Achilles Rupture Early Weight-Bearing: A Step Towards Faster Recovery
Achilles tendon rupture is a common injury that can be debilitating. Historically, it often required surgical intervention for proper healing. In the past, the recovery process for Achilles tendon ruptures involved lengthy period of immobilization in a cast or brace, followed by gradual return to weight-bearing activities.
However, in the recent years, there has been a paradigm shift towards Achilles rupture early weight-bearing and functional loading, which has shown promising results in speeding up recovery and improving outcomes. In this blog, we will explore the concept of early weight bearing post Achilles rupture and its potential benefits.
Understanding Achilles Tendon Rupture
The Achilles tendon is the largest tendon in the human body, connecting the calf muscles to the heel bone. It plays a crucial role in walking, running and jumping. A rupture typically occurs as a result of a sudden forceful overstretch of the Achilles tendon, leading to a partial or complete tear. It commonly occurs during a step back motion in basketball and tennis or changing directions in soccer.
Historical Approach: Immobilization
Traditionally, the treatment approach for Achilles tendon rupture involved immobilization of the ankle in a cast or brace for an extended period, often up to 8-12 weeks. This method aimed to protect the injured tendon and allow it to heal gradually. However, it had several disadvantages:
Muscle Atrophy: Extended immobilization and rest leads to significant muscle loss in the calf and thigh resulting in weakness and loss of function
Stiffness and Reduced Range of Motion: Immobilization and rest could lead to joint stiffness and a decreased range of motion in the ankle and foot, making it challenging to regain normal function and allow proper strengthening of the calf muscle.
Delayed Rehabilitation: Prolonged immobilization delayed the start of rehabilitation, leading to slower recovery, a higher rate of re-ruptures and a higher risk of complications like blood clots.
Mental challenges due to “not being able to do anything” for weeks or months. We refer to this as the “couch potato syndrome”.
The New Kid on The Block: Early Weight-Bearing
In recent years, orthopedic research has focused on finding more efficient and effective ways to treat Achilles tendon ruptures. Early weight bearing and functional loading, also known as accelerated rehabilitation, has gained popularity as a treatment approach and protocol.
This method involves initiating gradual weight-bearing and early mobilization of the ankle within 3 weeks of the Achilles rupture or surgical repair. This is true for both surgical and non surgical approach.
Why weight bearing early is good for you?
Faster Recovery: Early functional loading promotes faster healing of the tendon and surrounding tissues. It stimulates blood flow to the injured area, which accelerates the natural healing process.
Reduced Muscle Atrophy: Weight-bearing activities and range of motion exercises help maintain muscle strength and reduce muscle atrophy during the recovery period.
Improved Range of Motion: Early mobilization helps preserve and improve the range of motion in the ankle joint, which is essential for normal function.
Lower Risk of Complications: Studies have shown that early functional loading may reduce the risk of complications such as deep vein thrombosis and joint stiffness.
Earlier Return to Normal Activities: Patients undergoing early functional loading often return to daily activities and sports sooner than those following traditional immobilization methods.
Improved mood and reduced fear in the early stages: Starting to work on weight-bearing exercises within the first month following and Achilles rupture is highly beneficial mentally compared to patients who have to wait 6-8 weeks to start physiotherapy.
The Rehabilitation Process
Early weight bearing post Achilles rupture involves a well-structured rehabilitation program under the guidance of a physical therapist and an orthopedic specialist. The process typically includes:
Gradual Weight-Bearing: Patients start with partial weight-bearing using crutches and a walking boot. Over time, they gradually increase the amount of weight they put on the injured leg.
Range of Motion Exercises: Gentle ankle exercises help improve flexibility and reduce stiffness. Initially, it is all performed with the foot pointed down to protect the Achilles tendon and avoid excessive stretch in the early stages.
Strength Training: Progressive strengthening exercises for the calf muscles and surrounding muscles are essential to regain full function.
Gait Training: Learning to walk properly again is a crucial part of rehabilitation.
Functional Activities: As the patient progresses, they will incorporate more functional activities and sports-specific exercises to prepare for a return to normal activities.
Are you curious about 416 Physio’s very own early weight-bearing rehab protocol? Visit our Achilles Care page and download it for free!
At 416 Physio, we have treated over 150 patients with Achilles ruptures in the past 3 years. Our team of physios, chiros and massage therapists are passionate about promoting and helping people recover from Achilles-related injuries. If you are interested in in-person or virtual care, even if it is just a one-off consultation, reach out to us or book below.
The Bottom Line
Achilles rupture early weight bearing represents a significant advancement in the treatment of this challenging injury. It offers patients the opportunity for
faster recovery
reduced calf muscle loss
improved ankle range of motion
lower risk of complications
reduced fear and mental challenges
However, it's essential to consult with a healthcare professional to determine the most suitable treatment approach and protocol for each individual case. With the right guidance and rehabilitation plan, many patients can look forward to a full recovery and a return to their active lifestyles.
Further Readings on Achilles Ruptures:
Aufwerber S, Heijne A, Edman G, Silbernagel KG, Ackermann PW. Does Early Functional Mobilization Affect Long-Term Outcomes After an Achilles Tendon Rupture? A Randomized Clinical Trial. Orthop J Sports Med. 2020;8(3):2325967120906522. Published 2020 Mar 16. doi:10.1177/2325967120906522
Zellers JA, Christensen M, Kjær IL, Rathleff MS, Silbernagel KG. Defining Components of Early Functional Rehabilitation for Acute Achilles Tendon Rupture: A Systematic Review. Orthop J Sports Med. 2019;7(11):2325967119884071. Published 2019 Nov 25. doi:10.1177/2325967119884071
