Exercises | Physiotherapy for an Achilles tendon rupture

Exercises

1. Supporting exercises First of all the supporting should be practiced to get along with the walking aids and not to load the foot, one begins therefore with the supporting strength training. This is done by supporting the edge of the bed or back of the chair with the hands or with the help of a theraband, which is attached to a railing or a bar and the elbows are stretched.
2. PNF (Proprioceptive Neuromuscular Facilitation) In order to avoid stress on the foot, with the support of a therapist, muscular tension can be achieved across the diagonal of the body (PNF pattern). The patient tenses with the arm upwards outwards against resistance, thus ensuring that the tension continues into the affected opposite leg.

   PNF is a therapeutic treatment technique and involves 3-dimensional movements that are typical in everyday life. With this treatment technique, in addition to mobilization, strength can also be improved and it addresses the extremities, i.e. hand, elbow and shoulder, as well as hip, knee and foot, so that complete tension is created. The technique proceeds in a specific direction of movement and setting.

   If the foot is not under load, it cannot be included in the movement, but the PNF leg pattern can be performed for the hip and knee muscles. The therapist guides the leg into a final flexion, external rotation and abduction (spreading the leg) or flexion, internal rotation and adduction (pulling the leg up) (combinations must be adhered to according to the PNF), while the knee is also flexed and the foot is left in a neutral position. Then he returns the leg to the stretched position and repeats the procedure until the patient is able to carry the movement without errors.In order to get a muscular tension the therapist lets the patient execute the direction of movement independently and also gives a resistance in the certain directions of movement.

   The patient can do the exercise alone without guided resistance to avoid a large loss of strength in the leg.

3. Cycling while lying down: In addition to PNF techniques, exercises such as cycling in a lying position without involving the feet are suitable for maintaining muscle strength. As long as a load is not allowed, no exercises with pressure over the foot, such as knee bends or bridging, may be performed.
4. Start of muscle training: Once the load is released, the calf muscles should be trained. The push up to the heel position must be worked slowly, but can be used as an optimal strengthening training.

   In the further course, a one-legged heel position will intensively train the calf. Because of the longer immobilization, general strengthening exercises for the arch of the foot should be performed. Claws of the toes and picking up objects with the toes should be performed. Running on uneven surfaces and standing on them improves the perception and stability of the foot.