Managing Stiffness After Achilles Tendon Repair Surgery: Solutions and Tips

Post-surgical tendon stiffness following Achilles tendon repair?

Hello, in February of this year, I ruptured my left Achilles tendon while playing basketball.
I underwent tendon repair surgery on the same day.
It has now been seven months, and I experience a pulling pain in my Achilles tendon when going up and down stairs.
There is also some pain when I try to run.
Since having my cast removed, I have been undergoing rehabilitation for six months, but my Achilles tendon seems to have become very stiff.
The physical therapist mentioned that this stiffness might be due to the tendon hardening, but I have been unsure how to address this issue.
I would like to know if there are any methods to resolve this problem.

JORDAN, 40~49 year old female. Ask Date: 2018/09/17

Dr. Li Yongheng reply Orthopedics

It is recommended that you undergo an ultrasound examination or MRI to assess the healing status of the Achilles tendon.
Typically, it takes about a year for the Achilles tendon to return to normal after surgery.

Reply Date: 2018/09/17

More Info

Managing stiffness after Achilles tendon repair surgery can be a challenging process, especially when you have already undergone surgery and rehabilitation for several months. The stiffness and discomfort you are experiencing, particularly when going up and down stairs or attempting to run, are not uncommon following such an injury and subsequent repair. Here are some insights and strategies that may help you manage your symptoms and improve your recovery.

Understanding Stiffness After Surgery
After an Achilles tendon repair, it is normal to experience stiffness due to several factors, including scar tissue formation, changes in the tendon structure, and muscle atrophy from immobilization. The Achilles tendon is crucial for activities such as walking, running, and jumping, and any stiffness can significantly impact your mobility and quality of life.

Solutions and Tips for Managing Stiffness
1. Physical Therapy: Continuing with physical therapy is essential. A skilled physical therapist can provide tailored exercises that focus on improving flexibility, strength, and range of motion. They may use techniques such as manual therapy, ultrasound, or electrical stimulation to help reduce stiffness and promote healing.

2. Stretching Exercises: Incorporate gentle stretching exercises into your routine. Stretching the calf muscles and the Achilles tendon can help alleviate stiffness. Some effective stretches include:
- Calf Stretch: Stand facing a wall, place your hands on the wall, and step one foot back, keeping it straight while bending the front knee. Hold for 15-30 seconds and switch sides.

- Tendon Stretch: Sit on the floor with your legs extended. Use a towel to pull your toes toward you while keeping your knee straight. Hold for 15-30 seconds.

3. Strengthening Exercises: Strengthening the muscles around the ankle and calf can help support the tendon and improve function. Exercises like heel raises, toe taps, and resistance band exercises can be beneficial. Start with low resistance and gradually increase as tolerated.

4. Gradual Return to Activity: It’s important to gradually return to activities like running. Start with low-impact exercises such as swimming or cycling to maintain cardiovascular fitness without putting too much strain on the tendon. Once you feel more comfortable, you can slowly introduce running, starting with short distances and increasing gradually.

5. Ice and Compression: If you experience pain or swelling after activity, applying ice to the area can help reduce inflammation. Compression wraps can also provide support and minimize swelling.

6. Footwear: Ensure that you are wearing supportive footwear that provides adequate cushioning and stability. Avoid high heels or shoes that place excessive strain on the Achilles tendon.

7. Massage Therapy: Consider seeking out a massage therapist who specializes in sports injuries. They can help break down scar tissue and improve circulation in the area, which may alleviate stiffness.

8. Patience and Consistency: Recovery from an Achilles tendon injury can take time. It’s important to be patient and consistent with your rehabilitation efforts. Regularly practicing your exercises and following your therapist's recommendations will yield the best results.

When to Seek Further Help
If you continue to experience significant pain, stiffness, or functional limitations despite following these strategies, it may be beneficial to consult with your orthopedic surgeon or a sports medicine specialist. They can assess your recovery progress and determine if any additional interventions, such as imaging studies or further treatment options, are necessary.

In summary, managing stiffness after Achilles tendon repair surgery involves a combination of physical therapy, stretching and strengthening exercises, gradual return to activity, and proper self-care techniques. By staying proactive in your rehabilitation and seeking professional guidance when needed, you can work towards regaining full function and reducing discomfort in your Achilles tendon.

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