Restoration of tarsal joint flexibility and muscle strength after surgical treatment of the rupture of the Achilles tendon in athletes

Raztrganina Ahilove tetive je težka poškodba spodnje okončine, ki prizadene običajno vrhunske ali rekreativne športnike zaradi degenerativnih sprememb kite kot posledico dolgotrajnih preobremenitev. Konservativni način zdravljenja z mavčno oblogo je v zadnjih letih nadomestila operativna terapija raztrganine z odprtim ali zaprtim pristopom in šivi kite preko kože. Posamezne strokovne dileme pa ostajajo še naprej na področju pooperativne rehabilitacije, predvsem z vidika pričetka razgibavanja skočnega sklepa in obremenjevanja spodnje okončine. V monografskem diplomskem delu smo uporabili deskriptivno metodo z zbiranjem, presojo in temeljito analizo prispevkov in rezultatov s področja zdravljenja in rehabilitacije poškodovancev z raztrganino Ahilove tetive. Prispevke smo zbirali v ustrezni bazi podatkov v domači in tuji literaturi ter vključili tudi dosedanje lastne izkušnje pri reševanju teh poškodb. Na podlagi zbranih podatkov in z ustrezno statično analizo le teh, smo odgovorili na trditve v zastavljenih ciljih in hipotezah diplomskega dela. Rezultati zbranih podatkov so nam namreč potrdili pravilnost zgodnje pooperativne rehabilitacije, razgibavanje sklepa in dozirano obremenjevanje spodnje okončine, kar omogoči hitro povrnitev omejene gibljivost skočnega sklepa in mišično moč in s tem omogočiti vrhunskim športnikom hitro vključitev v proces treninga in tekmovanja, pri rekreativnih športnikih pa povrnitev v normalen ritem vsakodnevnih aktivnosti. Hkrati smo opredelili tudi vlogo kineziologa v zgodnjem rehabilitacijskem procesu, ki lahko s svojim znanjem in specifičnimi vajami pomembno prispeva k optimalni rehabilitaciji poškodovanca.Rupture of the Achilles tendon is a severe injury of the lower extremity, usually occurring in professional or recreational athletes on account of degenerative changes in tendons as well as resulting from permanent overload. In recent years the conservative manner of treatment with plaster casts has been replaced by the surgical treatment of the rupture with open or closed approach and by passing sutures through the skin and pulling the ruptured ends of the tendon together. Individual expert dilemmas tillremain open in the field of postoperative rehabilitation, especially when the exercising the tarsal joint and loading of the lower extremity should be initiated. In this diploma paper we used the descriptive approach by collecting, assessing and thoroughly analysing the papers and results from the field of treatment and rehabilitation of patients with a rupture of the Achilles tendon. The papers were collected from the database of domestic and foreign literature and we included our own experience in managing these types of injuries. Based on the collected data and proper statistical analysis, we responded to arguments in the objectives and hypotheses set out in this diploma paper. The results of the collected data have confirmed the correctness of early postoperative rehabilitation, exercising the joint and controlled loading of the lower extremity, which enables a fast restoration of tarsal joint flexibility and muscle strength necessary for top athletes to return to the training and competition process fast and for recreational athletes to return to their normal rhythm of daily activities. We also defined the role of a kinesiologist in the early rehabilitation process who significantly contributes with expert knowledge and specific exercises to the optimal rehabilitation of the injured person