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Evidence-based accelerated rehabilitation protocol following operative repair of acute Achilles tendon ruptures; DF: dorsiflexion, PF: plantar flexion, ROM: range of motion. Current Updates in the Treatment of Achilles Tendon Rupture We mostly see ruptures of the Achilles tendon in high-impact sports predominantly in the male athlete. ,8vue6Tq]6u06glk+zBE)wY4DNmJM4Y >I>UB5|g`dd?#ap_N#r*cCQm5&tcH_~vw~DXOI)J,!u Would you like email updates of new search results? % The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). NCI CPTC Antibody Characterization Program, Foot Ankle Surg. Achilles Tendon Repair Rehabilitation Protocol | Stony Brook Medicine May begin sports specific training drills: if returning to contact sport only controlled Fibrin biopolymer sealant and aquatic exercise association for calcaneal tendon repair. Conclusion: 2003 Jun;54(6):1171-80; discussion 1180-1. doi: 10.1097/01.TA.0000047945.20863.A2. Begin standing calf stretch at 5 weeks (knee flexed and extended) Continue eversion, inversion and plantar flexion isometrics with resistance bands. 3. The tendons twist from proximal to distal as they insert into the calcaneous, creating a shearing force. Surgical repair after acute Achilles tendon rupture leads to lower re-rupture rates than non-surgical treatment. but an accelerated rehabilitation program should be accompanied by good results. Mark-Christensen T, Troelsen A, Kallemose T, Barfod KW. nb^t~luNS zRBR}mHbKz!MKCZ?/ibO'"qwDG&lQz=>4 QG`7]qvZ;{t;-rq@ .iij1QB\:Lw;hxAMOPNw(v9`K-{ig@@HymirxF> CAMBOOT with 20mm heel lift or VACOPED (2) and wedge sole for 3rd week. Achilles Tendon Rupture: Mechanisms of Injury, Principles of - MDPI This acute (sudden) injury occurs when the tendon stretches to its breaking point. Front Cell Dev Biol. Achilles Tendon Rupture - Foot & Ankle - Orthobullets endobj 2021 Apr 7;9:654084. doi: 10.3389/fcell.2021.654084. A prospective randomized study. 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. 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. =+Q%90Z6U='-rj\Ig pV.4FqW%W)53s^#D3 a`CN3=z[lmOgEA5CWwpLz9r4-+94Is9>}n-9k=n6R LAJxeF$ylM>MY@0vFEviCM ml@5s? An official website of the United States government. x=ko8?hsQH{i~Pb%1{$[lt@Y$ujzS^/W8X:RNj]_/U9..7z" 1990 Mar;18(2):188-95. Rehabilitation following operative treatment of acute Achilles tendon ruptures: a systematic review and meta-analysis. 0_'|,t0:!: . ^Fz,l6N}{D6Y?TP),#uz/i3F~bHG(BQ" Clipboard, Search History, and several other advanced features are temporarily unavailable. Acute Achilles tendon rupture: minimally invasive surgery versus non operative treatment, with immediate full weight bearing. An Achilles tendon rupture is a full or partial tear of the Achilles tendon. Accelerated rehabilitation following Achilles tendon repair after acute Introduction. endobj Would you like email updates of new search results? Bookshelf PDF Rehabilitation Guidelines for Achilles Tendon Repair - UW Health Consequently, the aim of our study was to systematically search the evidence available and define a precise rehabilitation programme after operative repair of acute Achilles tendon rupture based on the trials with the highest level of evidence. 2014 Nov;45(11):1782-90. doi: 10.1016/j.injury.2014.06.022. Introduction Optimal postoperative rehabilitation regimen for acute Achilles tendon rupture (AATR) remains unclear. management of Achilles tendon ruptures. Partial x\*"S&Rd9l)+%\hwMROw3$\Z1~v/^x|m],^}3fdY7iTe*)XU6ugshO_KQ`F5vYU? government site. 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. SWE is a convenient noninvasive method to determine the progress of the healing process after tendon injury. Scribd is the world's largest social reading and publishing site. Patient Information > Achilles Tendon Ruptures - BOFAS 2022 Jul 25;2022:9722458. doi: 10.1155/2022/9722458. endstream endobj startxref 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. Achilles Rupture - Physiopedia endobj Achilles Tendon Rupture - Core EM s% i5iYd}mYSz;0Wj|*:2aO5ZmJeNWhqLx* EUgm"5l94`0;C1B]@-yH?0{2ER'fL-j6U,@tyS]?sZn|(E31-*=} high load ankle, knee, hip Hi folks, I am in week three post full Achilles rupture repair surgery. 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. E=wNh|3Ln]8iwGuxfws7xl+|Y0~Pu Orthop J Sports Med. x][~|.T%c<8A+qwX+)#`T];% t4!^}I? Hydrotherapy The Alfredson Protocol is an exercise program for people with Achilles tendonitis ( tendinopathy ). No tackling, sudden unexpected change Four studies performed full weight bearing, all demonstrating good functional results, an early return to work/sports and high satisfaction. Squat and lunge to 70 degrees knee flexion without weight shift. Hydrotherapy may begin if wound healing is adequate. PDF ACHILLES TENDON RUPTURE Accelerated Functional Rehabilitation Protocol The https:// ensures that you are connecting to the necessary. Achilles Tendon Rupture: Mechanisms of Injury, Principles of Accelerated rehabilitation following Achilles tendon repair after acute rupture development of an evidence-based treatment protocol. Acute Achilles Tendon Rupture Repair Rehab The Achilles tendon is the biggest and strongest tendon in the human body and is formed by the tendons of the soleus and gastrocnemius muscles which both insert at the calcaneus. !.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 Achilles Tendon Rupture - Non-operative treatment rehabilitation In conclusion, the rehabilitation protocol after Achilles tendon repair should allow immediate full weight bearing. Development of an accelerated functional rehabilitation protocol following minimal invasive Achilles tendon repair. After the Achilles tendon rupture repaired , patients were randomly divided into 2 groups, and the rehabilitation protocol was traditional rehabilitation protocol and accelerated rehabilitation protocol under ultrasonic monitoring , respectively, to study the difference in efficacy between the groups. <>/ExtGState<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 792 612] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> outcome drills ie. stream Unauthorized use of these marks is strictly prohibited. A Closer Look At A New Protocol To Manage Achilles Tendon Rupture (10% body 2,14,20 This finding was believed to . Disclaimer. Achilles tendon rupture - Symptoms and causes - Mayo Clinic Sports massage techniques and ultrasound can aid torn Achilles rehabilitation by helping to realign the new fibres in line with the tendon. PDF Rehabilitation Protocol for Achilles Rupture Repair Biomed Res Int. Immediate full weight bearing led to significant higher patient satisfaction, earlier ambulation and return to pre-injury activity. Therefore, the rehabilitation protocol is an integral aspect to restore the pre-injury activity level. (open!andclosed!kinetic!chainas!well!as!functional activities)-!start!withTheraband!tubingexercises! The acute rupture of the Achilles tendon is a protracted injury. 2022 Oct 26;7(10):680-691. doi: 10.1530/EOR-22-0072. 2017 Mar;137(3):333-340. doi: 10.1007/s00402-017-2627-9. Achilles tendon rupture is a clinical diagnosis. It's important to get the right diagnosis so you can get the right treatment. TABLE E-1 Achilles Tendon Rupture Rehabilitation Protocol Time Frame Activity 0-2 weeks Posterior slab/splint; non-weight-bearing with crutches: immed. The site is secure. Operative versus nonoperative treatment of acute Achilles tendon ruptures: a multicenter randomized trial using accelerated functional rehabilitation. A LOCATION OF STONY BROOK ORTHOPAEDIC ASSOCIATES. Accelerated Rehab Program | Mr Daniel Goldbloom | Melbourne KoreaMed Synapse Injury. Achilles Tendon Repair Rehab Protocol & Recovery Time Frame (50% BW) by -, Am J Sports Med. 2013 Dec;41(12):2867-76 Cardiovascular: Upper body circuit training, Physical therapy appointments begin one to two visits per week. The site is secure. 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. Single leg stance with good control for 10 seconds. -, Injury. **No hopping, Carefully monitor the tendon and incisions for mobility and signs of scar tissue formation. Achilles Tendon Injuries | Johns Hopkins Medicine 3,10,13,25 Historically, surgical repair of Achilles tendon rupture was thought to decrease the risk of re-rupture substantially. The https:// ensures that you are connecting to the 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. endobj 4 0 obj movements (not past plantar grade). In some cases, the Achilles tendon can tear, or rupture. Goals: PT appointments are once every one to two weeks. q{b7\68wbZaX?MN3 ,iFaI!_>bT=BL~>k9Z'V>Y'Zo5M:Bt>Oby^|pRh/0UhclP"t~** 0! Higher level proprioception initially 4 0 obj Epub 2020 Dec 17. : MOFL?Wo(H&dxl. Cont. 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. Cardiovascular upper extremity circuit training. After nonoperative treatment with an accelerated rehabilitation program, the patient still experienced significant strength and functional deficits. 2023 Feb 10;11(2):23259671221145199. doi: 10.1177/23259671221145199. plantar grade only. Mastering proprioceptive control in wearing normal footwear. After the second postoperative week controlled ankle mobilization by free plantar flexion and limited dorsiflexion at 0 should be applied. CAMBOOT with no heel lift or VACOPED at (0) with flat sole. 2022 Oct 26;7(10):680-691. doi: 10.1530/EOR-22-0072. The body then heals the tendon in the appropriate position. In conclusion, the rehabilitation protocol after Achilles tendon repair should allow immediate full weight bearing. Lightsey HM, Noback PC, Caldwell JE, Trofa DP, Greisberg JK, Vosseller JT. Treatment of acute Achilles tendon rupture - a multicentre, non Injury to the Achilles tendon causes pain along the back of your leg near the heel. 3. Active ROM between 5 degrees of DF and 40 degrees of PF. Patient 2 was a 38-year-old male soldier who experienced a complete left Achilles tendon rupture while exercising. 3 0 obj The goal of surgery is to reapproximate the ruptured tendon ends in order to promote healing and restore overall strength. A re-rupture rate between one in 30 and One in 20. Regular soft tissue treatments (i.e. Bibliographic details: Brumann M, Baumbach SF, Mutschler W, Polzer H. Accelerated rehabilitation following Achilles tendon repair after acute rupture development of an evidence-based treatment protocol. Calf muscle rehabilitation post Achilles tendon rupture Goals: Achilles Tendon Repair Rehabilitation Protocol, North Fork Orthopaedic and Sports Medicine, Lower Extremity Fracture Care Post-Op Instructions. Acta Cir Bras. 2022 Jul 29;12(8):1824. doi: 10.3390/diagnostics12081824. After the second postoperative week controlled ankle mobilization by free. Disadvantages. MeSH %%EOF An Achilles tendon repair surgery is a scheduled outpatient procedure done in an operating room located in a hospital or surgery center. Careers. endobj Lantto et al. 2) Tendon shearing forces can rupture the Achilles. Five trials compared full to non weight bearing, all applying immobilization in equinus. ?ynKdl?~\X%__ =x18?O/Wo_I7j~tIdM)E:_QF'ljY*u=9PEF^},? We identified twelve randomized controlled trials comparing different treatment regimes after operative repair of the Achilles tendon. A Prospective Randomized Trial Comparing Surgical and Nonsurgical Treatments of Acute Achilles Nonoperative or Surgical Treatment of Acute Achilles' Tendon Rupture Ruptures of the tendo achillis. Discussion. Please enable it to take advantage of the complete set of features! 3 What to Wear You can wear anything comfortable for your surgery appointment. 2014 2. Static balance exercises (begin in two-foot stance, then two-foot stance on balance board and gradually progress to single-leg stance). Postoperative rehabilitation protocols for Achilles tendon ruptures: a <>>> endobj Achilles tendon rupture; Ankle mobilization; Evidence-based; Functional treatment; Immobilization; Rehabilitation; Surgical repair; Treatment protocol; Weight bearing. PoT"u+: It is recommended that clinicians collaborate ACHILLES TENDON RUPTURE ACCELERATED REHAB PROTOCOL - Fowler Kennedy Sport Medicine. The Achilles tendon is the biggest and strongest tendon in the human body and is formed by the tendons of the soleus and gastrocnemius muscles which both insert at the calcaneus. The acute rupture of the Achilles tendon is a protracted injury. . bearing ,dDu=hQ*S:m6 _0}NTD4%Dw $k7pQ(@Wi:s.K^ Sport/work-specific balance and proprioceptive drills. eCollection 2022. The use of early functional rehabilitation in the treatment of nonoperative Achilles tendon ruptures has been shown to provide patients with outcomes similar to operative treatments. )$Ffni(G"okg]3io m"7r ;NOsGL8ad{qF%k-+c0R N-1@i[L6Sy=0C4ddB2@g.! IM5^]rCFWD-0y- 9NL~4,MHJOh Despite several trials available comparing different treatment regimes, there is still no consensus regarding the optimal protocol. 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. ;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= Rehabilitation of Achilles tendon ruptures: is early functional rehabilitation daily routine? Achilles Tendon Surgery: Preparation and Recovery - Verywell Health Acute Achilles Tendon Rupture Repair Rehab | Early Rehab Exercises PDF Non-Operative Achilles Rupture Rehabilitation Guideline - Sanford Health Close suggestions Search Search. PMC Ankle strengthening with resistance bands. If you have a concern, please consult with Dr. Roe. It connects the muscles of your calf to your heel. Normalize gait on level surfaces without boot or heel lift. . <> jumping, running. 5 0 obj 1 0 obj Closed chain weight bearing quads, hamstrings, glutes, calf strengthening with physio guidance. ACHILLES TENDON RUPTURE ACCELERATED REHAB PROTOCOL - Fowler Kennedy Accelerated rehabilitation following Achilles tendon repair after acute rupture development of an evidence-based treatment protocol, Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet], Centre for Reviews and Dissemination (UK). FOIA Wr5)Z nK!e*~[~[)$WoU]sMHUoUbmJ9yOJ}` weight) eCollection 2021. 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 . 2010 Dec 1;92(17):2767-75. doi: 10.2106/JBJS.I.01401. 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 24 staples. J Bone Joint Surg Am 2010; 92: 2767 - 75. A prospective randomized study." 2022 Oct 14;19(20):13254. doi: 10.3390/ijerph192013254. /n%^xij_2]!J] n >!UGld Good control and no pain with sport/work-specific movements, including the impact. Achilles Tendinopathy Treatment & Rehab Protocol - Dublin Sports Injury Achilles Tendon Rupture Accelerated Rehab Protocol PDF | PDF V.&!Na 1"}2C1[irXd8`<9f4X|(iTerx_&>uQMAv/>My]Zg}?;fl|Hpt. Accelerated rehab protocol without surgery. hYmo6+DU f[j;;4vv+yw=lrD endstream endobj 180 0 obj <>/Metadata 7 0 R/PageLayout/OneColumn/Pages 177 0 R/StructTreeRoot 11 0 R/Type/Catalog>> endobj 181 0 obj <>/ExtGState<>/Font<>/XObject<>>>/Rotate 0/StructParents 0/Type/Page>> endobj 182 0 obj <>stream en Change Language. %PDF-1.5 % To correct these problems, a physical therapist may show you exercises or use hands-on techniques to ease the tension. 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. Achilles Tendon Repair Rehab Protocol - manhattansportsdoc.com Avoid overstressing the repair (avoid large movements up and down, forceful PF while in a dorsiflexed position, aggressive passive ROM, and impact activities). The length of the incision and the surgical approach will depend on location of the rupture. endobj Surgery is only the beginning of a long rehabilitation period. The only randomized controlled trial performed the most accelerated protocol demonstrating a superior functional outcome and fewer complications after immediate full weight bearing combined with free ankle mobilization. ACHILLES RUPTURE: OPERATIVE PROTOCOL In this surgery, the torn ends of the tendon are sewn together with strong suture. Functional Rehabilitation for Nonsurgical Treatment of Acute Achilles The Achilles tendon gives your leg strength to walk, run and jump. Initiate balance exercises (double leg wide base narrow . Early functional rehabilitation protocol for Achilles tendon rupture improved patient satisfaction, compared with standard immobilisation regimens, with reductions in minor complications and no difference in re-rupture rates. This site needs JavaScript to work properly. 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. PDF ACHILLES RUPTURE: NONOPERATIVE PROTOCOL - South Bend Orthopaedic Associates <>/F 4/A<>/StructParent 0>> It happens most frequently while playing sports. Accelerated Rehabilitation in Non-operative Management of Acute An Achilles tendon rupture surgery reconnects the ends of the torn tendon. Achilles Tendon rupture: Post Surgery actions and recovery protocols and concerns. 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. Level of evidence: Initially a walking boot is used for the first 4-5 weeks. . Frontal and sagittal plane stepping drills (side-step, crossover step, grapevine step). PDF Non-Operative Treatment of Achilles Tendon Rupture This was the standard procedure (long back of the leg incision vs newer technique with a shorter cut and a heel incision). PDF Standard of Care: Achilles Tendinopathy - Brigham and Women's Hospital With!weighted!resisted . Graduated!resistanceexercises! eCollection 2021 Dec. Hidd SMCM, Tim CR, Dutra EF Jr, Maia Filho ALM, Assis L, Ferreira RS Jr, Barraviera B, Silva JF, Amaral MM. A systematic literature search in Embase, MEDLINE and Cochrane Library for prospective trials reporting on early functional rehabilitation after minimal invasive repair was performed. Knee Surg Sports Traumatol Arthrosc. Achilles tendon repair is performed after injury occurs to the Achilles tendon. Massen FK, Shoap S, Vosseller JT, Fan W, Usseglio J, Boecker W, Baumbach SF, Polzer H. EFORT Open Rev. Achilles Tendon Repair Surgery | Johns Hopkins Medicine In chronic and neglected rupture, surgical treatment is preferred over non-surgical treatment. Federal government websites often end in .gov or .mil. Hydrotherapy, stationary cycling. Achilles tendinopathy can be described as an insertional or mid-portion, the difference . Surgery is only the beginning of a long rehabilitation period. All trials found mobilization to be superior as it shortens time to return to work and sports significantly. bearing transitioning towards full weightbearing. 4 However, this . Hepatocyte Growth Factor-Induced Tendon Stem Cell Conditioned Medium Promotes Healing of Injured Achilles Tendon. Surgical and non-surgical treatment of Achilles Tendon rupture. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). 24 staples. without in air contact 2011 Dec;17(4):211-7 Our rehab protocols outline timing, precautions and progression criteria for returning to activity. The injury is often accompanied by an audible and palpable pop with limited ability to push off of the injured limb. Therefore, the rehabilitation protocol is an integral aspect to restore the pre-injury activity level. A rupture of the Achilles Tendon (ATR) is a common pathology being the most commonly ruptured tendon in the human body. of direction, jumping 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. Squat to 30 degrees knee flexion without weight shift. Ankle strengthening concentric and eccentric gastroc strengthening. % Immediate full weight bearing led to significant higher patient satisfaction, earlier ambulation and return to pre-injury activity. Good control and no pain with functional movements, including step-up/down, squats and lunges. <> Rehabilitation of Achilles tendon ruptures: is early functional rehabilitation daily routine? Pain-free isometric ankle inversion, eversion, DF and submaximal PF. Operative versus nonoperative treatment of acute Achilles tendon ruptures: a multicenter randomized trial using accelerated functional rehabilitation. <> xwn $8sxkL=. *MoaoLzhN:fOad)t-h96.&JxEys4JUy-nEu  Achilles tendon is the biggest and strongest tendon in the body. Unauthorized use of these marks is strictly prohibited. The Achilles Tendon is the strong fibrous band that attaches the calf muscles to the calcaneus bone. This was the standard procedure (long back of the leg incision vs newer technique with a shorter cut and a heel incision). In conclusion, the rehabilitation protocol after Achilles tendon repair should allow immediate full weight bearing. x\n#}!{B^pq8h*S=rz YTWu]N]zGo?Sz$ByhTTu_[UtzrVZO7'. Cardiovascular: replicate sport/work-specific energy demands. weight Morimoto S, Iseki T, Nakayama H, Shimomura K, Nishikawa T, Nakamura N, Tachibana T. Regen Ther. Federal government websites often end in .gov or .mil. Strengthening (can be performed 2021 Jun;24(6):536-543. doi: 10.1016/j.jsams.2020.12.005. Epub 2018 Jan 8. MeSH Must be a complete, mid-substance Achilles tendon rupture & not a tendon avulsion from the calcaneus or gastroc/soleus. Functional rehabilitation of patients with acute Achilles tendon rupture: a meta-analysis of current evidence. 1995 Jan;98 (1):21-32 This combination was most beneficial. The Accelerated Rehabilitation Program lasts for 12 weeks and is supervised by your Physiotherapist.