Techniques in Achilles Tendon Rehabilitation

Abstract

There are estimates of approximately 30 to 34 million runners within the United States, of which one quarter to one half will sustain a yearly injury severe enough to cause modification or cessation of training. 1,2 This conservatively accounts for 7.5 million running related injuries per year. Pathologies involving the Achilles tendon are a frequent source of symptoms in the musculoskeletal arena. These vary from acute tendonitis to complete rupture and subsequent repair. Achilles tendon disorders represent the third most common complaint in injured runners, exceeded only by knee pain and posteromedial shin pain. Achilles tendon disorders account for approximately 11% of running injuries per year. 3,4 Teitz et al 5 reports Achilles tendon injury rates of 9% in dancers, 5% in gymnasts, 2% in tennis players, and less than 1% in football players. Using these data, Achilles disorders may well affect well over one million athletes per year. When recognized and treated early, this condition is commonly treated nonoperatively. However, when conservative treatment fails, and operative treatment is required, progression of the rehabilitation programs is based upon functional biomechanics. Changes in operative versus nonoperative rehabilitation programs are based upon tissue quality, healing restraints, and fixation strengths. The techniques noted within this article are used in both arenas, although timeframes vary based upon surgical and healing limitations. The rehabilitation professional who has a firm foundation in the anatomy, biomechanics, and pathomechanics of these disorders is better prepared to obtain an optimal functional outcome in the least amount of time.