When can physiotherapy be started after an Achilles tendon rupture?

Physiotherapy for an Achilles tendon rupture can begin immediately after the rupture, but always adapted to the course of treatment and healing. As mentioned above, in the early phase of wound healing, only exercises for the arms should be performed as preparation for supporting or exercises for the entire leg, as a maintenance of the musculature. If the load may be increased, the calf muscles are automatically strengthened by physiological rolling.

However, this can be intensified through specific strengthening exercises, such as the calf press. The calf press is only possible when the movement is released and can be performed. To strengthen this exercise, the calf press can be performed in a one-legged position. Due to the difficulty level of this exercise, it will only be possible at a late stage.

Do I need special shoes or insoles for an Achilles tendon rupture?

With general Achilles tendon problems and also after an Achilles tendon rupture, patients often receive a heel insole in which the foot is lifted. The load on the foot is transferred to the forefoot and the metatarsus. The materials of the insoles range from gel and foam to hard plastic and mixed materials.

It is important that these insoles are comfortable so that they can be worn permanently. Not every material is suitable for every patient. In addition to simple heel insoles, more complex insoles can be customized for the entire foot.

The heel is also raised in order to achieve relief and nubs in the area of the arch are incorporated to stimulate the muscles according to the arch. It is important that you take the time to break in the insoles. An improvement of the symptoms only happens in the long run and the first days with the insoles are associated with sore muscles.

Shoes with heels and flip flops should be avoided. Both types of shoes put extreme strain on the feet and do not form a good footbed. For running shoes or work shoes that are worn for several hours under heavy strain, care should be taken to ensure an exact fit.

A running analysis by experts who pay attention to how the patient rolls his or her foot is recommended. In the case of a certain weakness, the muscles should be trained to create a physiological gait pattern. It is also important to change shoes regularly and to run barefoot sometimes. Especially in summer, running over meadows, pebbles, streets and sand can improve the proprioception of the feet (perception of movement in space and perception of the position of individual parts of the body in relation to each other) and thus activate the muscles. Stretching exercises for the foot and loosening the fasciae are also important tasks for a healthy Achilles tendon.