Recovering From an Achilles Tendon Rupture: Five More Treatment Considerations
Posted by Jenn F. on Friday, March 2nd, 2018
Last week, we discussed the decision to have surgery for a ruptured Achilles, methods for tendon strengthening, expectations for recovery timetable, how to predict success, and the importance of controlling inflammation. This week, we look at five more of our West Coast colleague Dr. Richard Blake’s “Secrets To Keep Moving.” These important tips with help you on the journey of recovering from an Achilles tendon rupture.
1. Start Rehab with Range of Motion Exercises and Progress to Strengthening
Guided range of motion exercises can begin as early as 72 hours after surgery. Activities are done slowly and smoothly, progressing from one set to two, and eventually to three. Many of the stretches we do can be found in this pamphlet. One of your earliest goals in rehabilitation is to strengthen the tendon enough to perform 50 one-sided toe raises. Once you achieve this milestone, we can move on to more active stretching and range of motion goals. We like to use TheraBands for gentle resistance exercises.
2. Use Deep Calf Massage to Stimulate Circulation
Who doesn’t love a good massage? Therapeutic massage certainly has its place when recovering from an Achilles tendon rupture. After the fresh tendon injury has healed—usually somewhere between weeks 6-8—vigorous massaging is important for breaking up stiffness and scar tissue adhesions that may otherwise cause you trouble down the road. Massage therapy is also credited with reducing swelling and aiding circulation. Light massage may be performed daily, but deep tissue massage should have time for recovery between sessions, as you would do with any workout.
3. Avoid Negative Heel Stretching
Surely you’ve heard the generalized advice touted by fitness magazines: “Simply stand on a stair and dip your heels down to stretch the heel cord.” However, negative heel stretching can actually be extremely damaging to a newly repaired tendon, not to mention the plantar fascia band of tissue running across the arch. We do not recommend this type of stretch, as it lowers the foot into an unnatural position, with your full body weight going into the Achilles and plantar fascia attachments. You will also want to avoid negative heel shoes, such as Kalso Systemet’s Earth Shoe, as it places undue stress on the Achilles.
4. Choose a Shoe with a Firm Heel Lift or Get Fitted for Orthotics
Here in the office, we have all the equipment necessary to scan you for custom orthotics. These insoles are fitted to the unique contours of your feet and go into almost any type of footwear to move the foot into an offloading position, so your Achilles can recover without excess strain. We prefer to use custom orthotics because they are more durable and customized to your individual foot shape. However, in some cases, you may do well with a basic over-the-counter heel lift. It’s always best to consult with a podiatrist before making any aftermarket modifications to your footwear so you do not cause more harm.
5. Address Issues of Overpronation or Oversupination Now
Neutral feet that remain completely flat as the foot rolls from heel to toe are the rare exception, not the rule. Overpronation occurs when the foot naturally rotates inward with each step. An estimated 50-60% of runners are mild pronators, while 20-30% are severe overpronators. About 10% of the population are supinators, meaning that the feet roll outward as they run or walk. Orthotic devices are crucial in stabilizing the feet of overpronators or oversupinators. Having this correction can reduce future stresses on the healed tendon at a very minimal cost to you. If you’re not sure whether you have any of these issues, gait analysis can reveal the information.
If you have an Achilles tendon rupture, it’s important that you get the best care possible. Here at the Center for Podiatric Care and Sports Medicine, we have all the latest tools and advanced techniques to treat your Achilles tendon injury. Contact us today to book your appointment.
If you have any foot problems or pain, contact The Center for Podiatric Care and Sports Medicine. Dr. Josef J. Geldwert, Dr. Katherine Lai, Dr. Ryan Minara and Dr. Mariola Rivera have helped thousands of people get back on their feet. Unfortunately, we cannot give diagnoses or treatment advice online. Please make an appointment to see us if you live in the NY metropolitan area or seek out a podiatrist in your area.