Damaged tendon: how to repair a torn Achilles. Achilles tendon rupture - treatment and rehabilitation How long does the Achilles tendon heal after surgery

Injuries happen not only to athletes, but they can also occur in any person with excessive load, as a result, a complete or partial rupture of the Achilles tendon may occur, the treatment and rehabilitation after surgery to restore which takes a lot of time. However, if you follow all the recommendations of the doctor, you can fully recover from such a condition.

Anatomically, the Achilles tendon connects the heel bone to the so-called gastrocnemius muscle. It helps a person when walking and running, ensures the functionality of the lower extremities in everyday life, so that when this ligamentous apparatus is injured, it becomes simply impossible to walk and perform normal activities.

Tendon rupture leads to acute pain, localized in the back of the leg in the shin area. It is impossible for a person to lean on a sore leg, a feeling of stiffness joins, swelling will be visually determined at the place where the tendon is attached. In such a situation, it is necessary to contact the emergency room as soon as possible, where the patient will be provided with qualified assistance.

Achilles tendon rupture treatment

In a trauma hospital, an MRI is performed on the victim to determine the degree of damage to the tendon tissue. Based on the data obtained, the doctor prescribes therapeutic measures. With a complete rupture of this tendon connection, surgical intervention is performed. If the rupture is partial, the so-called plaster splint is applied to the patient for about one and a half, two months.

Under the influence of a plaster cast, the ankle joint is immobilized, which brings domestic inconvenience, you have to walk on crutches or with a stick, but what you can’t do for the sake of restoring health.

In addition, the period of rehabilitation (recovery) takes quite a long time and requires certain efforts from the patient in order to regain the function of the Achilles tendon lost due to injury.

Achilles tendon rupture - rehabilitation after surgery

Typically, tendon repair after surgery begins one to six weeks after surgery. An increase in the load on the leg must be agreed with the attending traumatologist.

The rehabilitation program takes into account all four phases of Achilles tendon repair (inflammation, proliferation, in addition, remodeling, and maturation). The ligamentous apparatus is weakest in the first six weeks after surgery, and after 12 months its mechanical strength begins to increase.

First phase of rehabilitation

During this period, the tendon is protected from excessive flexion, and its active fusion is also observed. This period lasts from 1 week to 6 weeks. The degree of dosed load is selected for the patient, and the optimal method of immobilization is also determined.

For successful recovery, as well as fusion of the tendon, a load on the so-called muscle-tendon complex is necessary, which will prevent subsequent muscle atrophy, as well as contracture (immobility) of the joints, in addition, deep vein thrombosis and arthritis.

After a dosed axial load, it is recommended to add classes on a special exercise bike to the rehabilitation program.

In order to properly heal the repaired gap, rehabilitation includes massage of the so-called postoperative scar, which prevents the formation of scar adhesions. For the purpose of anesthesia, the doctor conducts cryotherapy, to relieve swelling, it is recommended to keep the limb in an elevated position.

Second phase of rehabilitation

The second phase of rehabilitation, correcting the tear, after Achilles tendon surgery lasts from 6 to 12 weeks. During this period, it is recommended to slightly increase the mobilization of the limb, and physical stretching exercises are also recommended. Provided that the postoperative wound is completely epithelialized, the patient is allowed to walk on the so-called underwater treadmill, which reduces the axial load on the diseased limb.

Third phase of rehabilitation

During this period, early strengthening of the tendon occurs. This rehabilitation period lasts from 12 to 20 weeks. The amplitude of active movements in the leg is restored. During this period, you can exercise on simulators according to a specially designed program. After the restoration of gait, you can start running on the so-called underwater treadmill.

The intensity of exercise performed by the patient should be regulated by a rehabilitation therapist. The criterion for the transition to the fourth phase is the restoration of the patient's ability to balance on one leg.

Fourth phase of rehabilitation

During this period, increased physical activity begins, close to sports loads. This phase lasts from 20 to 28 weeks. It is usually recommended for people who are professionally involved in sports to return them to their former shape.

On the twentieth week after surgery, the so-called isokinetic testing is performed, while the rehabilitation doctor will receive the necessary objective data on the endurance of the leg muscles, on their strength.

Conclusion

If the tendon has a rupture, treatment begins with an urgent appeal to a trauma center. The rehabilitation process should be carried out under the guidance of a specialist.

The Achilles tendon is the most powerful ligament in the human body that unites the muscles of the lower leg and calcaneus. Because of the place of localization, it received the name - heel. A large and strong fibrous ligament, with strong stretching, can rupture either partially or completely. Achilles tear is a common injury to the back of the leg, often occurring in athletes and people who actively play sports.

Causes of injury and risk group

The anatomical structure of the calcaneal ligament is such that during active movements (running, walking, jumping), it is she who is responsible for pushing the foot off the surface and easy lifting on tiptoes. The tendon is simultaneously involved in the flexion of the foot, and is responsible for the lower leg - it is associated with the calf and soleus muscles. Achilles "pulls" the foot down, followed by the entire ankle joint. Even a simple tear of the Achilles tendon can lead to the loss of the ability to run.

An injury to any tendon is dangerous and unpredictable, so treatment must be started in a timely manner. Achilles injury is a complex injury related to trauma to the musculoskeletal system, so you should not delay its treatment.

At risk are adults in the age range from 30 to 50 years old, accustomed to leading an active lifestyle. Such an injury is common for them, it happens during active activities or games. This happens due to the wear and tear of connective tissues arising from degenerative age-related changes in the joints.

You can get an Achilles tendon stretch in everyday life, there is no certain insurance here. The conducted studies made it possible to reveal a kind of statistics that this tendon is most often damaged not by professional athletes, but by amateurs. Non-professional exercisers make the popular mistake of engaging in exercise and play without warming up their muscles sufficiently.

Injury classification

Classification of tendon disorders according to the type of damage:

Direct impact to the tendon - the injury occurs at the moment of impact on the ligament. Considered a direct type of injury, it is most likely to occur in football players due to the impact of an accelerated ball on the leg.
An indirect type of injury is caused by a sharp contraction of the muscles in the extended leg. This happens at the time of the jump, common among volleyball and basketball players.

An injury can occur due to an unexpected bend of the foot - occurs during landing on an extended toe of the foot. The usual type of injury is a closed rupture, but an open rupture often occurs. The reason for this is damage to the Achilles tendon with a sharp object.

Common factors that increase the likelihood of injury include:

the age of the victim statistically ranges from 30 to 50 years, the injury occurs due to the weakening of the entire ligamentous apparatus, where microscopic damage accumulates. In case of injury, they have the role of a "snowball" - the more of them, the higher the likelihood of a tendon rupture;
active games associated with a full range of movements - jumping, running, the need to quickly respond and stop movement. The cause of the injury is the lack of a full-fledged warm-up and warm-up of the muscles before classes;
gender of the injured person - most often they are men;
taking medications aimed at treating the ankle joint - with its inflammation and discomfort from pain. Many drugs can cause laxity of the surrounding ligaments, which is why increased stress can injure the Achilles tendon. In addition to steroid drugs, antibiotics cause a similar effect.

It is necessary not only to thoroughly warm up before active exercises, but also to monitor the diet. Unbalanced food can weaken the ligamentous apparatus and become an indirect cause of injury.

Clinical symptoms of injury

The rupture of the fibers of the connective tendon shows all the symptoms characteristic of such injuries:

the strongest pain syndrome, from pain in the literal sense "legs bend under." It is permanent and aching in nature, localized at the site of injury;
at the site of injury, tissues are seen to sink inward;
the damaged area immediately swells strongly;
blood vessels are damaged, extensive hemorrhage into soft tissues gradually develops. The maximum period of appearance is 3 days. The hematoma may eventually spread from the heel to the toes;
when palpating the tendon, a strong defect is revealed - thickenings at different ends of the gap;
it is not possible to bend the foot - with a complete rupture, a partial one entails weakened movements, while activity drops sharply;
complete or partial tear does not affect the passive activity of the ankle, only accompanied by severe pain - stretching of the torn heel tendon;
a characteristic crunch is inherent in the injury;
severe limitation of mobility - there is no way to climb stairs, walking is painful;
the victim is unable to stand on tiptoe.

Many of the problems associated with such an injury are associated with the triceps muscle. This results in lameness.

Damage Diagnosis

Determining a torn heel ligament is quite simple if the symptoms listed above appear. An accurate diagnosis can only be given by an orthopedic traumatologist, so seeking medical help is essential.

When diagnosing, the palpation method is used, which determines the likely symptom of a "failure" - an obvious rupture of the ligament. Calf muscle compression tests are used.

Such sign as "positive symptom of Thomson" is diagnosed. It is characterized by the following diagnostic method: the calf muscle is fixed, with a healthy limb, the foot should bend. Rupture of the calcaneal tendon is demonstrated by the fact that there is no flexion - the tension does not extend to the heel, the movement of the ankle is paralyzed.

Another characteristic feature is the “positive symptom of Pirogov”. The victim must be placed on his stomach, while the feet should hang above the floor. The injured person is urged to contract the triceps muscles on both legs. On a healthy one, the contours of the calf muscle will appear, but they will be absent on the damaged one.

An accurate diagnosis is made after ultrasound and MRI on the local area of damage. Pictures of these procedures allow you to determine not only the extent of the rupture, but also to find out whether the ligament is completely or partially torn.

Emergency First Aid

At the moment of injury, a characteristic crack or crunch is obviously audible, with which the fibers of the connective tissue are torn. Mobility is sharply disturbed, any movement is accompanied by increasing pain.

It is necessary to ensure complete rest and immobility of the injured leg until the pain subsides. The victim should sit or lie down so as to minimize the load on the injured limb. You should raise your leg - this will reduce swelling, reducing swelling. A backpack, a folded jacket, a small pillow can serve as a kind of roller - if the injury occurred at home.

The affected area must be anesthetized. The easiest way to achieve this is to apply ice. The role of a cold compress can be performed by ice from the refrigerator, wrapped in a cloth and a plastic bag. A bottle of cold water, semi-finished products, raw frozen meat - they will relieve swelling, reduce hemorrhage due to the fact that the vessels narrow under the influence of cold. Do not apply a compress for a long time, 10 minutes will be enough, after which you need to take a break for 20 minutes.

You can relieve the pain syndrome with painkillers - this is necessary for the period of the trip to the hospital in order to get there without problems. For the duration of the movement, the limb must be tightly bandaged with an elastic bandage.

Medical therapy

Treatment can occur in two ways: conservative and surgical. The choice of therapy is made depending on the age of the victim, the activity and severity of the injury. Surgical intervention is typical for young victims, while for the elderly it is preferable to use a conservative method of treatment. Both methods are equally effective, but the choice is made individually depending on the overall picture of the diagnosis.

Traditional treatment

The basis for conservative treatment is the complete immobilization of the injured leg. A plaster cast is applied, or an ankle brace is used. The limb is fixed in the position of the raised heel - thus the minimum distance between the ends of the torn calcaneal ligament is achieved.

Immobilization is safer than surgery and its consequences - anesthesia and infection of the incision. But the risk of re-injury increases, in which recovery will be significantly slowed down.

Possible types of immobilization used to achieve full fixation of the leg:

plaster splint - the foot is extended forward, the knee is slightly bent. Superimposed for 2 months;
polymer plaster cast - the principle is the same, but it is much easier to live - you can wash, the leg itself is light due to light materials, while maintaining strength;
orthosis - a corset for the leg, a kind of boot that fixes the damaged foot in one position. The superiority of the method lies in its ability to individually adapt to each patient.

Traditional treatment and subsequent passive recovery are recommended for those who live a quiet life that does not require increased activity. It is also used if surgery is contraindicated for a person due to chronic and hereditary diseases - hemophilia, heart disease, kidney disease, etc.

Modern methods have gone far ahead, so two types of surgery can be performed: open - the skin is cut to open access to the damaged tendon, and closed - the incision is not made.

An open operation is performed to stitch the tear - the ends of the ligament are connected by stitching together. If the injury is serious, then the ligament is additionally strengthened with artificial material.
Closed surgery consists in the treatment of a heel tear by applying a “percutaneous” suture. Threads are passed through the skin, capturing and connecting the ends of the tendon. A significant disadvantage is that the doctor cannot accurately see the ligaments and therefore does not match them too tightly. The result will be a bad splice.

Surgical intervention has a number of complications - infection and trauma to the nerve endings. The infection can be introduced even during a sterile operation, due to which the suture will fester. Only a small incision, together with the use of antiseptics during dressings, can reduce the risk.

Every surgeon can damage a nerve by accident, but this happens extremely rarely. The consequences of the operation include a cosmetic defect in the heel area - a scar. For some time, the mobility of the foot may be limited.

Recovery from surgery also requires the wearing of a cast to ensure complete immobilization of the injured leg. The bandage is applied for 1-2 months. You can only move with crutches.

Regardless of the type of treatment, anti-inflammatory painkillers are prescribed to relieve pain and inflammation in the damaged foot.

Recovery period

After successful treatment, a course is prescribed, aimed at restoring habitual mobility and strengthening muscles. The rehabilitation period lasts about 3 months, full restoration of tissues and return to the usual way of life can be expected only after six months.

The course includes physiotherapy exercises and physiotherapy. After removing the plaster splint, the use of massage techniques is allowed. All methods are aimed at strengthening damaged tissues.

Exercise should be started as soon as possible so that muscle tissues that have been immobile for a long time begin to stretch. To begin with, it is enough to strain and relax the muscles of the lower leg. Gradually, it is worth moving on to performing complicated exercises in the gym.

Massaging the ankle and foot will give the best effect. The circulation of lymph and blood will improve, tissue repair will accelerate. Physiotherapy in the course of rehabilitation is a supportive process aimed at relieving pain and swelling.

Prevention

It is important to avoid re-injury, because this increases the risk of unpleasant consequences. After the course of treatment, you must follow some rules:

develop and strengthen the muscles of the ankle and foot;
alternate sports with good rest;
choose good orthopedic shoes;
do not start training immediately, you need to gradually increase their intensity;
pay attention to the road when walking, bypass slippery and uneven places.

If the treatment is delayed, diagnostics are not carried out, or the victim decided not to seek help at all, then the ends of the tendon will gradually disperse, aggravating the injury. Often repeated or subsequent treatment will be useless. Timely diagnosis of the injury, its treatment and full recovery will save the victim from lameness for life.

According to statistics, most Achilles tendon ruptures are recorded among people involved in active sports. This is an injury in which the tendon that connects the muscles of the back of the leg to the calcaneus is completely or partially torn.

With this damage, you can feel a click or crackle, after which the strong and back of the ankle sharply appears. An injury almost always prevents normal walking, and many doctors recommend surgery as the most effective treatment for a tear. However, more conservative approaches can also work.

Symptoms

Although Achilles tendonitis and its subsequent rupture may be asymptomatic, most people notice one or more signs of damage:

pain (often severe and accompanied by swelling in the ankle area);
inability to bend the foot downwards or push off the ground with the affected leg while walking;
inability to stand on the tips of the fingers on the injured leg;
clicking sound or popping sound at the moment of tendon rupture.

Even if there is no pain syndrome as such, it is necessary to seek medical advice immediately after you hear a click or crack in the heel, especially if you have lost the ability to walk normally immediately after this sound.

The reasons

Helps to lower the moving part of the foot down, rise on tiptoe and push off the foot from the ground when walking. It gets involved in one way or another every time you move your foot.

The rupture usually occurs at an area six centimeters above the junction of the tendon with the calcaneus. This area is especially vulnerable, as blood circulation is difficult here. For the same reason, the tendon heals very slowly after an injury.

Very common examples of Achilles tendon ruptures caused by a sharp increase in load are known:

increasing the intensity of sports, especially if they include jumping;
falling from height;
foot in a hole.

Risk factors

Some circumstances increase the risk of Achilles tendon ruptures:

Age. Most often, injuries of this type are observed in patients from thirty to forty years.
Floor. According to statistics, for every female patient, there are five men with a tendon rupture.
Sports. Most often, damage is caused by physical activities, including running, jumping, and alternating sudden movements and stops. Examples are football, basketball, tennis.
Steroid injections. Doctors sometimes prescribe steroid injections to reduce pain and inflammation. However, these substances can weaken nearby tendons and eventually lead to ruptures.
Taking some, such as "Ciprofloxacin" or "Levofloxacin", increase the risk of injury in everyday activities.

Before visiting a doctor

Given that a tear (as well as inflammation) of the Achilles tendon can lead to the inability to walk normally, you should immediately seek medical help. You may also need to visit a doctor who specializes in sports medicine or orthopedic surgery.

To make the consultation as effective as possible, immediately before the appointment, write down the following information on paper:

a detailed description of the symptomatology and the previous event that caused the injury;
information about past health problems;
a list of all medications and nutritional supplements taken;
questions you would like to ask your doctor.

What will the doctor say?

The specialist is likely to ask you the following questions:

How did the tendon injury happen?
Did you hear (or perhaps not hear, but feel) a click or pop when you were injured?
Can you stand on your fingertips on an injured leg?

Diagnostics

During the initial physical examination, the doctor will examine the lower leg for tenderness and swelling. In many cases, a specialist can manually feel the rupture in the tendon if it has completely torn.

Your doctor may ask you to kneel in a chair or lie on your stomach on the examination table with your feet hanging over the edge of the table. With this diagnostic method, the doctor squeezes the patient's calf muscle to check the reflex: the foot should automatically bend. If it remains motionless, it is likely that the Achilles tendon has become inflamed. That is what ultimately led to the injury.

If there is a question about the extent of damage (that is, whether the tendon is completely torn or only partially), the doctor will prescribe an ultrasound or magnetic resonance imaging. Thanks to these painless procedures, detailed images of any tissues and organs in the body can be taken.

Treatment

Many people injure their Achilles tendons to some extent. Treatment often depends on age, level of physical activity, and the severity of the injury. In general, young patients and physically active people usually choose surgery, this is the most effective method. Patients of older age groups tend to conservative treatment more often. According to recent studies, correctly prescribed conservative therapy can be as effective as surgery.

Treatment without surgery

With this approach, patients usually wear special orthopedic shoes with a platform under the heel - this allows the torn tendon to heal on its own. This method eliminates many such as infection. However, recovery while wearing orthopedic shoes takes much longer than treating an injury with surgery, and there is a high risk of re-rupture. In the latter case, you still have to resort to surgery, but there is a high probability that it will now be much more difficult for the surgeon to correct the Achilles tendon rupture.

Operation

Usually surgery consists of the following. The doctor makes an incision in the back of the leg and stitches the torn parts of the tendon together. Depending on the condition of the damaged tissue, it may be necessary to reinforce the sutures with other tendons. Possible complications after surgery include infections and nerve damage. The risk of infection is greatly reduced if the surgeon makes small incisions during the operation.

Contraindications

Surgical treatment of Achilles tendon ruptures is contraindicated in those who have been diagnosed with an active infection or skin disease at the site of injury. Conservative therapy is also prescribed for patients with general poor health, diabetes, smoking addiction. Circumstances such as a sedentary lifestyle, the use of steroids, and the inability to follow the surgeon's postoperative instructions are also contraindications. Any health concerns should be discussed with your doctor first.

Rehabilitation

In order to permanently cure a torn Achilles tendon (after surgery or conservative therapy - it doesn’t matter), you will be prescribed a rehabilitation program that includes physical exercises to train the muscles of the legs and Achilles tendon. Most patients return to their normal lifestyle four to six months after the end of therapy or surgery.

Exercises

After conservative treatment, rehabilitation exercises can be started immediately after the disappearance of the pain syndrome, after surgery - as soon as the surgical wound heals. Physical activity is the key to a full recovery from injuries (especially if the injury is an Achilles tendon rupture). Rehabilitation begins with massage and increasing the overall mobility of the ankle - the feeling of stiffness should disappear. After two weeks of gentle therapy, active exercise is prescribed, and the best results can be achieved if you shine the much-needed physical activity from 12 to 16 weeks. The load begins with stretching, then they move on to strength exercises, including bending and straightening the knee.

If the pain syndrome has passed completely, you can connect a more sports-oriented load to training. It is desirable for athletes to go jogging and make more jumps. Recurrent Achilles tendinitis and subsequent rupture will become much less likely if the patient carefully adheres to the prescribed rehabilitation measures.

Rupture of the Achilles tendon is considered an injury that athletes are most susceptible to, but it is possible to get a rupture at home. In 90% of cases, full recovery is possible only with the help of surgery, and it is impossible to return to full-fledged activity and life without a subsequent course of rehabilitation.

Achilles tendon after injury may have:

Stretching. This is the easiest type of injury, and the tendon returns to normal after a short fixation of the joint, and a short recovery process;
Partial tendon rupture. In this case, the traumatologist, after a series of studies, decides on the need for surgery. If most of the tendon is intact, the patient's ankle is fixed, and after some time a course of restorative procedures is prescribed;
Complete rupture of the tendon, recovery in which is possible only by the surgical method. With a complete rupture of the Achilles tendon, recovery occurs in several stages, which include the postoperative period.

In each of the presented cases, a recovery period is necessary, and the intensity of the loads, duration, conditions, are recommended by the attending physician individually to each patient.

Postoperative period

There are two types of Achilles tendon surgery:

Open surgery to ligate, stitch, or implant a torn tendon;
A closed operation in which the tendon is tightened without a skin incision. Through special punctures, the surgeon sews the torn parts together and tightens them with suture threads.

In both cases, the postoperative and rehabilitation period are the same.

Immediately after the operation, a splint is applied to the operated leg from the toes to the upper thigh. The leg is fixed with an extended toe in the “away from you” position. Thus, tension is removed from the calf muscle, to which the operated tendon is attached.

On the 2nd - 3rd day after the operation, a magnetic field is applied to the area of the postoperative wound. Daily, for 10 days, this procedure is aimed at improving blood circulation, as well as reducing the possibility of adhesion formation.

It is very important in the first three weeks not to allow the slightest stretching of the calf muscle and tendon in order to avoid a rupture at the suture site. The longet is removed only for dressing and processing the seam. After removing the sutures on the 5th - 7th day, the splint remains for another two weeks.

At this point, easy rehabilitation after the operation begins. It includes general gymnastics to maintain the tone of the whole body. Exercises are performed sitting and lying down. Exercises for the upper body can be performed with the help of simulators, provided that the operated leg is treated with care.

Within two months after the operation, you will have to use crutches, and this is a significant burden for an untrained body, and overweight patients.

After three weeks, the plaster splint is shortened to the knee, and the patient can bend the leg at the knee. This facilitates movement with crutches, allows you to take a more comfortable sitting and lying position.

Recovery from an Achilles tendon rupture during this period is to increase activity. To the above, you need to add hip exercises. Due to intense workloads:

Improves blood circulation;
Several atrophied thigh muscles are restored;
The general condition improves;
Preparations are underway for the subsequent, effective period of rehabilitation.

rehabilitation period

6 weeks after the operation, the splint is fixed, the leg is fixed, and removed. And it is important to immediately begin a course of recovery after an Achilles rupture. This is an intensive course of procedures, including:

Observation of a rehabilitation specialist - orthopedist, analysis of the process, dynamics of recovery;
Massage;
Physiotherapy room;
Water procedures;
Electrical stimulation of the posterior leg muscles.

After removing the splint, the doctor conducts an examination and gives recommendations on the correct setting and stretching of the ankle. The foot hardly returns to its usual position, and the correct setting of the angle depends on the level of stretching of the tendon.

The patient continues to use crutches, but he is able to lean slightly on his leg.

Some patients, having specified how long the rehabilitation after an Achilles tendon rupture lasts, refuse these procedures in the hope of coping with this task on their own. In the absence of the necessary knowledge in this area, the patient may not calculate his strength. With insufficient stretching and development, contracture is possible, and with excessive load, a repeated rupture.

Observation of a rehabilitologist

The whole process must be carried out under the strict supervision of a physician. In the best case, take a course directly under the supervision of the doctor who performed the operation. This practice is common, and has a positive result.

The doctor observes the dynamics of the whole process, and changes the intensity of a particular procedure, notes the changes.

Massage

A light massage of the ankle and calf muscles immediately after removing the splint radically changes both the physical and emotional state. A muscle that has been in a static position for a long time is atrophied, and the purpose of the massage is to increase tone and improve blood circulation.

Already after the first procedure, the patient feels an improvement due to the effect on the part of the body that has been immobilized for a long time.

Massage, with each procedure becomes more intense, and only after a thorough warming up of the muscle, the patient goes to the exercise therapy room.

Physiotherapy room

From the first days of rehabilitation after a rupture of the Achilles tendon, the intensity of the load increases in the physiotherapy room. The first exercises are aimed at stretching the tendon.

To reduce the load, exercises are carried out while sitting, or with the help of an arm rest. With the help of special simulators, exercises are carried out to restore muscle tone.

The rehabilitation doctor monitors the step setting, the presence of foot rolling, and performs procedures that reduce stress. Massage devices for the foot help to quickly and painlessly stretch the tendon, and set the desired angle of the foot.

Standing on the toe is carried out only on two legs, running and jumping cannot be used in the first days of the rehabilitation course, since there is a high chance of a repeated rupture without proper stretching of the tendon and development of the calf muscle.

After 2.5 - 3 months after the operation, provided that the patient performs all the prescribed exercises, you can start putting on the toe, easy running. Jumping is best avoided for the first 6 to 7 months after surgery.

For a full recovery, you must constantly monitor the quality of the step, do the necessary exercises.

Water exercises and electrical stimulation

Rehabilitation after an Achilles rupture is faster when using all the possible procedures presented by the clinic. Exercises in the pool, thanks to the support of water, are easier. Swimming quickly restores muscle tone, allows you to perform exercises of any complexity.

Electrical muscle stimulation - forced contraction of the back muscles of the ankle. Atrophy after prolonged immobilization does not allow the full use of the tendon, and the action of the current, aimed at muscle contraction, leads them to tone. Thanks to this procedure, combined with exercise therapy and massage, the recovery process is much easier and painless.

Recovery without surgery

Repair of a torn Achilles tendon without surgery is possible only in case of a partial rupture. In this case, the patient's ankle is fixed, as in the case of a complete rupture, depending on the severity of the injury. Rehabilitation after a rupture of the Achilles tendon, even with a partial rupture, proceeds in the same way as with a complete rupture.

In any case, only a traumatologist can correctly assess the severity and prescribe treatment.

Operations of this kind are not performed on people with diabetes, the elderly, and patients with heart disease.

Rehabilitation after a sports injury

The rehabilitation of athletes after an Achilles rupture is aimed at the fastest possible recovery, and enhanced special training is added to the above process.

Due to good physical shape, full recovery occurs much earlier than in people far from sports.

Even light running is included in the training regimen no earlier than 3-4 months, and a full return to sports is possible only 6 months after the operation.

In case of an injury of any kind, the conclusion of a traumatologist is necessary. The sooner treatment is started, the easier the surgery and recovery process will be.

The Achilles tendon is named after the hero of the ancient Greek epic Achilles, whose mother, the goddess Thetis, wishing to make her son immortal, dipped him, according to one version, into the oven of Hephaestus, according to another, into the waters of the River Styx, while holding his heel. In this ill-fated heel, which remained the only weak point of the hero, he was struck, according to one version, by Paris, according to another by the god Apollo himself, which led to his immediate death.

The Achilles (heel) tendon is the strongest and largest human tendon, capable of withstanding a load of up to 350 kg. Through it, the muscles of the back of the lower leg move the foot, which allows you to stand on your toes and push off the ground when walking or running.

Achilles tendon rupture is one of the most common injuries in the working population. Most often occurs in men 30-40 years old, occasionally involved in sports. The rupture occurs most often at a distance of 4-6 cm from the calcaneal tubercle (in this place the tendon is least supplied with blood). The right calcaneal tendon is more developed, since in most people it is the right leg that is under the most stress and is the leading one, therefore the Achilles tendon of the left leg is more often damaged.

Achilles tendon rupture symptoms:

sudden pain, similar to a blow to the shin and ankle with a stick;
a crunch can be heard accompanying the gap;
it is impossible to stretch the foot or stand on tiptoe;
there is pain when walking;
foot and ankle are swollen.

If you experience the above symptoms, do not massage the calf muscles and tendons. Apply something cold to the tendon and see a doctor.

Achilles tendon rupture diagnosis:

examination by a specialist, conducting a series of diagnostic tests to confirm the rupture of the Achilles tendon;
radiography;
MRI study;

Despite the apparent simplicity of the clinical picture, Achilles tendon ruptures are not diagnosed in a timely manner in 25% of victims. Therefore, the doctors of our Clinic of Dr. Grigorenko pay especially close attention to all patients with complaints of weakness of the plantar drive and gait disturbance, especially if the injury is shortly before treatment.

Mechanisms of damage to the Achilles tendon.

1. Closed injury:

a. direct: a blow with a blunt object on a stretched Achilles tendon leads to a sudden sharp contraction of the calf muscle and rupture of the tendon (more often this mechanism occurs when playing sports);

b. indirect: as a result of a sharp contraction of the calf muscles with an extended leg (when trying to jump in basketball or volleyball); with an unexpected sharp dorsiflexion of the foot (when slipping from the stairs); when falling from a height onto a leg with an extended toe (at the time of a jump or landing by volleyball players, gymnasts, ballet dancers).

2. Open trauma:

as a result of a cut with a sharp object of the posterior-lower part of the lower leg.

3. Rupture of the Achilles tendon may occur due to his chronic disease from overexertion.

Achilles tendon rupture treatment:

Calcaneal tendon ruptures can be treated conservatively and surgically.

conservative method.

if the injury is fresh and tendon ends can be compared;
if the patient does not play sports;
if the functional requests of the patient are reduced due to age, little physical activity or other reasons.

Conservative treatment is not much inferior in its results to surgical treatment, and most importantly, it is characterized by the absence of the risk of infectious complications. The disadvantages of conservative treatment are considered to be a longer rehabilitation period compared to surgical treatment. This treatment includes:

1. Immobilization of the leg with an extended toe for 1.5-2 months. This is necessary to bring the ends of the tendon closer to each other and ensure their fusion.

2. The development of the joint, it begins even during the immobilization of the limb, and this approach improves the results of treatment. For recovery, the patient is recommended exercises in therapeutic exercises and physiotherapy.

3. A course of osteopathy and manual therapy - helps to accelerate tissue regeneration, gently corrects violations of body functions, helps to eliminate functional blocks of muscles, ligaments and joints, optimizes the circulation of fluids in tissues, activates internal reserves for natural healing.

4. Physiotherapy - has an effect on deep tissues, improves blood circulation, stimulates metabolism, maintains muscle tone in a damaged area, is aimed at improving muscle tone and elasticity, eliminating muscle spasms and eliminating congestion in muscles, helps to avoid edema.

5. The course of mud therapy - has a local analgesic, anti-inflammatory and absorbable effect on damaged tissues, normalizes metabolism, improves tissue nutrition, causes softening of scars, accelerates the process of tissue fusion, reduces stiffness in the joints.

6. The course of mechanotherapy - helps to strengthen the muscular frame of the whole body and maintain the body in good shape, provides functional restoration of the joints, eliminates the complications of diseases, develops physical qualities - strength, flexibility, endurance, mobility, develops the correct stereotypes of movements and postures.

7. Functional training - helps to work out the mechanisms of movement necessary for a person in everyday life, prepare the body for any stress, promotes the development of coordination of movements, flexibility, increased muscle strength and endurance, strengthens the articular apparatus.

8. Therapeutic physical culture - helps to restore the impaired properties of the musculoskeletal system, teaching the correct and safe performance of movements, improving the function of blood circulation, respiratory organs, metabolism, increasing endurance, strength and coordination.

9. Acupuncture - helps to improve blood circulation and nervous regulation at the site of injury, reduces the risk of loss of motor functions in injuries.

10. Compliance with the necessary appropriate diet - muscle tissue must regenerate, and for this it is necessary to consume vitamins and minerals during the rehabilitation period and directly - treatment.

surgical method.

Surgical intervention should be performed in cases where the rupture of the Achilles tendon was not diagnosed in a timely manner, the rupture occurred against the background of pre-existing connective tissue diseases, or conservative treatment did not give the expected effect.

After the surgical assistance, it is necessary to carry out a number of rehabilitation measures similar to those used in the conservative method of treatment. Self-rehabilitation can be dangerous, transitions from one stage of rehabilitation to another should be carried out only under the strict supervision of a specialist.

Complications after suffering a rupture of the Achilles tendon:

Complications of conservative treatment are considered to be a higher risk of re-rupture and fusion with elongation, resulting in weakness of the plantar drive. However, timely and competent conservative treatment is rarely accompanied by these types of complications and is comparable in its effectiveness with surgical methods.

Complications of surgical treatment include primarily infectious complications observed in 5-10% of cases. The smaller the access to soft tissues during the operation, the lower the risk.