Phase 1-Acute Phase: Immediately after the injury occurs, the individual needs to begin the basic steps of treatment. Although the steps seem minimal, they are crucial and must be administered. These steps consist of rest, ice, compression, elevation, and immobilization. In this injury you want to minimize the blood flow to the affected area. Resting reduces the risk of further injury. Ice should be applied 24 to 48 hours after the injury and will not only reduce swelling but any of the acute pain. Compression will reduce bleeding and reduce swelling, just as elevation will use gravity to reduce bleeding and reduce swelling by allowing fluids to flow away from the site of injury. There are many misconceptions about the way to apply ice,
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When doing a surgical repair on the tendon, there are multiple ways to operate. The one I will go into is called open repair. In an open repair both medial and longitudinal approaches are used. A tourniquet is used and the rupture gap is palpated. Incisions are made through the skin down to the paratenon, which is the fatty material between a tendon and its sheath. The paratenon is then divided to uncover the ruptured ends. By plantar flexing the ankle, the ends are then reconnected and secured with heavy non-absorbable sutures using a modified Kessler, Krackow, or Bunnell technique. The surgeon has to be sure not to over tighten the repair. If this occurs the tendon length might be shorten which would lead to loss of dorsiflexion. After the repair is done, the paratenon and skin are closed. A cast is placed on the lower leg/foot region following the operation.
Phase 3- Rehabilitation Phase: Total recovery from an Achilles tendon rupture is estimated to be between 6-9 months. The general outline of post surgical rehabilitation consists of 6 to 8 weeks of immobilization, heel lifts, passive and active range of motion exercise, progressive resistance exercise, and ice after workout. A cast or brace should be placed on the patient for 6 to 8 weeks to protect the repair