Tendon Achilles repair (TA repair)

Achilles tendon is a tough band that comprises of a fibrous tissue which connects the calf muscles to the heel bone and it is also known as the calcaneal tendon. When the soleus muscles and the gastrocnemius muscles unite into one band of tissue becomes the Achilles tendon at the low end of the calf. Bursae which are the small sacs of fluid cushions the Achilles tendon at the heel. It is the strongest and the largest tendon in the human body.

Mainly, when calf muscle flex, the tendon pulls on the heel and this movement allows us to stand on our toes while walking, jumping or running. Though it has got strength, but the tendon is also vulnerable to injury, due to its limited blood supply and the high tensions placed on it.

Symptoms of Achilles tendon

Some of the symptoms that arouse before Achilles tendon are a mild ache in the back of the leg or above the heel after some sports activity including running. More severe pain may occur after prolonged stair climbing, running or sprinting.You might also experience some sort of tenderness or stiffness, especially in the morning, which casually improves with mild activity.

Causes of Achilles tendon

The structure of the tendon weaken up with age that makes it more susceptible to injury and is present particularly in people who may participate in sports only on the weekends or those who have suddenly increased the intensity of their running programs. It mostly occurs in men.

Risks of Achilles tendon

  • Physical problems– A naturally flat arch in your foot can put more strain on the Achilles tendon. Tendon strain also can be increased with obesity and tight calf muscles.
  • Training choices-Running in worn-out shoes can increase your risk and tendon pain occurs more frequently in cold weather than in warm weather. Also, running on hilly terrain can lead you in injury.
  • Medical conditions-Psoriasis or high blood pressure in people can lead to higher risk of developing Achilles tendinitis.
  • Medications– Use of Certain types of antibiotics, called fluoroquinolones, have been associated with higher rates of Achilles tendinitis.

 

Rehabilitation for Achilles tendon

Phase I- Surgery to two weeks after surgery

  • Rehabilitation appointments begin 14-16 days after surgery
  • Protection of the surgically repaired tendon
  • Wound healing Precautions
  • Continuous use of the boot in locked plantarflexion (20-30°)
  • Touchdown weight bearing (TDWB) using the axillary crutches
  • Keep the incision dry
  • Watch for signs of infection
  • Avoid long periods of dependent positioning of the foot during the first week to assist in wound
  • Upper Body Ergometer (UBE) circuit training Progression Criteria
  • Two weeks after surgery

Phase II- begin after meeting Phase 1 criteria, usually 2 -4 weeks after surgery)

  • Normalize gait with weight bearing as tolerated (WBAT) using the boot and axillary crutches
  • Protection of the post-surgical repair
  • Active dorsiflexion to neutral

Phase III- begin after meeting Phase 1 criteria, usually 2 -4 weeks after surgery)

  • Normalize gait on level surfaces without boot or heel lift
  • Single leg stand with good control for 10 seconds
  • Active ROM between 5° of dorsiflexion and 40° of plantarflexion

Phase IV- begin after meeting Phase 1 criteria, usually 2 -4 weeks after surgery)

  • Normalize gait on all surfaces without boot or heel lift
  • Single leg stand with good control for 10 seconds

Phase IV- begin after meeting Phase 1 criteria, usually 2 -4 weeks after surgery)

Good control and no pain with sport/work specific movements, including impact