Methods of postoperative nursing and rehabilitation training for achilles tendon rupture;
This period of time is the most painful after the operation. Medicine should be used first after operation, and then fixed from foot to thigh and knee with long plaster. At this time, the knee should be bent 60 degrees. ~70? The ankle joint is in a moderate plantarflexion position, and the toes should be pressed down. Because the achilles tendon is shorter than normal after operation, this leg and foot posture can ensure that the stitched achilles tendon is not involved, but the ankle joint should not be excessively plantar flexed, that is, the toes should not be pressed down too much, otherwise the texture pressure at the suture between skin and tendon will increase, which is not conducive to the healing of skin and achilles tendon.
During this time, I mainly lie in bed to rest and reduce outdoor activities. If you really want to go to the ground, you need to go to the ground with crutches, and the affected limb can't touch the ground. Standing time shall not exceed 10 minute.
02 65438+ 0-2 days after operation:
Bed rest 1-2 days after operation. At this time, how to put your feet is a headache. You will find that no matter what posture your feet pose, they will be particularly uncomfortable. I still need to go to the ground less during this time.
Cold compress the surgical site with ice packs regularly every day to reduce the inflammation and swelling of the wound. Rehabilitation training mainly focuses on lateral leg lifting, straight leg lifting and hind leg lifting, and with toe movement, it is mainly to prevent thigh muscle atrophy and maintain toe flexibility. Toe exercise does not involve achilles tendon, so you can do it boldly.
Leg lifting training can last once 10 second, 20 times in each group, 3 times a day.
Toe training can be carried out 20 times each time, 5 times as a group, and 5- 10 group every day.
3-4 days after operation:
It is usually necessary to change the dressing during this time, because the wound has healed a little. In order to prevent nonunion caused by bloody gauze infection, a dressing change is needed.
The rehabilitation training during this period is mainly to adhere to the previous training, and in addition, thigh muscle strength training can be carried out. The method is to tighten and relax the thigh muscles with your mind and keep the thigh position unchanged. This method needs to be felt by everyone, that is, static muscle strength training. You can feel more and don't have to worry about pulling your achilles tendon. As long as it is not affected by external forces during this plaster period, training will not hurt the achilles tendon.
Static muscle strength training can tighten muscles for 5 seconds at a time, each group 10 times, about 5 times a day.
At 1 week 04:
Adhere to the above training, change the dressing for the second time within one week, and ensure that the surgical suture site is not infected and kept dry. After dressing change, the long leg plaster is still fixed to ensure that the foot is not interfered by external forces.
2 weeks after operation:
The second week, on the basis of the above training, the wound was taken out, bandaged and stitched with gauze, and then the leg was still fixed with long leg plaster.
06 The third week after operation:
At this time, rehabilitation training should increase the training of knee joint on the basis of adhering to the above training. First of all, we should hot compress our knees with hot towels every day. Long-term fixation will lead to the decrease of knee joint mobility. After hot compress, you can carry out knee joint activity training.
Training can be sitting on the bed, bending the affected limb with the knee as the fulcrum, constantly practicing lifting the calf until the leg is parallel to the ground, and then bending, mainly to restore the function of the knee. Lift the leg 20 times each time 1 group, and carry out 10 group every day.
07 4th week after operation:
On the basis of the above training, take off the plaster every day, soak your feet with hot water or traditional Chinese medicine, preferably in a bucket, which can soak the achilles tendon, promote blood circulation, remove blood stasis and reduce swelling, massage the achilles tendon after soaking, and exercise your ankles properly, but control the angle, lift the instep and toes properly, or even pull them up by hand. At this time, the achilles tendon has basically grown up and can be slowly recovered.
5 weeks after operation:
Continue the previous rehabilitation training, and on this basis, add roller training, rolling bottles, stepping on sandbags, holding towels and so on. That is, find a cylinder or bottle and put it under your feet, and press the bottle with your feet to roll back and forth. This training method is of great significance to increase the plantar flexion angle of ankle joint and properly pull open achilles tendon.
The method is: remove the plaster every day, and the length of the tube or bottle is preferably above 20 cm, and the diameter is 10 cm to 15 cm. Each activity lasts about 20-30 minutes and is conducted three times a day.
09 6th week after operation:
At this stage, we can take off the plaster and put on Achilles boots, which are available online or in hospitals, or we can make our own Achilles pads, cut them into heel pads with cardboard boxes and walk with crutches. After finding the balance slowly, we can remove the crutches, walk slowly, and remove one heel pad every day until all the heel pads are removed in about 20 days, which will give the ankle an adaptation process.
/kloc-0 7-8 weeks after operation:
Through daily roller bottle training and walking training of Achilles tendon boots and pads, the angle has been slowly restored, and the Achilles tendon has been slowly pulled and stretched. At this time, you can cooperate with wall pushing training.
The wall-pushing training is to push the wall with both hands, with the feet lunging, the injured foot arching and sticking to the wall, and the healthy foot pulling backward, or conversely, the healthy foot arching forward and the injured foot straightening backward, which can help to correct and practice the angle, restore the ankle dorsiflexion and plantarflexion angle, and change the wall-pushing for 5 minutes each time, 65,438+00 times a day.
9- 1 1 week after operation:
At this stage, you will walk on the ground with all your feet. You should fully recover the mobility of ankle joint, focus on practicing calf muscle strength and strengthen the strength of Achilles tendon. You can carry out two-legged heel-lifting training, injured pedaling training, and one-legged heel-lifting and two-legged landing training. This stage is mainly the recovery of calf muscles, so we should feel the strength of calf muscles in the above training, so as to achieve the training effect.
Lift heel's feet are lifted together with the heels, and the sick and wounded pedal the bed with the forefoot of the injured foot, and the calf muscles are tightened and forced. Lifting the heels with both feet and landing with one foot is to lift the heels together and then support the injured foot to land independently. The above actions are trained 3-5 times a day for about 20 minutes each time.
Week 13-24 after operation:
At this time, we should focus on strengthening the strength of the calf. By practicing one-legged heel lifting and proper jogging and brisk walking, we can help the calf recover its muscle strength and muscle.
13 25th week after operation:
Basically restored the muscle strength of the leg and strengthened the achilles tendon. On the basis of previous recovery, athletes can resume training by appropriately increasing the intensity and duration of exercise. If you recover well, you can basically continue to engage in sports.
Special note, the specific effect varies from person to person, and you need to follow the doctor's advice;
The overall rehabilitation course of old achilles tendon rupture was extended by one week, basically four weeks of plaster cast and four weeks of short plaster cast, according to the doctor's arrangement;
During the recovery period, you should avoid all situations that may lead to sudden landing on your feet or other unexpected stress on your legs, and be extra careful;