2018 Mar;26(3):846-853. doi: 10.1007/s00167-015-3795-1. Online Physical Therapy Protocol Quality, Variability, and Availability in Achilles Tendon Repair. The https:// ensures that you are connecting to the Mastering proprioceptive control in wearing normal footwear. official website and that any information you provide is encrypted <>/ExtGState<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 792 612] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>>
It is recommended that clinicians collaborate
It happens most frequently while playing sports. 5 0 obj
In addition, surgical repair involves, but is not limited to, an increased risk of infection, adhesions and disturbed skin sensibility with a pooled relative risk of 10.6 (95% CI; 4.8;23.3) as . x\n#}!{B^pq8h*S=rz YTWu]N]zGo?Sz$ByhTTu_[UtzrVZO7'. J Bone Joint Surg Am 2010; 92: 2767 - 75. Active stretching. initially Three trials compared the combination of full weight bearing and early ankle mobilization to immobilization. Results: Four studies performed full weight bearing, all demonstrating good functional results, an early return to work/sports and high satisfaction. Weight-bearing: Touchdown weight-bearing (TDWB) with crutches en Change Language. Normal gait mechanics without the boot on all surfaces. Disclaimer. 2021 Apr 7;9:654084. doi: 10.3389/fcell.2021.654084. <>
All trials found mobilization to be superior as it shortens time to return to work and sports significantly. eCollection 2021. Surgery is only the beginning of a long rehabilitation period. Achilles tendon is the biggest and strongest tendon in the body. 2010 Dec 1;92(17):2767-75. doi: 10.2106/JBJS.I.01401. Movement control exercises beginning with low velocity, single plane activities and progressing to higher velocity, multi-plane activities. x\*"S&Rd9l)+%\hwMROw3$\Z1~v/^x|m],^}3fdY7iTe*)XU6ugshO_KQ`F5vYU? Open navigation menu. It is rare to have this procedure immediately after going to the emergency room for an injury. Active ROM between 15 degrees of dorsiflexion and 50 degrees of plantarflexion. TABLE E-1 Achilles Tendon Rupture Rehabilitation Protocol Time Frame Activity 0-2 weeks Posterior slab/splint; non-weight-bearing with crutches: immed. Squat and lunge to 70 degrees knee flexion without weight shift.
The "2-2-2" Early Mobilization Protocol in Achilles Tendon Rupture: A Review Accelerated rehabilitation following Achilles tendon repair after acute rupture - Development of an evidence . 2014 2. +2 b6b ] ]-oF%@ZUiV'US7\4yk@RAQA$EB-;D2yR"H#YH ~Z/K>S'E_
R>-C^^[i. Active ROM between 5 degrees of dorsiflexion and 40 degrees of plantarflexion. Our rehab protocols outline timing, precautions and progression criteria for returning to activity.
Ruptured Achilles: How to Recover From Achilles Tendon Injury - WebMD Achilles tendon rupture; Ankle mobilization; Evidence-based; Functional treatment; Immobilization; Rehabilitation; Surgical repair; Treatment protocol; Weight bearing. Massen FK, Shoap S, Vosseller JT, Fan W, Usseglio J, Boecker W, Baumbach SF, Polzer H. EFORT Open Rev.
Achilles Tendon rupture: Post Surgery actions and recovery protocols Goals: Achilles Tendon Repair Rehabilitation Protocol, North Fork Orthopaedic and Sports Medicine, Lower Extremity Fracture Care Post-Op Instructions. Moderate load plyometrics at Accelerated rehabilitation following Achilles tendon repair after acute rupture development of an evidence-based treatment protocol, Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet], Centre for Reviews and Dissemination (UK). Knee Surg Sports Traumatol Arthrosc. Epub 2014 Jul 7. Procedure: Conservative Management of Tendo-Achilles Rupture - Accelerated 8-week protocol Indications for Procedure: Tendo-Achilles Rupture Expected Length of Stay: n/a Surgeons: All orthopaedic trauma surgeons Scope of Practice These guidelines are designed to guide physiotherapists when treating patients following conservative management .
PDF ACHILLES TENDON REPAIR CLINICAL PRACTICE GUIDELINE - Ohio State University Our recommended treatment protocol provides quality assurance for the patient and reliability for the attending physician. Despite several trials available comparing different treatment regimes, there is still no consensus regarding the optimal protocol. ACHILLES-TENDON-RUPTURE-ACCELERATED-REHAB-PROTOCOL.pdf - Free download as PDF File (.pdf), Text File (.txt) or read online for free. SWE is a convenient noninvasive method to determine the progress of the healing process after tendon injury. In conclusion, the rehabilitation protocol after Achilles tendon repair should allow immediate full weight bearing. Rehabilitation following Achilles tendon repair is vital in regaining motion, strength and function. Epub 2010 Oct 29. Rehabilitation of Achilles tendon ruptures: is early functional rehabilitation daily routine?
No tackling, sudden unexpected change hYmo6+DU f[j;;4vv+yw=lrD Results: <>
Patients showed significantly higher satisfaction, less use of rehabilitation resources, earlier return to pre-injury activities and further demonstrated significantly increased calf muscle strength, reduced atrophy and tendon elongation. 1. The non-comparative study reported high satisfaction, good functional results and an early return to work/sports following combined treatment. Single leg stance with good control for 10 seconds. Rehabilitation following operative treatment of acute Achilles tendon ruptures: a systematic review and meta-analysis. Non-Operative Treatment of Achilles Tendon Rupture Post-Operative Protocol Accelerated Rehabilitation Program: Weeks 1-2: Short leg fiberglass cast with ankle in plantarflexion of ~20 degrees Non-weight bearing with crutches for ambulation assistance Weeks 2-6: Transition to CAM walking boot with 6 heel lifts A Prospective Randomized Trial Comparing Surgical and Nonsurgical Treatments of Acute Achilles Injury to the Achilles tendon causes pain along the back of your leg near the heel. Copyright 2014 Elsevier Ltd. All rights reserved.
A Closer Look At A New Protocol To Manage Achilles Tendon Rupture Lightsey HM, Noback PC, Caldwell JE, Trofa DP, Greisberg JK, Vosseller JT. Sports massage techniques and ultrasound can aid torn Achilles rehabilitation by helping to realign the new fibres in line with the tendon. jumping, running. An official website of the United States government. Bibliographic details: Brumann M, Baumbach SF, Mutschler W, Polzer H. Accelerated rehabilitation following Achilles tendon repair after acute rupture development of an evidence-based treatment protocol. 2019 Feb;12(1):16-24. doi: 10.1177/1938640017751185.
Current Updates in the Treatment of Achilles Tendon Rupture Multi-plane proprioceptive exercises single-leg stance.
Percutaneous achilles tendon repair with absorbable suture: Outcomes The acute rupture of the Achilles tendon is a protracted injury.
[PDF] Accelerated rehabilitation following Achilles tendon repair after Achilles Tendon Rupture - Non-operative treatment rehabilitation guidelines 0-2 WEEKS REST (PHASE 1) Goals Rest, recovery and mobilise non-weight bearing safely on crutches Immobilisation Plaster cast/Rigid boot with foot pointing downwards 20 (with 3 wedges inside - 22/16/10, more if needed) V.&!Na 1"}2C1[irXd8`<9f4X|(iTerx_&>uQMAv/>My]Zg}?;fl|Hpt.
PDF Achilles Tendon Repair: Post Operative Accelerated Rehabilitation Protocol Keywords: The aim of this study was to define the most effective and safe post-operative rehabilitation protocol following minimal invasive repair.
PDF ACHILLES RUPTURE: NONOPERATIVE PROTOCOL - South Bend Orthopaedic Associates Post-op weeks 3-4: boot at 10 degrees, sleep in boot, TTWB with crutches. 0
Surgery is only the beginning of a long rehabilitation period. This was the standard procedure (long back of the leg incision vs newer technique with a shorter cut and a heel incision). 4 0 obj
May begin walking, light jogging after 12 weeks, swimming, cycling. VQ4 L}3Sz~zzDM>{z?NO?UI(/oO=:0QI]WrDctQa4TxR6=&eA>F2z>'%62p2{c86Y82b%q}`D U4x$!fGjGg$grJ,l6hqs&Sn5?1qX:{6G|8(?Mu83V\kZO._C9=7R4z-XW3"tcFWPoJ^&K.HfZ5E.LJSe=jC7S'r++@7Tka'k{e1u_X\W{Rv3x:gj. 24 staples. Operative versus Nonoperative Treatment of Acute Achilles Tendon Ruptures: A Multicenter Randomized Trial Using Accelerated Functional Rehabilitation Kevin Willits, Annunziato Amendola, Dianne Bryant, Nicholas G. Mohtadi, J. Robert Giffin, Peter Fowler, Crystal O. Kean and Alexandra . HHS Vulnerability Disclosure, Help Would you like email updates of new search results?
Insulin-like growth factor binding protein 4 loaded electrospun etc until cleared by The aim of this study was to define the most effective and safe post-operative rehabilitation protocol following minimal invasive repair. hbbd```b``"Z@$"d8XDI90L~_DH`U&(H( X$D I]@k"_ 6' An Achilles tendon rupture is a full or partial tear of the Achilles tendon. -.
PDF Rehabilitation Protocol for Achilles Rupture Repair Injury. outcome drills ie. Your surgeon and you will determine what is best for you by discussing your specific injury and goals. bearing Patient 2 was a 38-year-old male soldier who experienced a complete left Achilles tendon rupture while exercising. doi: 10.1590/ACB360407.
PDF Rehabilitation Guidelines for Achilles Tendon Repair - UW Health Avoid overstressing the repair (avoid large movements up and down, forceful PF while in a dorsiflexed position, aggressive passive ROM, and impact activities). J Bone Joint Surg Am. A potentially more accelerated rehabilitation and return to activity; Tendon healing with optimal end to end re-attachment, hence restoring Calf muscle-Achilles anatomy with minimal scar tissue bridging.
Achilles Tendon Rupture: Mechanisms of Injury, Principles of 3 0 obj
2 0 obj
Three trials compared the combination of full weight bearing and early ankle mobilization to immobilization. 2010 Dec 1; 92(17): 276-75. . 204 0 obj
<>/Filter/FlateDecode/ID[<5F38DF44F3FF7641895593BD7106A5BB>]/Index[179 50]/Info 178 0 R/Length 115/Prev 119698/Root 180 0 R/Size 229/Type/XRef/W[1 3 1]>>stream
ACCELERATED ACHILLES PROTOCOL Time Frame Activity . Operative versus nonoperative treatment of acute Achilles tendon ruptures: a multicenter randomized trial using accelerated functional rehabilitation. The body then heals the tendon in the appropriate position. Closed chain weight bearing quads, hamstrings, glutes, calf strengthening with physio guidance. Patients showed significantly higher satisfaction, less use of rehabilitation resources, earlier return to pre-injury activities and further demonstrated significantly increased calf muscle strength, reduced atrophy and tendon elongation. Continue resisted inversion and eversion through range, Double leg stance out of boot; single leg stand in boot progressing to out of boot as balance improves.
Acute Achilles Tendon Rupture Repair Rehab | Early Rehab Exercises Rehabilitation of Achilles tendon ruptures: is early functional rehabilitation daily routine? Brumann M, Baumbach SF, Mutschler W, Polzer H. Injury. ':IU""e"E/JT?|OW:_Yn]n7buq}].moS_7xbU]}\o/|`ND^QTK/EnTYJ=U6~U1 Normalize gait on all surfaces without boot or heel lift. Moderate load close/open chain calf strengthening to %
^C<
^/PgN`r3~LV*m{ (3Nl(+J?~I x][~|.T%c<8A+qwX+)#`T];%
t4!^}I? The clinical outcomes are similar regardless of the surgical treatment, but an accelerated rehabilitation program should be accompanied by good results. The Accelerated Rehabilitation Program lasts for 12 weeks and is supervised by your Physiotherapist. 2022 Oct 26;7(10):680-691. doi: 10.1530/EOR-22-0072. PMC Tripping, falling or twisting your ankle can also cause an Achilles tear. Keep incision/splint clean and dry. Achilles tendon repair is performed after injury occurs to the Achilles tendon. Higher level proprioception Bookshelf In conclusion, the rehabilitation protocol after Achilles tendon repair should allow immediate full weight bearing. Detailed Description: We mostly see ruptures of the Achilles tendon in high-impact sports predominantly in the male athlete. Hydrotherapy may begin if wound healing is adequate. After the second postoperative week controlled ankle mobilization by free. 1 This is called "eccentric loading." If you have Achilles tendonitis, walking and running can be painful. This article describes a high-quality accelerated functional rehabilitation program that begins with early diagnosis and appropriate patient selection to allow initiation of the nonoperative protocol. Bethesda, MD 20894, Web Policies Accessibility Healing time clock restarts from day of surgery rather than day of injury We performed a systematic literature search in Medline, Embase and Cochrane library.
Achilles Tendon Rupture: Symptoms, Treatment, Recovery | HSS The Achilles tendon is the biggest and strongest tendon in the human body and is formed by the tendons of the soleus and gastrocnemius muscles which both insert at the calcaneus. Normalize gait on level surfaces without boot or heel lift. CAMBOOT with 20mm heel lift
or VACOPED (2) and wedge sole for 3rd week. We identified twelve randomized controlled trials comparing different treatment regimes after operative repair of the Achilles tendon. David Gordon, Consultant Orthopaedic Surgeon - Achilles Tendon Repair Post Operative Accelerated Rehabilitation Protocol: A Patient Guide Nov 2016 Achilles Tendon Repair: Rehabilitation Protocol Reference List Cetti, R., L. O. Henriksen, and K. S. Jacobsen. Before Cardiovascular: replicate sport/work-specific energy demands. but an accelerated rehabilitation program should be accompanied by good results. Initiate balance exercises (double leg wide base narrow . Early functional treatment versus early immobilization in tension of the musculotendinous unit after Achilles rupture repair: a prospective, randomized, clinical study.
PDF Non-Operative Achilles Rupture Rehabilitation Guideline - Sanford Health This acute (sudden) injury occurs when the tendon stretches to its breaking point. The exercises stretch your Achilles tendon in ways that help it handle forces and stress better. Surgery is only the beginning of a long rehabilitation period. 2021 May 21;36(4):e360407. high load ankle, knee, hip An Achilles tendon repair surgery is a scheduled outpatient procedure done in an operating room located in a hospital or surgery center. "A new treatment of ruptured Achilles tendons. Accelerated rehabilitation following Achilles tendon repair after acute rupture - Development of an evidence-based treatment protocol. < Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet]. 1990 Mar;18(2):188-95. This site needs JavaScript to work properly. The injury is often accompanied by an audible and palpable pop with limited ability to push off of the injured limb. Close suggestions Search Search. Disclaimer. 0_'|,t0:!:
. ^Fz,l6N}{D6Y?TP),#uz/i3F~bHG(BQ" accelerated functional rehabilitation.
Achilles Tendon Repair Rehabilitation Protocol | Stony Brook Medicine and transmitted securely. endobj
training.
PDF Standard of Care: Achilles Tendinopathy - Brigham and Women's Hospital Mosconi M, Pasta G, Annunziata S, Guerrieri V, Ghiara M, Perelli S, Torriani C, Grassi FA, Jannelli E. Diagnostics (Basel). =+Q%90Z6U='-rj\Ig pV.4FqW%W)53s^#D3 a`CN3=z[lmOgEA5CWwpLz9r4-+94Is9>}n-9k=n6R LAJxeF$ylM>MY@0vFEviCM
ml@5s? movements (not past plantar grade). -, Am J Sports Med. It mainly occurs in people playing recreational sports, but it can happen to anyone. 2021 Jun;24(6):536-543. doi: 10.1016/j.jsams.2020.12.005. Post-op weeks 4-6: If the pt can reach neutral PF/DF comfortably, then neutral boot with small heel lifts, sleep in boot, WBAT (based on pain, swelling and wound) with crutches and boot, active DF to neutral. The Achilles Tendon is the strong fibrous band that attaches the calf muscles to the calcaneus bone. 2021 May 28;18:112-116. doi: 10.1016/j.reth.2021.05.002. Clinical, Ultrasonographic, and Elastographic Comparison. Independent gait. s% i5iYd}mYSz;0Wj|*:2aO5ZmJeNWhqLx*
EUgm"5l94`0;C1B]@-yH?0{2ER'fL-j6U,@tyS]?sZn|(E31-*=} Therefore, the rehabilitation protocol is an integral aspect to restore the pre-injury activity level. HHS Vulnerability Disclosure, Help MeSH Wr5)Z nK!e*~[~[)$WoU]sMHUoUbmJ9yOJ}`
Begin physio guided active range of motion ankle exercises from week 3-4. Mark-Christensen T, Troelsen A, Kallemose T, Barfod KW. 4 0 obj
and transmitted securely. Ankle strengthening with resistance bands. Achilles tendon rupture is a clinical diagnosis. Goals: Physical therapy appointments are once every one to two weeks. Impact control exercises beginning with two feet to two feet, progressing from one foot to the other, and then one foot to the same foot. government site. xwn $8sxkL=. *MoaoLzhN:fOad)t-h96.&JxEys4JUy-nEu Avoid forceful active and passive range of motion of the Achilles for 10 - 12 weeks. bearing transitioning towards full weightbearing. MRI studies may be indicated for surgical management of chronic injuries. %PDF-1.5
%
Percutaneous and open surgical repairs of Achilles tendon ruptures: a comparative study. Begin by using one to two-inch heel lifts in tennis shoes for short distances on level surfaces and gradually remove heel lifts during the fifth through the eighth week depending on symptoms. This can strain your Achilles tendon.
PDF Achilles Tendon Rupture Conservative Management Accelerated 179 0 obj
<>
endobj
Various treatment methods are used for acute and chronic rupture. Rerupture after Achilles repair is reported at about 2-12%, with no statistical difference reported between open, percutaneous, augmented, or closed treatment methods [1-4, 7, 9, 16].Open rerupture is an exceedingly rare complication and has only been described a handful of times [17-19].This report is the first case that we are aware of described in the literature of an . Please enable it to take advantage of the complete set of features! Y!_x"o7/_"H4IE(:}/1 2011 Dec;17(4):211-7 228 0 obj
<>stream
MeSH Consequently, the aim of our study was to systematically search the evidence available and define a precise rehabilitation programme after operative repair of acute Achilles tendon rupture based on the trials with the highest level of evidence. 3 0 obj
endobj
PMC 2011 Apr;39(4):820-4 It connects the muscles of your calf to your heel. After open repair, early functional rehabilitation improves outcome, but there are risks of infection and poor wound healing. stream
eCollection 2021 Dec. Hidd SMCM, Tim CR, Dutra EF Jr, Maia Filho ALM, Assis L, Ferreira RS Jr, Barraviera B, Silva JF, Amaral MM. Pain-free isometric ankle inversion, eversion, DF and submaximal PF. Unable to load your collection due to an error, Unable to load your delegates due to an error. Careers. Static balance exercises (begin in two-foot stance, then two-foot stance on balance board and gradually progress to single-leg stance). All trials found mobilization to be superior as it shortens time to return to work and sports significantly. This was the standard procedure (long back of the leg incision vs newer technique with a shorter cut and a heel incision). 3,10,13,25 Historically, surgical repair of Achilles tendon rupture was thought to decrease the risk of re-rupture substantially. endobj
Immediate full weightbearing and ankle motion exercise after repair of acute Achilles tendon rupture can provide a good rehabilitation option with a low re-rupture rate and satisfactory functional results. The Achilles tendon gives your leg strength to walk, run and jump. Download Accelerated Rehab Program Patient Information Sheet.
Achilles tendon rupture - Symptoms and causes - Mayo Clinic A re-rupture rate between one in 30 and One in 20. Plaster Cast
or CAMBOOT with 30mm heel lift
or VACOPED (3) plus wedge sole for 1st week. We performed a systematic literature search in Medline, Embase and Cochrane library. Westin et al. Fast Functional Rehabilitation Protocol versus Plaster Cast Immobilization Protocol after Achilles Tendon Tenorrhaphy: Is It Different? cJ%]lKSfd9\{5D
y} Ua~0i}::1Qq){)+"0xpOp bd%\`3 G{$u~` mlEt$/yf;'ds;Z1y4@$ Xr Hi folks, I am in week three post full Achilles rupture repair surgery. (open!andclosed!kinetic!chainas!well!as!functional activities)-!start!withTheraband!tubingexercises! . stream
Introduction. **No hopping, [1] [2] Achilles tendinopathy has a detrimental effect on physical and mental well-being [3] [4]. In chronic and neglected rupture, surgical treatment is preferred over non-surgical treatment. An insight is given into the mechanism of injuries of an ATR, related principles of rehabilitation, and RTP to give an insight into the course of recovery after ATRs. <>/F 4/A<>/StructParent 0>>
Would you like email updates of new search results? health, rehab compliance and injury severity, our team has established time frames, precautions and progression criteria that help ensure a safe return to sport. Achilles tendon ruptures (ATRs) mainly occur during sports activities . BMC Musculoskelet Disord. Operative versus non-operative treatment of acute Achilles tendon ruptures: a multi-center randomized trial using accelerated functional rehabilitation. ?h{vV4ECHD+A?E_Q-9U1DJY;p9 I* XX%|EjbwJH(g0Nf5.I ;v$c7H(d
a_2d6QN&m Functional movements (squats, step backs, lunges). The only randomized controlled trial performed the most accelerated protocol demonstrating a superior functional outcome and fewer complications after immediate full weight bearing combined with free ankle mobilization.
Sport/work-specific balance and proprioceptive drills. Conclusion:
Application of Doctor-Nurse-Patient Co-Decision-Making Nursing Intervention Based on Evidence-Based Problems in the Rehabilitation of Acute Ankle Lateral Collateral Ligament Injury. Objectives To (1) describe which resistance exercises are used in the first 8 weeks of treatment for acute Achilles tendon rupture and (2) assess the completeness of reporting of the exercise descriptions. One study allowed early mobilization leading to excellent subjective and objective results.
Achilles Tendon Repair Rehab Protocol - manhattansportsdoc.com With!weighted!resisted . 2022 Aug 19;2022:2363230. doi: 10.1155/2022/2363230.
ACHILLES TENDON RUPTURE ACCELERATED REHAB PROTOCOL - Fowler Kennedy Arch Orthop Trauma Surg. Brumann, M., Baumbach, S. F., Mutschler, W., & Polzer, H. Accelerated rehabilitation following Achilles tendon repair after acute rupture-Development of an evidence-based treatment protocol.
PDF ACCELERATED ACHILLES PROTOCOL - Indiana Total Therapy 4 0 obj
Achilles Tendon rupture: Post Surgery actions and recovery protocols and concerns. Our analysis using SWE has revealed the detailed chronologic changes in SWE values and related mechanical properties of a healing Achilles tendon rupture, which can be used for devising appropriate rehabilitation protocols. Minimal invasive surgery reduces these risks; however, there are concerns about its stability. Treatments are chosen based on the size of the tendon defect. 1 0 obj
Can commence light isometric calf exercises at low resistance and reps, not past plantar grade. Cardiovascular: Upper body circuit training, Physical therapy appointments begin one to two visits per week. Acute Achilles tendon rupture: minimally invasive surgery versus non operative treatment, with immediate full weight bearing. Operative versus nonoperative treatment of acute Achilles tendon ruptures: a multicenter randomized trial using accelerated functional rehabilitation. Regular soft tissue treatments (i.e. Place heel raises (1-2cm) in shoes to take some of the pressure off the Achilles tendon. Post-activity soreness should resolve within 24 hours. There is increasing evidence, summarized in systematic reviews, that one can successfully use a non-operative treatment protocol to manage patients who suffer an acute rupture of the Achilles tendon. 2020-2023 Mr Daniel Goldbloom | Privacy Policy | Disclaimer | Website design: Berwick - St John of God Consulting Suites. The Alfredson Protocol is an exercise program for people with Achilles tendonitis ( tendinopathy ). A prospective randomized study." Continue hip and In an acute Achilles Tendon Rupture, there are two options: Surgical repair with accelerated rehab protocol. !.XyR-Kd-+"v+l3,~l|LR {Z^R}TTKS`p*9szqAdJAs2QGE6pzHf)'a n7=pMi-Sn3r7$5B"yUMQy^&hkj)V&a55JZp5JSb^]"37H919=N]?&h6.M{Af[Uf`0R;DW x^Q^5fu;%)Ptu$DtqEHg No study found an increased rerupture rate for the more progressive treatment. Hi folks, I am in week three post full Achilles rupture repair surgery. 2014 Nov;45(11):1782-90 Therefore, the rehabilitation protocol is an integral aspect to restore the pre-injury activity level. Post-op weeks 2-3: boot at 20 degrees, sleep in boot, TTWB with crutches, no active DF. Frankewycz B, Krutsch W, Weber J, Ernstberger A, Nerlich M, Pfeifer CG. 2018.
Late Achilles Tendon Rupture Repair Rehab - Physiotutors The use of early functional rehabilitation in the treatment of nonoperative Achilles tendon ruptures has been shown to provide patients with outcomes similar to operative treatments.