The Achilles tendon is the largest tendon in the body, connecting your calf muscles to your heel bone. A rupture of the Achilles can occur as result of overstretching the tendon or an overuse injury. The primary goal of rehabilitation is to heal the tendon and reduce the pain and inflammation. The next of phase is the restore pain free range of motion and mobility to the ankles. Your physician will recommend a rehabilitation program to restore strength, normal gait, full range of motion and proprioception to your leg and ankles.
Range of Motion Exercises
The primary objective of your rehabilitation program is to regain pain free range of motion in your ankle joint and lower leg. As your ruptured Achilles tendon heals, you can begin gentle movements such as bending and straightening your ankles. As your progress and become more comfortable with bending and straightening your ankles, you can begin to rotate them from side to side, and then rotate your ankles clockwise and counter clockwise. Once your regain pain-free range of motion in your ankles, you can proceed to active rehabilitative exercises.
Stretching Exercises
The next phase is gentle stretching and flexibility exercises that target and promote flexibility in the calf muscles and anterior muscles of your shin. Your physician may recommend soleus and gastrocnemius stretches for your calf muscles. A toe stretch, calf-planter fascia stretch, floor stretch, and stair stretch may be recommended to prevent shortening of the muscles in your calves, and maintain flexibility in your leg and tendon. You will typically begin with gentle active calf stretching. Simply pull the toes of your affected leg upward so your Achilles tendon and calf muscles can stretch. Hold this position for five seconds and repeat as advised by your physician or physical therapist.
Strengthening Exercises
Strengthening exercises that target your Achilles tendon and calf muscles will be a part of the rehabilitation process and are essential in improving ankle and foot musculature and promoting mobility. They should be introduced slowly and systematically to ensure the Achilles tendon is not overloaded. Your physician or physical therapist will begin with isometric exercise in which the ankle joint is immobilized but a force is applied, and the calf muscles and your Achilles tendon are contracted. You will typically progress to resisted exercises using a resistance tubing to strengthen muscles in your ankles and foot. Other strengthening exercises your physician may recommend include toe raises, resisted planter flexion and calf raise.
Balance Exercises
Nerve damage is common complication of an Achilles tendon rupture, resulting in a decreased sense of balance and equilibrium, which increases your injury potential. Balance exercises are essential in the rehabilitation process. Walking on one foot, walking along a straight line and balancing on a beam are balance exercises that you should begin with. As you progress with these balance exercises and become more comfortable, you can progress to advanced exercises, as on a balance board, to increase your awareness of body position.
References
- Sportsinjuryclinic.net: Rehabilitation (Total Rupture of the Achilles Tendon)
- MDGuidelines: Repair, Ruptured Achilles Tendon
- "The Stretching Handbook"; Rehabilitation Exercises to Prevent Achilles Tendonitis Re-Injury; Brad Walker
- Sportsinjuryclinic.net: Stretching (Total Rupture of the Achilles Tendon)
- Physiotherapy Sports Injury Clinic; Achilles Tendon Rupture; Roland Jeffery
- Sportsinjuryclinic.net: Strengthening (Total Rupture of the Achilles Tendon)
