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The achilles tendon

What sort of problems exist? | The chronically painful Achilles tendon | What symptoms might i have? | Why does the Achilles tendons degenerate? | What treatments are available? | How soon should they work? | What is the chance of success? | What can be done if non operative treatment fails? | Why not inject around a tendon with tendinosis? | What if the Achilles tendon is degenerate (tendinosis)? | What is the rationale behind the operations? | FHL transfer for severe tendonopathy | After the operation | Achilles paratenon stripping and tendon incision | After the operation | Complications | Problems of the Achilles insertion | Treatment of insertional Achilles problems

 

After the operation

The first 24 hours

Pain relief
This is by means of a regional femoral and sciatic nerve blockade supplemented by tablets or PCA .

Cast/splintage
A temporary plaster cast will be applied after the operation and changed the next day to a lightweight cast.
 
DVT prophylaxis
Aspirin 150mgs, used for 6 weeks unless 
Contra-indicated.

Length of stay
You will require on average one to two days post operatively in Hospital.

Physiotherapy
Within 24-48 hours you will be mobilised non weight bearing. This means using two crutches for walking.
Generally this continues for 4-6 weeks after the operation date.

At two weeks
Outpatient visit to ensure wounds have healed and a
Change of cast.

At six weeks
Weight bearing out of cast commenced using an Aircast Achilles walking boot. Physiotherapy supervision of progressive range of movement followed by strengthening excercises. 

achilles aircast walking boot

The Achilles Aircast walking boot. A variety of heel raises are available, to offload the Achilles tendon.

aircast achilles walking boot

The Aircast Achilles walking boot.

At three months
Out of Aircast boot progressively.
You will require an in-shoe heel raise for a month or two.
No sports for six months.
Full strength may take 12 months to achieve.

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