Question:I ruptured my left Achilles tendon over the weekend. The surgeon can't fit me into the schedule until next week. Is this going to delay my recovery?
Answer:Probably not. There is still much debate about the best way to treat Achilles' tendon ruptures. Some patients opt to avoid surgery and wear a brace or a cast for six weeks. Surgery has improved over the years so recovery is faster than it used to be and with fewer complications.
But the final outcome between conservative treatment and surgical repair remains about the same for many people. In both methods, a semifunctional rehab program begins two weeks after the injury or repair. A special walking boot is used for about eight weeks.
At first, patients can put partial weight on that side when walking. The ankle is kept in a plantar flexed position (toes pointing down) to avoid overstretching the healing tendon.
Stationary cycling is allowed during the third week. By the fourth week, the foot and ankle are brought back up to a neutral position. Neutral means the ankle isn't dorsiflexed (toes up toward the face) or plantar flexed. Active foot and ankle motion are started in the fourth week and slowly progressed to full motion.
Around the sixth week, the amount of weight-bearing (load) allowed is increased. The patient can continue to gradually increase the amount of weight placed through the foot and ankle until full load is reached. At this point (usually around eight weeks), the brace or cast can be removed. Rehab can progress at a full pace to restore muscle length and strength.Francesco Ceccarelli, MD, et al. Percutaneous and Minimally Invasive Techniques of Achilles Tendon Repair. In Clinical Orthopaedics and Related Research. May 2007. No. 458. Pp. 188-193.
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