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LDN PHYSIO's Achilles Rupture Criteria Decoded: Returning to Running

Recovering from an Achilles tendon injury or rupture can be a challenging journey, but with the right guidance and expertise, returning to running can be a reality. At LDN, our sports physios and clinicians specialise in ensuring a safe and effective return to running (and then to sports - in that order), prioritising both the recovery process and long-term performance. In this article, we'll explore the phases of our Achilles rehabilitation and how LDN PHYSIO's approach sets the stage for a successful return to running.




Embarking on the Road to Achilles Recovery with LDN PHYSIO


In the aftermath of an Achilles tendon injury, the journey back to running is a testament to resilience and commitment. At LDN, we become a partner in this recovery, guiding our LDNers through a comprehensive process aimed at not just restoring function but enhancing long-term performance.


Despite the extend and severity of Achilles ruptures there is little scientific evidence or agreement within the literature to help guide rehab. However, looking over towards ACL injuries (a similar timeframe of recovery) and there seems to be a never-ending supply of opinions and experts to back up research. Yes, it is not an as common injury. On the other hand, it takes someone out of sports for longer and is a more challenging road to recovery. At LDN, we’ve always taken huge interest in advancing the level of care to ensure you get the very best and Achilles tendon rehab is right up there.



Setting the Stage: Aims of Physiotherapy in Your Recovery


The first steps involve restoring essential elements:


Restoring Range of Motion


The journey commences with a deliberate and controlled increase in range of motion. Your consultant or surgeon will be telling you what you're not allowed to do with regards to range. This is 100% respected the entire journey. Our Physios' knowledge but also creativity on a range of exercises and hands-on treatment helps to get the best out of the early stages. The initial stages will be tough though. Expect to be in a boot and finding it tough to get around for a few months. When the time is right, gradually allowing the tendon to return to its previous length whilst ensuring healing, strength and function are optimised is so crucial. No stretching to start with please!


Restoring Strength and Function


Starting strength in the early phases encourages healing, strength in the tendon and improves your long term outcomes. Again, there’s a lot your doctor will tell you not to do. At LDN, we are here to safely advise you what you can do. Calf raises for instance (from a chair mind you) can be initiated fairly early, but the specifics on how to keep this safe and progressing at the right time needs someone who knows their stuff. From here on in you’ve got to develop that tendon to deal with the stresses running will place on the Achilles with every step. Slow-heavy-eccentric strength exercises, development of early plyo-preparation within safe parameters and to assess using our tried and tested Return to Run Criteria will ensure your recovery does not fail.


Eventually when you embrace the challenge of running and jumping, our graded approach to getting you back on the road again is important to follow. Being seen by a running specialist with our high-tech sensors and pressure plates is the only way to truly see beneath the surface of what the naked eye can’t see. Fear not - this is our bread and butter!


Additional Healing Practices


Lifestyle adjustments become integral – we’re not here to preach, but quitting smoking, maintaining a healthy diet, reducing sugar and alcohol intake are all going to be pretty key to ensuring you get the best out of the hard work you’re going to put in to this. In addition to this, hydration, adequate sleep, and meticulous wound care all contribute to your healing.


Navigating Phases and Achieving Milestones


Milestones are like checkpoints in your recovery. Time is a healer, but time alone won’t mean you’ve now got a strong and springy tendon again. The correct development of strength and plyometric exercises, guided by your LDN PHYSIO team, will be what gets you there. For instance, you will get tested on our ForceDecks, that can measure your ground contact time when hopping. Is your tendon still sluggish and not able to cope with a springy ‘rebound effect’?The final stages of rehab will cover this, ensuring huge reduction in risk of injury.


Time is a healer, but time alone won’t mean you’ve now got a strong and springy tendon again.




LDN PHYSIO's Achilles Return to Run Criteria


As mentioned at the start of this article, there isn’t much in the way of guidelines to support a safe return to running after Achilles ruptures. Even for Achilles tendinopathy, the guidelines seem inadequate and don’t really represent rehab that’s covered the demand running puts on the Achilles.


Let’s break it down. Let’s say you want to go for a mere 5-minute run to start with. With an average of about 170 steps per minute (cadence) you’ll be hopping and landing on one foot 85 times per minute, which is 425 single leg hops, land and spring forwards. Continuous! Has your rehab been rigorous enough to ensure your Achilles can cope with this? Have you been through assessment and testing to ensure you’ve got the green light? Check us out why don’t ya.


Physical Metrics Assessment


Comprehensive assessments, including evaluations of calf strength, height of calf raise, dynamic control, and biomechanics, provide the foundation. Continuous walking for 30 minutes becomes both a benchmark and a testament to progress.


LDN adapt research across other injuries and understanding the demands on an Achilles tendon to formulate our benchmark of tests. We use normative data, adapted tests, limb symmetry (% of strength versus a non-injured leg), not just fatigue but height of heel raises, then the completion of graded plyometric preparation rehab. The journey culminates in tests like double leg jumps and single leg hops, marking the final preparations for the return to running.

What does this tell us? You’re ready to start your long-awaited journey back on the road.


Gradual Return to Running


Under the watchful guidance of physiotherapists, patients embark on a gradual return to running. Incremental increases in distance, speed, and intensity become part of personalised programs aligned with overall rehabilitation goals.Using coaching and conditioning principals, our comprehensive running analysis clinic and expertise we’ll develop adaptable training programs to hit the targets you need to get back to pushing your PBs.


For some people recovering from Achilles injuries endurance running doesn’t seem as significant to their sporting goals. However, completion of 30 minutes continuous running within decent cardio-zones is a requirement before we consider a return to sports. Plus, a correct and graded training plan will mean running will strengthen your tendon for the better.


The journey concludes with a 🎊return to running🎊 that goes beyond being a mere milestone; it is a testament to dedication and collaboration. LDN PHYSIO's comprehensive approach ensures a safe and effective recovery, celebrating not just the return to running but the renewed confidence in one's own physical capabilities. For those on the road to recovery, initiating a consultation with LDN PHYSIO early in the journey becomes a pivotal step, mapping out a personalised rehabilitation plan and signalling a commitment to your long term well-being and performance.


You’re now well on your way to recovering from your Achilles injury. Returning to sports is some way off but at least things are getting more interesting. Your going to be in the gym 3 times a week and running a couple of times too. If you want the science behind how to develop your Achilles to the spring-loaded tissue it once was check out our plyometric series on our blog page.


Next up, return to sports!

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