Rehabilitation for Achilles Tendonitis

Achilles tendonitis is an inflammation of the Achilles tendon, the strong band of tissue that connects the calf muscle to the heel. This condition frequently affects athletes and occurs when excessive stress and pressure are placed on the tendon. Achilles tendonitis is usually a painful but short-lived condition. Treatment for Achilles tendonitis varies and can range from conservative treatments that may include rest, anti-inflammatory medication and ice, to surgery for more severe cases. Although the methods used to treat Achilles tendonitis may vary, rehabilitation is often necessary after the initial treatment, to restore full movement and mobility and help the patient return to all usual activities.

Nonsurgical Rehabilitation for Achilles Tendonitis

Patients with mild cases of Achilles tendonitis may benefit from physical therapy as they recover from the condition. Treatment may include applying moist heat and massage to control pain and swelling. Stretching and strengthening exercises may be slowly introduced, depending on the patient's level of discomfort. As the condition improves, calf-strengthening exercises can help the patient regain motion and mobility. Strengthening exercises may include:

  • Isometric exercises that work the muscles while protecting the area that is healing
  • Eccentric exercises to work the calf muscle while it lengthens

A small heel lift may be recommended to be inserted in the heel of the shoe to minimize the stress on the muscle and Achilles tendon. Recovery periods may vary, but with physical therapy most patients experience a full recovery from Achilles tendonitis within about 8 weeks.

Rehabilitation After Achilles Tendonitis Surgery

In persistent cases of Achilles tendonitis, surgery may be recommended. Surgery may involve splitting the tendon and removing inflamed tissue from the area. The split tendon is then repaired and allowed to heal. After surgery, the affected area is put in a cast or set in a brace for 6 to 8 weeks, and a physical therapist works with the patient to make sure that crutches are used safely. When the cast is removed, initial treatment may include ice, massage and whirlpool treatments to control swelling and pain.

Physical therapy treatments focus on improving range of motion without putting excessive strain on the healing tendons. Muscle-stengthening exercises and range of motion exercises may all be used to increase movement and mobility. Exercises are sometimes performed in a pool because the buoyancy of the water helps people to exercise safely without putting too much pressure or tension on the healing tendon. After surgery, physical therapy may be necessary for up to 4 or 5 months and full recovery may take up to 6 months.

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