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- DOI 10.18231/j.jeths.v.12.i.2.2
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Conservative management of ruptured Achilles tendon: A physiotherapist’s perspective
Ruptured Achilles tendons are a common injury, often occurring among athletes and middle-aged individuals involved in recreational activities. In patients, such as those with partial ruptures, small tendon gaps, or medical comorbidities, conservative management without surgical intervention is an effective alternative option. This approach requires immobilization through a below knee cast holding ankle in plantarflexed position or walking boot, followed by rehabilitation through gradual weight-bearing and structured physiotherapy sessions. Rehabilitation focuses on pain management through mobility restoration, calf muscle strengthening, and balance improvement. Physiotherapy aided by early mobilization and progressive weight bearing helps in improving active tendon healing, muscle strength, and functional recovery. Physiotherapists play a crucial role in guiding the rehabilitation process, as they educate and motivate patients on adherence, monitoring their progress, guiding and modifying rehabilitation to prevent complications like re-rupture or tendon elongation. Studies have shown that properly implemented conservative treatment, especially in low demand patients, can provide outcome results similar to surgical treatment. Advancements in recovery support technology like wearable devices and platelet-rich plasma (PRP) are expected to boost restoration efforts and enhance recovery in future.
References
- Maffulli N, Longo UG, Gougoulias N, Loppini M, Denaro V. Long-term health outcomes of youth sports injuries. Br J Sports Med. 2010;44(1):21–5.
- Lo IK, Kirkley A, Nonweiler B, Kumbhare DA. Operative versus nonoperative treatment of acute Achilles tendon ruptures: a quantitative review. Clin J Sport Med. 1997;7(3):207–11.
- Järvinen TA, Järvinen TL, Kääriäinen M, Kalimo H, Järvinen M. Muscle injuries: biology and treatment. Am J Sports Med. 2005;33(5):745–64.
- Sharma P, Maffulli N. Biology of tendon injury: healing, modeling and remodeling. J Musculoskelet Neuronal Interact. 2006;6(2):181–90.
- Jiang N, Wang B, Chen A, Dong F, Yu B. Operative versus nonoperative treatment for acute Achilles tendon rupture: a meta-analysis based on current evidence. Int Orthop. 2012;36(4):765–73.
- Mubark I, Abouelela A, Arya S, Buchanan D, Elgalli M, Parker J, et al. Achilles tendon rupture: Can the tendon gap on ultrasound scan predict the outcome of functional rehabilitation program? Cureus. 2020;12(9):e10298.
- Gulati V, Jaggard M, Al-Nammari SS, Uzoigwe C, Gulati P, Ismail N, et al. Management of achilles tendon injury: A current concepts systematic review. World J Orthop. 2015;6(4):380–6.
- Suchak AA, Bostick GP, Beaupré LA, Durand DC, Jomha NM. The influence of early weight-bearing compared with non- weight-bearing after surgical repair of the Achilles tendon. J Bone Joint Surg Am. 2008;90(9):1876–83.
- Kangas J, Pajala A, Siira P, Hämäläinen M, Leppilahti J. Early functional treatment versus early immobilization in tension of the musculotendinous unit after Achilles rupture repair: a prospective, randomized, clinical study. J Trauma. 2003;54(6):1171–80.
- Barfod KW, Bencke J, Lauridsen HB, Ban I, Ebskov L, Troelsen A. Nonoperative dynamic treatment of acute Achilles tendon rupture: the influence of early weight-bearing on clinical outcome: a blinded, randomized controlled trial. J Bone Joint Surg Am. 2014;96(18):1497–503.
- Willits K, Amendola A, Bryant D, Mohtadi NG, Giffin JR, Fowler P, et al. Operative versus nonoperative treatment of acute Achilles tendon ruptures: a multicenter randomized trial using accelerated functional rehabilitation. J Bone Joint Surg Am. 2010;92(17):2767–75.
- Sun C, Zhuo Q, Chai W, Chen J, Yang W, Tang P, et al. Conservative interventions for treating Achilles tendon ruptures. Cochrane Database Syst Rev. 2017;2017(7):CD010765.
- Khan RJ, Fick D, Keogh A, Crawford J, Brammar T, Parker M. Treatment of acute Achilles tendon ruptures: a meta-analysis of randomized, controlled trials. J Bone Joint Surg Am. 2005;87(10):2202-10.
- Park S-H, Lee HS, Young KW, Seo SG. Treatment of acute Achilles tendon rupture. Clin Orthop Surg. 2020;12(1):1–8.
- Alfredson H, Pietilä T, Jonsson P, Lorentzon R. Heavy-load eccentric calf muscle training for the treatment of chronic Achilles tendinosis. Am J Sports Med. 1998;26(3):360–6.
- El-Akkawi AI, Joanroy R, Barfod KW, Kallemose T, Kristensen SS, Viberg B. Effect of early versus late weightbearing in conservatively treated acute Achilles tendon rupture: a meta- analysis. J Foot Ankle Surg. 2018;57(2):346–52.
- Cleaver C. Achilles tendon rupture: A conservative management pathway. Physiotherapy. 2021;113:e79.
- Zhao JG, Meng XH, Liu L, Zeng XT, Kan SL. Early functional rehabilitation versus traditional immobilization for surgical Achilles tendon repair after acute rupture: a systematic review of overlapping meta-analyses. Sci Rep. 2017;7:39871.
- Liu X, Dai TJ, Li BL, Li C, Zheng ZY, Liu Y. Early functional rehabilitation compared with traditional immobilization for acute Achilles tendon ruptures: a meta-analysis. Bone Joint J. 2021;103-B(6):1021–30.
- Abdolrazaghi S, Akram N, Boksh K, Elbashir M, Thomas O, Divall P, et al. Platelet-rich plasma in acute achilles tendon ruptures: a systematic review and meta-analysis. Foot Ankle Orthop. 2022;7(4):2473011421S00549.
- Han Y, Li X, Zhang Y, Han Y, Chang F, Ding J. Mesenchymal stem cells for regenerative medicine. Cells. 2019;8(8):886.
- Physical therapy and dorsaVi technology. Dorsavi.com. Available from: https://dorsavi.com/physical-therapy-and- dorsavi-technology/.
- Arensman R, Kloek C, Pisters M, Koppenaal T, Ostelo R, Veenhof C. Patient perspectives on using a smartphone app to support home-based exercise during physical therapy treatment: qualitative study. JMIR Hum Factors. 2022;9(3):e35316.
- Physitrack PLC. Track the progress of your patient. Physitrack.com. Available from: https://support.physitrack.com/article/376-track-the-progress- of-your-patient.
- Rossetto G, Scalona E, Comotti P, Gatti L, Di Maso D, Gobbo M, et al. Ultrasound elastography in the evaluations of tendon- related disorders—a systematic review. Appl Sci. 2023;13(8):4920.
- Jielile J, Badalihan A, Qianman B, Satewalede T, Wuerliebieke J, Kelamu M, et al. Clinical outcome of exercise therapy and 40 Gupta and Gupta / Journal of Education Technology in Health Sciences 2025;12(2):32–40 early post-operative rehabilitation for treatment of neglected Achilles tendon rupture: a randomized study. Knee Surg Sports Traumatol Arthrosc. 2016;24(7):2148–55.
- Glazebrook M, Rubinger D. Functional rehabilitation for nonsurgical treatment of acute Achilles tendon rupture. Foot Ankle Clin. 2019;24(3):387-98.
- Shamrock AG, Dreyer MA, Varacallo MA. Achilles tendon rupture. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2025.
- Svedman S, Edman G, Ackermann PW. Deep venous thrombosis after Achilles tendon rupture is associated with poor patient-reported outcome. Knee Surg Sports Traumatol Arthrosc. 2020;28(10):3309-17.
- Hsu CJ, Meierbachtol A, George SZ, Chmielewski TL. Fear of Reinjury in Athletes. Sports Health. 2017;9(2):162–7.
How to Cite This Article
Vancouver
Gupta H, Gupta L. Conservative management of ruptured Achilles tendon: A physiotherapist’s perspective [Internet]. J Educ Technol Health Sci. 2025 [cited 2025 Oct 04];12(2):32-40. Available from: https://doi.org/10.18231/j.jeths.v.12.i.2.2
APA
Gupta, H., Gupta, L. (2025). Conservative management of ruptured Achilles tendon: A physiotherapist’s perspective. J Educ Technol Health Sci, 12(2), 32-40. https://doi.org/10.18231/j.jeths.v.12.i.2.2
MLA
Gupta, Himani, Gupta, Lalit. "Conservative management of ruptured Achilles tendon: A physiotherapist’s perspective." J Educ Technol Health Sci, vol. 12, no. 2, 2025, pp. 32-40. https://doi.org/10.18231/j.jeths.v.12.i.2.2
Chicago
Gupta, H., Gupta, L.. "Conservative management of ruptured Achilles tendon: A physiotherapist’s perspective." J Educ Technol Health Sci 12, no. 2 (2025): 32-40. https://doi.org/10.18231/j.jeths.v.12.i.2.2