Post-operative rehabilitation depends on 3 people: the surgeon, the patient, and the therapist. Obviously, the surgeon must be technically proficient, the patient must be compliant, and the therapist must promote healing without damaging the surgical repair. Orthopedic surgeons often have therapists follow specific rehabilitation protocols, usually based on tissue-healing timeframes.
Prescribing therapeutic exercise at the appropriate dosage is essential since some tissue stress is necessary to facilitate proper healing; however, too much stress can damage the repair. Little is known about the stresses to tissues during Achilles tendon exercises. Thera-Band® Academy Scientific Advisory Board member Tim Tyler, PT ATC presented EMG analysis data on common Achilles exercises at the 2011 TRAC Annual Meeting.
Ten healthy subjects performed several common exercises, including Thera-Band resisted plantar flexion. The EMG activation levels are reported as a percentage of a maximal contraction:
Seated toe raise : 11%
- Single-leg balance on Wobble Board : 25%
- Prone ankle pumps : 38%
- Plantar flexion with red Thera-Band exercise band : 45%
- Walking : 47%
- Lateral Step-up : 60%
- Single leg heel raise : 112%
- Single leg jump : 112%
While EMG levels are not a direct measure of tissue stress, they can help establish an appropriate progression of high to low intensity activities. For example, Thera-Band ankle pumps should be prescribed prior to or at the time of full weight-bearing. Understanding these levels will help the clinician make better clinical decisions about prescribing exercises for Achilles tendon reconstruction rehabilitation.
His study is in press in the journal, Sports Health.
Read the abstract of his study here: EMG Analysis of the Triceps Surae Muscle Complex During Achilles Tendon Rehabilitation Program Exercises
Listen to a podcast interview with Tim about his project by clicking on the link below: