Wicker A, Matschi W
Department of Physical Medicine and Rehabilitation
General Hospital of Salzburg, Àustria
Inclusion criteria for non-surgical treatment:
- Sonography: max. 5mm dehiscence of the tendon remnants at 20° of plantar flexion angle
- Patients - prerequisites: (reliable, enough time available, symptoms)
Plan of treatment:
Phase I (1st to 7th day)
- 1 week plaster cast in 20° of plantar flexion angle
- Walking with crutches - non-weight-bearing
Phase II (2nd to end of 6th week)
- 3 times a week lymph massage
- 6 weeks of wearing a Vario Stabil Shoe, also during night.
- 4th week: CPM o isokinetic system (ROM 40° - 30° of plantar flexion angle) - three times a week.
- Increase of ROM 40° to neutral within 2 weeks.
- 5th week: Beginning with underwater exercises (gait, flexion-extension exercises of the ankle) -three times a week.
- Cycling with Vario-Stabil Shoe
Phase III (7th week to 12th week)
- Isokinetic exercises - plantar flexion in concentric-eccentric mode with daily adjusted progressive resistance.
- Increase of ROM to 20° dorsal flexion
- Normal walking with ski poles
- Intensive aqua-jogger training in deep water
- Cycling
- Proprioceptive training (Biodex, ADAM, balance boards, etc.)
Phase IV (12th week to 20th week)
- Power walking
- Plyometric training
- Isokinetic testing
- Sport specific training
- Skiing
