Rupture of the Achilles tendon usually occurs in middle-aged males while playing basketball, tennis, racquetball or some other form of activity that involves ballistic movements. Surgery and immobilization are required to reduce the rupture. After removal of the cast, the patient should see a physical therapist to normalize the range of motion and develop functional strength for ambulation. Once the client has a normal range of motion, a referral is made to begin exercise with a personal trainer to regain full functional strength. Maintaining and increasing range of motion of dorsiflexion and plantarflexion are important. Power more so than strength is essential for recovery and return to sports. The gastrocnemius is the muscle that propels the body forward when walking and running. Without a fully functional gastrocnemius, an athlete will not have the ability to push-off with any authority when participating in sports.
The gastrocnemius is a two joint muscle crossing the ankle and knee. It is predominately a type II muscle. It is normally responsible for explosive movements. Training should begin with seated calf raises and eventually progress to ballistic type training. Flexibility is introduced at the beginning of the program and emphasized throughout the program. Frequent stretching should be encouraged. Stretching is done for the gastrocnemius and soleus. Any stretching is done by gradually increasing intensity. The goal is a full range of motion dorsiflexion actively. Strength training should begin with seated calf raises and progress to standing calf raises and plyometrics. Leg press can be done to increase overall leg strength. Leg extensions and leg curls should be done to improve quadriceps and hamstring strength. Circuit training to improve the functional ability for a return to sports can be done in the later stages of the program. If at any time during the exercise program the client develops calf pain or swelling the exercise should be discontinued and the referral source contacted.
