
After the strength is increased, both hands can be used to lift heavy objects as load or add sandbags at the ankle joint as load. 20 times/group, 30 seconds interval between groups, 2-4 groups in a row, 2-3 times/day.
7 weeks after surgery.
(1) Start static squatting exercises to strengthen the leg strength in order to strengthen the function of the lower limb and the control of the whole lower limb. 2 minutes/repetition, 5 seconds rest, 10 times/group, 2-3 sets/day.
(2) resistance to rubber band resistance to complete the “hook foot (toe up hook action)” action, 30 times / group, 30 seconds rest between groups, 4-6 groups of continuous, 2-3 exercises / day.
(3) resistance “taut foot”
Resist the resistance of the rubber band to complete the “tense foot (toe down movement)” action, 30 times / group, 30 seconds rest between sets, 4-6 sets in a row, 2-3 exercises / day.
8 weeks after surgery.
(1) Seek to achieve normal gait walking.
(2) Continue to strengthen the muscles around the ankle joint.
Sitting down leg “hook foot” exercise
Resist the weight of sandbags and other heavy objects as resistance to complete the movement, 30 times/group, 30 seconds rest between groups, 4-6 groups in a row, 2-3 times practice/day.
Resistance inside-out and outside-in exercises; resistance to rubber band to complete the action, 30 times / group, 30 seconds rest between groups, 4-6 groups in a row, 2-3 times practice / day.
(3) Strengthen the muscle strength of the lower limb, start the single knee squat exercise on the affected side
Requires slow, controlled movements and no swaying of the upper body. If necessary, lift heavy objects with both hands to increase the difficulty of the exercise. 3-5 minutes/time, 2-3 times/group, 2-3 groups/day.
3.3 months after surgery
(1) You can use stationary bicycle exercises if you have the conditions, no load to light load, no obvious pulling sensation at the Achilles tendon. 30 minutes/time, 1-2 times/day.
(2) Swimming can be started. But absolutely avoid slipping!
(3) The athlete starts special exercises for the base movement. However, the sutured tendon is not strong enough during this period, so the exercises and training should be gradual, not forced or blindly adventurous. And the muscle strength should be strengthened to ensure the stability of the ankle joint in the movement, and should pay attention to safety, absolutely avoid falling again!
(4) You can start the transition from slow walking to fast walking exercises.
(5) Start heel lifting exercises (i.e. stand on your toes, 2 minutes / time, rest 5 seconds, 10 times / group, 2-3 groups / day.) Gradually transition from double heel lifting to single foot heel lifting.
(6) can begin to try.
Protect the lower full squat (evenly distribute the weight between the legs and make the buttocks touch the heel as much as possible. 3-5 minutes/rep, 1-2 times/day.
Step front down exercise (after the strength is increased can be hands can lift heavy objects for the load or add sandbags at the ankle joint for the load. 20 times/group, 30 seconds interval between groups, 2-4 groups in a row, 2-3 times/day.
(7) Return to exercise from 6 months after surgery.