Achilles tendinosis and calf muscle strength. The effect of short-term immobilization after surgical treatment.
We prospectively studied calf muscle strength in 7 men and 4 women (mean age, 40.9 +/- 10.1 years) who had surgical treatment for chronic Achilles tendinosis. Surgery was followed by immobilization in a weightbearing below-the-knee plaster cast for 2 weeks followed by a stepwise increasing strength training program. Strength measurements (peak torque and total work) were done preoperatively (Week 0) and at 16, 26, and 52 weeks postoperatively. We measured isokinetic concentric plantar flexion strength at 90 and 225 deg/sec and eccentric flexion strength at 90 deg/sec on both the injured and noninjured sides. Preoperatively, concentric and eccentric strength were significantly lower on the injured side at 90 and 225 deg/sec. Postoperatively, concentric peak torque on the injured side decreased significantly between Weeks 0 and 16 and increased significantly between Weeks 26 and 52 at 90 deg/sec but was significantly lower than that on the noninjured side at all periods and at both velocities. The eccentric strength was significantly lower on the injured side at Week 26 but increased significantly until at Week 52 no significant differences between the sides could be demonstrated. It seems, therefore, that the recovery in concentric and eccentric calf muscle strength after surgery for Achilles tendinosis is slow. We saw no obvious advantages in recovery of muscle strength with a short immobilization time (2 weeks) versus a longer (6 weeks) period used in a previous study.
Alfredson
H
H
Department of Orthopaedic Surgery, University of Umeå, Sweden.
Pietilä
T
T
Ohberg
L
L
Lorentzon
R
R
D000125:Achilles Tendon / Q000503:physiopathology / Q000601:surgery*; D000328:Adult; D005080:Exercise Test; D005260:Female; D006801:Humans; D007103:Immobilization; D008297:Male; D018482:Muscle, Skeletal / Q000502:physiology* / Q000503:physiopathology; D026741:Physical Therapy Modalities; D011446:Prospective Studies; D015203:Reproducibility of Results; D018709:Statistics, Nonparametric; D052256:Tendinopathy / Q000534:rehabilitation / Q000601:surgery*; D019415:Torque