Rehabilitation after an Achilles tendon rupture

The treatment of an Achilles tendon rupture is followed by a lengthy rehabilitation phase. This is independent of whether a conservative treatment method or a surgical procedure was chosen. First the leg must be immobilised.

Usually for about 6 weeks in a special shoe and at an angle by putting the foot in a pointed position. The shoe should be worn for 24 hours. After 6 weeks the wearing time of the shoe is reduced, i.e. the leg only needs to be immobilised during the day.

About two weeks after the operation, the correction of the toe angle is already started. Slowly the special shoe can be changed in its alignment. Every week the foot can be brought a little closer to the normal position.

Before the shoe can be taken off completely after a total wearing time of approx. 8 weeks, the foot is in its normal position. Now physiotherapy begins with exercises, which consist mainly of passive exercises.

The therapist slowly moves the foot up and down. These movements are usually particularly difficult for the patient at the beginning of the rehabilitation phase, as the movements are no longer accustomed due to the long immobility. In addition, the newly grown Achilles tendon must first “learn” to move and contract again.

In order to be able to perform the passive movements on the foot even better, a so-called motor splint can be used. This is a frame in which the leg is placed and a certain leg and foot movement is performed in the same repetitive rhythm. The advantages of this are that the patient is not overburdened and the exercises in the motorized splint can be performed without any additional personnel.

After performing the passive exercises, the patient should begin to actively regain muscle tone. Experience has shown that this part of the rehabilitation is also difficult for the patient after the long rest period. Basically, the patient is allowed to put full weight on the leg again at this point.

Usually, the patient is only able to fully step on the leg at the beginning. Independent movements in the form of bending and stretching of the foot are not yet or only insufficiently possible. In order to challenge the patient again and not to relieve him or her of too much work, the use of the motor splint is no longer necessary.

Physiotherapeutic gait training and standing training are now on the programme. In addition, exercises to circle the foot are performed. The patient is asked to bend and stretch the foot as steeply as possible.

The possible angle is noted and the patient tries to increase it in the following days. After about 2-3 months the rehabilitation is completed.