A rifle shot or a car backfiring is the sound many of our patients describe hearing when they rupture their Achilles. They hear the shot and find themselves on the ground and wonder how they got there and who could have tripped them when there’s no one around.
The middle-aged weekend tennis player or basketballer are among the usual suspects attending our clinics post Achilles rupture. Their sport requires explosive change of direction and speed for which they are inadequately prepared due to poor fitness and little or no warm-up on top of a history of low-grade Achilles dysfunction. Throw in diabetes and corticosteroid use and you may as well book time off the court now.
First-timers are usually managed conservatively with crutches and a ‘moon’ boot to deload the damaged tissues and allow healing to take place.
Physiotherapy treatment to reduce inflammation and manage pain starts early on and as recovery progresses the physiotherapist works with the patient to restore muscle length, restore tendon and muscle strength and regain joint range of motion. The other component of rehabilitation involves addressing factors contributing to the original injury including poor foot and lower limb biomechanics; restricted neural tissue; balance and proprioception; and cardiovascular fitness.
For the patient presenting for a second or third lap around the Achilles rupture block or for those whose work or sport requires high-level function it’s off to the friendly local orthopaedic doc for a surgical repair. Depending on the doc’s point of view it’s 6 to 12 weeks in the boot before starting a similar rehab process outlined for conservative management.