achilles tendon rupture accelerated rehab protocol

The Thompson Test should be applied in all suspected cases Remember to brace or splint a rupture, even if suspected, in the resting equinus position for optimal healing and prevention of further injury Rehabilitation phases after an Achilles tendon rupture The rehabilitation can be divided into four phases (1): The decision when a patient should proceed from one phase to the next is proposed to be based on both the recovery of the patient and the time since the injury. Active ROM between 5 degrees of dorsiflexion and 40 degrees of plantarflexion. Tripping, falling or twisting your ankle can also cause an Achilles tear. Partial 1.Introduction. SWE is a convenient noninvasive method to determine the progress of the healing process after tendon injury. Achilles Tendon Rupture - Non-operative treatment rehabilitation guidelines 0-2 WEEKS REST (PHASE 1) Goals Rest, recovery and mobilise non-weight bearing safely on crutches Immobilisation Plaster cast/Rigid boot with foot pointing downwards 20 (with 3 wedges inside - 22/16/10, more if needed) endstream endobj startxref The acute rupture of the Achilles tendon is a protracted injury. Passive dorsiflexion both with knee in extension and flexed to 35 - 400 until gentle stretch on achilles. 179 0 obj <> endobj Injury. outcome drills ie. Keywords: high load ankle, knee, hip In an acute Achilles Tendon Rupture, there are two options: If you have any questions please do not hesitate to contact Mr Goldblooms rooms on 0493051985.The Accelerated Rehabilitation Program has been developed by Mr Goldbloom in conjunction with Physiotherapists Brodie Leonard-Shannon and Brendan Mason from Back in Motion, Aspendale Gardens. hYmo6+DU f[j;;4vv+yw=lrD building to endobj training. An objective assessment of surgical and non-surgical treatment. Continue resisted inversion and eversion through range, Double leg stance out of boot; single leg stand in boot progressing to out of boot as balance improves. . endobj Pull your toes upwards to stretch the Achilles tendon. %%EOF Impact control exercises beginning with two feet to two feet, progressing from one foot to the other, and then one foot to the same foot. )$Ffni(G"okg]3io m"7r ;NOsGL8ad{qF%k-+c0R N-1@i[L6Sy=0C4ddB2@g.! IM5^]rCFWD-0y- 9NL~4,MHJOh Diagnosis can be made clinically with weakness of plantarflexion with a positive Thompson's test. without in air contact The guiding principle for this rehabilitation protocol is early ankle motion, since it is believed to be the main reason why surgically treated Achilles tendon ruptures show a lesser rate of recurrence than those treated conservatively with a period of immobilization. 3 0 obj The site is secure. Achilles Rupture Non-operative Protocol Page 3 of 3 Last Updated September 3, 2020 REFERENCES: 1. and transmitted securely. This can strain your Achilles tendon. =+Q%90Z6U='-rj\Ig pV.4FqW%W)53s^#D3 a`CN3=z[lmOgEA5CWwpLz9r4-+94Is9>}n-9k=n6R LAJxeF$ylM>MY@0vFEviCM ml@5s? endobj Active ankle eversion/inversion. After the second postoperative week controlled ankle mobilization by free. The acute rupture of the Achilles tendon is a protracted injury. Injury to the Achilles tendon causes pain along the back of your leg near the heel. /n%^xij_2]!J] n >!UGld Post-op weeks 2-3: boot at 20 degrees, sleep in boot, TTWB with crutches, no active DF. #WDA Federal government websites often end in .gov or .mil. PMC Three trials compared the combination of full weight bearing and early ankle mobilization to immobilization. An official website of the United States government. Ankle strengthening with resistance bands. Accelerated rehabilitation following Achilles tendon repair after acute rupture development of an evidence-based treatment protocol. 3 0 obj Acute Ultrasonographic Investigation to Predict Rerupture and Outcomes in Patients with an Achilles Tendon Rupture. He was able to ambulate without assistive devices at the 5-week follow-up examination. Achilles tendon repair surgery is a type of surgery to fix a damaged Achilles tendon. [PubMed: 25059505]. Bethesda, MD 20894, Web Policies Westin et al. Consequently, the aim of our study was to systematically search the evidence available and define a precise rehabilitation programme after operative repair of acute Achilles tendon rupture based on the trials with the highest level of evidence. Sport/work-specific balance and proprioceptive drills. This protocol was updated and reviewed by Dr. Devries and Dr. Scharer of BayCare Foot & Ankle Center and by Jessica Sigl, DPT on . Copyright 2014 Elsevier Ltd. All rights reserved. Open chain strength exercises for quads, hamstrings, glutes hip flexors. Can commence light isometric calf exercises at low resistance and reps, not past plantar grade. 2017 Mar;137(3):333-340. doi: 10.1007/s00402-017-2627-9. It happens most frequently while playing sports. One randomized controlled trail, one prospective comparative and five prospective non-comparative studies were identified. partial weight 1 0 obj The goal of surgery is to reapproximate the ruptured tendon ends in order to promote healing and restore overall strength. official website and that any information you provide is encrypted Functional rehabilitation of patients with acute Achilles tendon rupture: a meta-analysis of current evidence. xwn $8sxkL=. *MoaoLzhN:fOad)t-h96.&JxEys4JUy-nEu  Epub 2018 Jan 8. Bookshelf Immediate weight bearing in a functional brace, together with early mobilization, is safe and has superior outcome following minimally invasive repair of Achilles tendon rupture. Frankewycz B, Krutsch W, Weber J, Ernstberger A, Nerlich M, Pfeifer CG. IRh3J@+ZR*RNE+Ni$Gg3) x):+!#$SEL*u:Jd4r In conclusion, the rehabilitation protocol after Achilles tendon repair should allow immediate full weight bearing. Achilles (uh-KILL-eez) tendon rupture is an injury that affects the back of your lower leg. ACHILLES-TENDON-RUPTURE-ACCELERATED-REHAB-PROTOCOL.pdf - Free download as PDF File (.pdf), Text File (.txt) or read online for free. The body then heals the tendon in the appropriate position. Our rehab protocols outline timing, precautions and progression criteria for returning to activity. York (UK): Centre for Reviews and Dissemination (UK); 1995-. It attaches your two calf muscles (gastrocnemius and soleus) to the heel bone (calcaneus) and helps you go up onto tiptoes. Treatment of acute Achilles tendon rupture in Scandinavia does not adhere to evidence-based guidelines: a cross-sectional questionnaire-based study of 138 departments . <>/ExtGState<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/Annots[ 32 0 R 33 0 R 34 0 R 35 0 R 36 0 R 37 0 R] /MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> Emerg Med Int. Continue hip and 4 0 obj Brumann M, Baumbach SF, Mutschler W, Polzer H. Injury. Achilles Tendon Repair Rehabilitation Protocol Phase I (surgery to 2 weeks after): Splint/Boot: Locked 20-30 degree plantarflexion for two weeks Weight-bearing: Touchdown weight-bearing (TDWB) with crutches Cardiovascular: Upper body circuit training Patient Precautions: Keep elevated. -, Unfallchirurg. Centre for Reviews and Dissemination (UK), York (UK). Jnsdttir US, Brorsson A, Nilsson Helander K, Tranberg R, Larson MEH. All trials found mobilization to be superior as it shortens time to return to work and sports significantly. Keywords: Development of an accelerated functional rehabilitation protocol following minimal invasive Achilles tendon repair. Immediate full weight bearing led to significant higher patient satisfaction, earlier ambulation and return to pre-injury activity. [1] [2] Achilles tendinopathy has a detrimental effect on physical and mental well-being [3] [4]. Literature Search We searched the MEDLINE, Embase, CINAHL, Cochrane Library, and Physiotherapy Evidence Database (PEDro) databases. close menu We performed a systematic literature search in Medline, Embase and Cochrane library. View a complete list of our locations and hours. Therefore, the rehabilitation protocol is an integral aspect to restore the pre-injury activity level. in surgical group, after injury in nonop. Evidence-based accelerated rehabilitation protocol following operative repair of acute Achilles tendon ruptures; DF: dorsiflexion, PF: plantar flexion, ROM: range of motion. knee strengthening as Disclaimer. bearing q{b7\68wbZaX?MN3 ,iFaI!_>bT=BL~>k9Z'V>Y'Zo5M:Bt>Oby^|pRh/0UhclP"t~** 0! Avoid forceful active and passive range of motion of the Achilles for 10 - 12 weeks. Surgical repair after acute Achilles tendon rupture leads to lower re-rupture rates than non-surgical treatment. . A systematic literature search in Embase, MEDLINE and Cochrane Library for prospective trials reporting on early functional rehabilitation after minimal invasive repair was performed. 2021 Jun;24(6):536-543. doi: 10.1016/j.jsams.2020.12.005. Mastering proprioceptive control in wearing normal footwear. In some cases, the Achilles tendon can tear, or rupture. Careers. stream 2007 Nov 6;8:108. doi: 10.1186/1471-2474-8-108. %PDF-1.5 Begin physio guided active range of motion ankle exercises from week 3-4. Rehabilitation following operative treatment of acute Achilles tendon ruptures: a systematic review and meta-analysis. Level of evidence: Single leg stance with good control for 10 seconds. Disclaimer. <> Plaster Cast or CAMBOOT with 20mm heel lift or VACOPED (2) plus wedge sole for 2nd week. VQ4 L}3Sz~zzDM>{z?NO?UI(/oO=:0QI]WrDctQa4TxR6=&eA>F2z>'%62p2{c86Y82b%q}`D U4x$!fGjGg$grJ,l6hqs&Sn5?1qX:{6G|8(?Mu83V\kZO._C9=7R4z-XW3"tcFWPoJ^&K.HfZ5E.LJSe=jC7S'r++@7Tka'k{e1u_X\W{Rv3x:gj. Cardiovascular upper extremity circuit training. etc until cleared by In addition, surgical repair involves, but is not limited to, an increased risk of infection, adhesions and disturbed skin sensibility with a pooled relative risk of 10.6 (95% CI; 4.8;23.3) as . In chronic and neglected rupture, surgical treatment is preferred over non-surgical treatment . The best approach varies for each individual. Surgical and non-surgical treatment of Achilles Tendon rupture. Achilles Tendon Repair; ACL Reconstruction: Quadriceps Tendon Autograft; Achilles tendon ruptures (ATRs) mainly occur during sports activities . %PDF-1.5 It is rare to have this procedure immediately after going to the emergency room for an injury. A rupture of the Achilles Tendon (ATR) is a common pathology being the most commonly ruptured tendon in the human body. 1. % surgeon and physio. Shooting Goals: Protection of repair and achieve active dorsiflexion (DF) to neutral. Mark-Christensen T, Troelsen A, Kallemose T, Barfod KW. Orthop J Sports Med. This site needs JavaScript to work properly. 5 0 obj Physical therapy appointments are once a week. We identified twelve randomized controlled trials comparing different treatment regimes after operative repair of the Achilles tendon. Achilles tendon rupture is a common sports injury encountered in younger populations. ,dDu=hQ*S:m6 _0}NTD4%Dw $k7pQ(@Wi:s.K^ <>>> The Accelerated Rehabilitation Program lasts for 12 weeks and is supervised by your Physiotherapist. endobj Light concentric and eccentric calf raises with heel lift and progression to resisted ankle official website and that any information you provide is encrypted Achilles tendinopathy can be described as an insertional or mid-portion, the difference . Transitioning towards plantargrade until boot is completely removed. In revision cases or when the tendon was damaged before the rupture, the tendon may need to be reconstructed using a graft from another tendon in your body. Everything went well, had the staples removed yesterday. ;ce%.WRu|^hR95eUmSkTusie\O~_TM6LoD,J/L-Y.Wjqw rU/>un+83ZI&|QUqsr7iWUJ/z\fv j7tvM bmmQ4Lz6kS2 K!bTFql:wGA?j)af/ \e9&Rx:V'mWJH~#u]2ZV=.7`yI10oRk 5sJ~bP[+;Ta;|r aQVJ~^%|8gd~YPnY@L}db'\2%k_ b7mQI00}yS$g7%i$wKfa58k&JV$ \&I[Z%sVl8= government site. Patients showed significantly higher satisfaction, less use of rehabilitation resources, earlier return to pre-injury activities and further demonstrated significantly increased calf muscle strength, reduced atrophy and tendon elongation. The clinical outcomes are similar regardless of the surgical treatment, but an accelerated rehabilitation program should be accompanied by good results. No wound complications. Low level calf plyometric exercises (fast CRs, tip toe In chronic and neglected rupture, surgical treatment is preferred over non-surgical treatment. There is still no consensus about the post-operative treatment after minimal invasive repair. kicking small. group 2-4 weeks Aircast walking boot with 2-cm heel lift* Protected weight-bearing with crutches Copyright 2014 Elsevier Ltd. All rights reserved. Treatments are chosen based on the size of the tendon defect. This combination was most beneficial. initially Scribd is the world's largest social reading and publishing site. Fast Functional Rehabilitation Protocol versus Plaster Cast Immobilization Protocol after Achilles Tendon Tenorrhaphy: Is It Different? 2,14,20 This finding was believed to . 2022 Oct 26;7(10):680-691. doi: 10.1530/EOR-22-0072. 2021 May 21;36(4):e360407. Discussion. Study Selection Criteria Randomized . <> 8600 Rockville Pike `p19~%t?JGw]Sv+[ ]RDir)A) '$M*0 eC5 7<81$^;c! Epub 2014 Jul 7. Pain-free isometric ankle inversion, eversion, DF and submaximal PF. x\n#}!{B^pq8h*S=rz YTWu]N]zGo?Sz$ByhTTu_[UtzrVZO7'. Lightsey HM, Noback PC, Caldwell JE, Trofa DP, Greisberg JK, Vosseller JT. Begin standing calf stretch at 5 weeks (knee flexed and extended) Continue eversion, inversion and plantar flexion isometrics with resistance bands. 24 staples. Surgery is only the beginning of a long rehabilitation period. Rehabilitation of Achilles tendon ruptures: is early functional rehabilitation daily routine? -, Injury. Tendon pathology can be a result of intrinsic and extrinsic factors.1 Intrinsic factors include: 1) Forces through the tendon; running and jumping forces have been estimated at 5000N. E=wNh|3Ln]8iwGuxfws7xl+|Y0~Pu L6YZN Ko:7}BFk| ':IU""e"E/JT?|OW:_Yn]n7buq}].moS_7xbU]}\o/|`ND^QTK/EnTYJ=U6~U1 NCI CPTC Antibody Characterization Program, Foot Ankle Surg. Please enable it to take advantage of the complete set of features! Operative versus Nonoperative Treatment of Acute Achilles Tendon Ruptures: A Multicenter Randomized Trial Using Accelerated Functional Rehabilitation Kevin Willits, Annunziato Amendola, Dianne Bryant, Nicholas G. Mohtadi, J. Robert Giffin, Peter Fowler, Crystal O. Kean and Alexandra . Results: 2023 Feb 10;11(2):23259671221145199. doi: 10.1177/23259671221145199. Clinical, Ultrasonographic, and Elastographic Comparison. Pool exercises if the wound is completely healed. To correct these problems, a physical therapist may show you exercises or use hands-on techniques to ease the tension. stream The achilles tendon accounts for 20% of all large tendon injuries 1 with an estimated incidence ranging from 11 to 37 per 100,000. For best outcomes, the Achilles tendon repair is typically performed within 2 weeks of the injury and recovery is expected to take between 6 to 9 months. As a result, an effective rehabilitation protocol for Achilles tendon rupture appears to be more important than the surgical treatment method itself. Knee Surg Sports Traumatol Arthrosc. A prospective randomized study. This combination was most beneficial. 1995 Jan;98 (1):21-32 Healing time clock restarts from day of surgery rather than day of injury A prospective randomized study." Methods: Seven studies were included. doi: 10.1590/ACB360407. 4 0 obj . Objectives To (1) describe which resistance exercises are used in the first 8 weeks of treatment for acute Achilles tendon rupture and (2) assess the completeness of reporting of the exercise descriptions. CAMBOOT with 30mm heel lift or VACOPED (3) plus wedge sole for 2nd week. Five trials compared full to non weight bearing, all applying immobilization in equinus. plantar grade only. Three trials compared the combination of full weight bearing and early ankle mobilization to immobilization. 3{pn04,NMi"]C@C!r-\8yJY cMylwJ nOVn:K"ldCsseC! Brumann, M., Baumbach, S. F., Mutschler, W., & Polzer, H. Accelerated rehabilitation following Achilles tendon repair after acute rupture-Development of an evidence-based treatment protocol. <>/ExtGState<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 792 612] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> accelerated functional rehabilitation. Everything went well, had the staples removed yesterday. (50% BW) by Online Physical Therapy Protocol Quality, Variability, and Availability in Achilles Tendon Repair. 2011 Apr;39(4):820-4 eCollection 2021. Walking). Hydrotherapy The acute rupture of the Achilles tendon is a protracted injury. Consequently, physicians may have reservations about adopting functional rehabilitation. The Achilles tendon, which is about 12-15 cm long and comprises both the gastrocnemius and the soleus tendons, is the thickest, strongest and largest tendon in the human body. Arch Orthop Trauma Surg. 4 However, this . cJ%]lKSfd9\{5D y} Ua~0i}::1Qq){)+"0xpOp bd%\`3 G{$u~` mlEt$/yf;'ds;Z1y4@$ Xr This article describes a high-quality accelerated functional rehabilitation program that begins with early diagnosis and appropriate patient selection to allow initiation of the nonoperative protocol. Goals: Physical therapy appointments are once every one to two weeks. $AIsQ(P>U[bwA4po@-CIqRg ;qjt*]&a7Vc)]|1:|0_ CAMBOOT with 10mm heel lift or VACOPED at (1) with flat sole for 4th week The aim of this study was to define the most effective and safe post-operative rehabilitation protocol following minimal invasive repair. Various treatment methods are used for acute and chronic rupture. Post-op weeks 4-6: If the pt can reach neutral PF/DF comfortably, then neutral boot with small heel lifts, sleep in boot, WBAT (based on pain, swelling and wound) with crutches and boot, active DF to neutral. HHS Vulnerability Disclosure, Help 2017 Mar;137(3):333-340. doi: 10.1007/s00402-017-2627-9. Consequently, the aim of our study was to systematically search the evidence available and define a precise rehabilitation programme after operative repair of acute Achilles tendon rupture based on the trials with the highest level of evidence. endobj The .gov means its official. Gentle calf stretching with a towel (not body weight). In conclusion, the rehabilitation protocol after Achilles tendon repair should allow immediate full weight bearing. eCollection 2021 Dec. Hidd SMCM, Tim CR, Dutra EF Jr, Maia Filho ALM, Assis L, Ferreira RS Jr, Barraviera B, Silva JF, Amaral MM. 2014 Nov;45(11):1782-90. doi: 10.1016/j.injury.2014.06.022. Unable to load your collection due to an error, Unable to load your delegates due to an error. 3. If you have a concern, please consult with Dr. Roe. It's important to get the right diagnosis so you can get the right treatment. Our analysis using SWE has revealed the detailed chronologic changes in SWE values and related mechanical properties of a healing Achilles tendon rupture, which can be used for devising appropriate rehabilitation protocols. Wr5)Z nK!e*~[~[)$WoU]sMHUoUbmJ9yOJ}` Would you like email updates of new search results? Your surgeon and you will determine what is best for you by discussing your specific injury and goals. . Goals: PT appointments are once every one to two weeks. Moderate load plyometrics at Squat and lunge to 70 degrees knee flexion without weight shift. Accessibility Weight-bearing: Touchdown weight-bearing (TDWB) with crutches ACHILLES TENDON RUPTURE Accelerated Functional Rehabilitation Protocol 0 - 2 WEEKS Aircast boot with 2 cm heel lift NWB with crutches 2 - 6 WEEKS Aircast boot with 2 cm heel lift Protected weight-bearing with crutches as required Active plantar and dorsi flexion to neutral, inversion /eversion below neutral health, rehab compliance and injury severity, our team has established time frames, precautions and progression criteria that help ensure a safe return to sport. <> It arises near the middle of the calf and rotates approximately 90 degrees laterally during its course to insert on the posterior aspect of the calcaneal tuberosity [ 1, 2 ]. Kangas J, Pajala A, Siira P, Hmlinen M, Leppilahti J. J Trauma. The Achilles tendon is the thickest, strongest and largest tendon in the human body, but despite its size and tensile strength, it frequently gets injured. -, Am J Sports Med. Initiate balance exercises (double leg wide base narrow . Wilkins R, Bisson Lj. necessary. 228 0 obj <>stream The site is secure. (open!andclosed!kinetic!chainas!well!as!functional activities)-!start!withTheraband!tubingexercises! Acta Cir Bras. Rehabilitation of Achilles tendon ruptures: is early functional rehabilitation daily routine? Active ROM between 15 degrees of dorsiflexion and 50 degrees of plantarflexion. Multiple surgical and nonsurgical approaches to treatment exist, 28 and the superiority of one over the other remains controversial and depends on patient factors and preferences. 3,10,13,25 Historically, surgical repair of Achilles tendon rupture was thought to decrease the risk of re-rupture substantially. Our recommended treatment protocol provides quality assurance for the patient and reliability for the attending physician. Jogging, increase exercise intensity, Sports specific drills, Full active ankle range of movement with dorsiflexion as tolerated, Progress muscle strengthening from open chain to closed chain during this period, Single leg stance, eyes closed, wobble board/ BOSU, Double heel raise progress to single heel raise, Dorsiflexion equal to contralateral side, no need to push to extreme, Hopping, Mini hurdle jumps, Straight line running, Introduce cutting/side to side/ carioca/ figure of 8 runs, Normal activity, explosive actions and return to sport. 2022 Aug 19;2022:2363230. doi: 10.1155/2022/2363230. After the second postoperative week controlled ankle mobilization by free plantar flexion and limited dorsiflexion at 0 should be applied. <>/Metadata 1559 0 R/ViewerPreferences 1560 0 R>> An Achilles tendon rupture surgery reconnects the ends of the torn tendon. This was the standard procedure (long back of the leg incision vs newer technique with a shorter cut and a heel incision). Carefully monitor the tendon and incisions for mobility and signs of scar tissue formation. Four studies performed full weight bearing, all demonstrating good functional results, an early return to work/sports and high satisfaction. The exercises stretch your Achilles tendon in ways that help it handle forces and stress better. !.XyR-Kd-+"v+l3,~l|LR {Z^R}TTKS`p*9szqAdJAs2QGE6pzHf)'a n7=pMi-Sn3r7$5B"yUMQy^&hkj)V&a55JZp5JSb^]"37H919=N]?&h6.M{Af[Uf`0R;DW x^Q^5fu;%)Ptu$DtqEHg endobj %PDF-1.5 % Four trials compared early ankle mobilization to immobilization. Rerupture after Achilles repair is reported at about 2-12%, with no statistical difference reported between open, percutaneous, augmented, or closed treatment methods [1-4, 7, 9, 16].Open rerupture is an exceedingly rare complication and has only been described a handful of times [17-19].This report is the first case that we are aware of described in the literature of an . Active stretching. Normal gait mechanics without the boot on all surfaces. 2014 Nov;45(11):1782-90 The use of early functional rehabilitation in the treatment of nonoperative Achilles tendon ruptures has been shown to provide patients with outcomes similar to operative treatments. Epub 2010 Oct 29. 2021 May 28;18:112-116. doi: 10.1016/j.reth.2021.05.002. Graduated!resistanceexercises! %PDF-1.7 2014. 1990 Mar;18(2):188-95. Ankle strengthening concentric and eccentric gastroc strengthening. Careers. Achilles tendon rupture is a clinical diagnosis. ^sR**aX^IZ9(cxq+{R r? Clipboard, Search History, and several other advanced features are temporarily unavailable. Mosconi M, Pasta G, Annunziata S, Guerrieri V, Ghiara M, Perelli S, Torriani C, Grassi FA, Jannelli E. Diagnostics (Basel). An official website of the United States government. Epub 2015 Sep 26. Good control and no pain with sport/work-specific movements, including the impact. 4 0 obj The acute rupture of the Achilles tendon is a protracted injury. Rehabilitation following operative treatment of acute Achilles tendon ruptures: a systematic review and meta-analysis. Accelerated rehabilitation following Achilles tendon repair after acute rupture - Development of an evidence-based treatment protocol. Low velocity and partial ROM for functional movements (squat, step back, lunges). nb^t~luNS zRBR}mHbKz!MKCZ?/ibO'"qwDG&lQz=>4 QG`7]qvZ;{t;-rq@ .iij1QB\:Lw;hxAMOPNw(v9`K-{ig@@HymirxF> Procedure: Conservative Management of Tendo-Achilles Rupture - Accelerated 8-week protocol Indications for Procedure: Tendo-Achilles Rupture Expected Length of Stay: n/a Surgeons: All orthopaedic trauma surgeons Scope of Practice These guidelines are designed to guide physiotherapists when treating patients following conservative management .

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