Rehab Of Achilles Tendon Rupture

Phase 1-Acute Phase:

Immediately after the injury occurs, the individual needs to begin the basic steps of treatment. Although the steps seem minimal, they are crucial and must be administered. These steps consist of rest, ice, compression, elevation, and immobilization. In this injury you want to minimize the blood flow to the affected area. Resting reduces the risk of further injury. Ice should be applied 24 to 48 hours after the injury and will not only reduce swelling but any of the acute pain. Compression will reduce bleeding and reduce swelling, just as elevation will use gravity to reduce bleeding and reduce swelling by allowing fluids to flow away from the site of injury. There are many misconceptions about the way to apply ice, especially in this injury; it must be administered correctly. The proper way to apply the ice is for about 15 minutes every 2 hours. This will vary depending on the amount swelling; this can be reduced gradually over the next 24 hours. Do not however apply heat or deep message to the rupture in the initial immediate treatment. As soon as RICE has been finished, the injured needs to immobilize the tendon, lower leg. This is done so the injury will not worsen. As mentioned earlier the individual who ruptures their Achilles tendon should seek prompt medical treatment just as soon as RICE has been administered. When the individual sees a physician, they can confirm the diagnosis and determine whether an operation is the best idea or not. Usually the choice of surgery, is determined patient by patient. In this research paper I will explore the surgical treatment of an Achilles tendon rupture, which is described in the repair phase.

Phase 2- Repair Phase:

The goal of surgical repair of an Achilles tendon rupture is to restore tendon continuity and length to allow the patient to regain his or her functional and desired activity level. Surgical repair usually is a more reliable treatment method as it is less likely to re-rupture; the re-rupture rate is 0-5% lower than that of a non-surgical repair. It is mostly performed on younger, healthy, more active individuals who are participating in high school, college, semiprofessional, or professional sports; whereas non-surgical treatment is used on patients who are in active or elderly. When doing a surgical repair on the tendon, there are multiple ways to operate. The one I will go into is called open repair. In an open repair both medial and longitudinal approaches are used. A tourniquet is used and the rupture gap is palpated. Incisions are made through the skin down to the paratenon, which is the fatty material between a tendon and its sheath. The paratenon is then divided to uncover the ruptured ends. By plantar flexing the ankle, the ends are then reconnected and secured with heavy non-absorbable sutures using a modified Kessler, Krackow, or Bunnell technique. The surgeon has to be sure not to over tighten the repair. If this occurs the tendon length might be shorten which would lead to loss of dorsiflexion. After the repair is done, the paratenon and skin are closed. A cast is placed on the lower leg/foot region following the operation.

Phase 3- Rehabilitation Phase:

Total recovery from an Achilles tendon rupture is estimated to be between 6-9 months. The general outline of post surgical rehabilitation consists of 6 to 8 weeks of immobilization, heel lifts, passive and active range of motion exercise, progressive resistance exercise, and ice after workout. A cast or brace should be placed on the patient for 6 to 8 weeks to protect the repair and skin incision. If the patient is an athlete or just one who wants to remain healthy and in shape, it is recommended that they take part in conditioning exercises to maintain good general muscle strength and aerobic fitness. Following the cast removal, the patient must undergo a rehabilitation program in order to return to normal movement and function. Heel lifts should be immediately placed in the patient's