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查詢或預約 Inquiry 1
查詢或預約 Inquiry 1
The Achilles tendon is the thickest tendon in the human body, connecting the calf muscles (gastrocnemius and soleus) to the heel bone (calcaneus). It plays a crucial role in plantar flexion (push-off motion), essential for walking, running, and jumping. Ruptures commonly occur in active individuals aged 30–50, often due to sudden bursts of force or overloading. With the rise in sports participation, the incidence of Achilles tendon ruptures has increased. Physiotherapy is critical in managing Achilles tendon ruptures, whether treated surgically or non-surgically, and requires a structured rehabilitation plan for optimal recovery.
Sudden acceleration or direction changes (e.g., basketball, tennis) that overload the tendon.
Chronic overuse, tendinitis, or poor blood supply (especially in the mid-tendon region) weakening the tendon structure.
Male gender, aging, obesity. Long-term steroid use. Poor training habits (e.g., inadequate warm-up).
Acute Phase:
Audible “pop” sound at the time of rupture, followed by sharp pain.
Inability to push off the foot (loss of plantar flexion).
Swelling, bruising, and a palpable gap in the tendon (positive Thompson test).
Chronic Phase:
Abnormal gait (e.g., limping).
Calf muscle atrophy.
Indications: Partial tears, low-activity patients, or high surgical risks.
Principle: Immobilization to promote natural healing.
Immobilization Phase (0–6 weeks)
Ankle fixed in 20–30° plantar flexion (to reduce tendon tension).
Use a walking boot or cast with crutches (non-weight-bearing).
Early Mobilization (6–12 weeks)
Gradual adjustment to neutral ankle position.
Gentle joint mobility and strength exercises (e.g., resistance band plantar flexion).
Physiotherapy: Ultrasound, electrotherapy, soft tissue massage.
Indications: Complete ruptures, active individuals.
Options:
Open Repair: Direct suturing, possibly with tendon grafts.
Minimally Invasive Surgery: Smaller incisions, lower infection risk.
Post-Op Immobilization: Short-term cast (2 weeks), then transition to a removable boot.
Goals:
Protect the repair.
Maintain hip/knee/core strength.
Control swelling/pain.
Weight-Bearing: Non-weight-bearing (NWB) with crutches and boot/cast.
Rehab:
Passive hamstring stretches (in boot).
Quad sets, straight leg raises, core/hip strengthening.
Ice and elevation for swelling.
Goals:
Restore ankle mobility (avoid dorsiflexion beyond 0°).
Begin partial weight-bearing.
Weight-Bearing:
Week 4: 25% body weight (3 heel wedges in boot).
Week 5: 50% weight (2 wedges).
Week 6: 75% weight (1 wedge).
Rehab:
Ankle pumps/circles (no dorsiflexion past neutral).
Seated heel slides, scar massage (once healed).
Seated heel raises, foot intrinsic muscle exercises.
Goals:
Full ankle range of motion.
Normalize gait (no wedges/crutches).
Weight-Bearing: Full weight-bearing (FWB) by Week 8.
Rehab:
Standing dorsiflexion stretches.
Resistance band ankle exercises.
Stationary biking (in boot).
Goals:
Normal gait in sneakers (1 cm heel lift).
Improve calf strength/balance.
Rehab:
Standing heel raises (progress to single-leg).
Balance training (e.g., wobble board).
Goals:
Remove heel lift.
Prepare for advanced training.
Rehab:
Eccentric calf raises.
Lunges, step-ups.
Goals:
Restore power/agility.
Prepare for sports.
Rehab:
Plyometrics (e.g., jump training).
Walk/jog intervals.
Goals:
Sport-specific drills.
Ensure ≥90% limb symmetry.
Assessments:
Single-leg hop, Y-balance test.
Psychological readiness (PRRS).
| Complication | Causes | Treatment |
|---|---|---|
| 1. Re-rupture | Early weight-bearing, poor surgical repair | – PRP injections, ultrasound monitoring. – Revision surgery if needed. |
| 2. Ankle Stiffness | Prolonged immobilization | – Early passive motion (2–4 weeks). – Joint mobilizations, heat therapy. |
| 3. Calf Atrophy | Muscle disuse | – NMES, progressive strength training. |
| 4. Chronic Tendinopathy | Scar tissue, overloading | – Deep friction massage, shockwave therapy (ESWT). |
| 5. Infection | Poor wound care | – Antibiotics, laser therapy (LLLT). |
| 6. Gait Abnormalities | Compensatory movements | – Biofeedback, balance/proprioception drills. |
MANA Healthcare dedicated integrating eastern and western techniques, which provides TCM and Physiotherapy Services. We focus on the natural healing approach for the body. Welcome to contact us and make appointment through Whatsapp.
