Physical therapy can be started after the orthopaedist is released, which usually takes place about 3 weeks after surgery. At this stage the person still needs to be immobilized but techniques can be used to accelerate healing, such as ultrasound and massage to reorganize the tendon collagen fibers, avoiding the formation of fibrosis points.
After the orthopaedist is released to remove the immobilization, stretching and strengthening exercises can definitely be started, which can happen between 6 and 8 weeks after surgery.
Treatment should be divided into phases:
While stationary
Some features that can be used are Tens, Ultrasound, Ice, Massage and stretching exercises and passive mobilization to release all the ankle movements but still without putting the weight of the body totally on the foot.
After the treatment the splint should be placed again and the person should not yet fully place the weight of the body on the affecting foot, using crutches to walk.
After removal of the immobilization splint
In addition to features like ice with tension, if you still have pain, ultrasound and massage, you can begin stretching exercises of the calf and active movement of the foot up and down in the sitting position. Catching marbles with your toes and wrinkling a towel also helps to improve the movement of the fingers.
At this stage, after the orthopedist release the person can put the weight of the body on the foot and proceed to use only 1 crutch to walk, serving only support.
To start strengthening muscles
After removing the crutches and putting the weight completely on the feet, it is normal that there is still ankle movement restriction and the person feels insecure to return their activities.
At this stage some exercises that can be indicated are to put a tennis ball under the foot and roll under the soles of the feet, front to back. Endurance exercises with elastic bands are also indicated.
When the ankle movement allows you can stay 20 min on the stationary bicycle as long as no pain. Squatting exercises, going up and down stairs can also be indicated.
Each person recovers in a way and therefore the treatment can vary from one person to another. Putting on ice and doing ultrasound after exercise may be indicated to decrease pain and discomfort at the end of each session.
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