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TREATMENT continued...

Stage IV

Tendon rupture requires surgical repair.

Medical Issues and Complications

Knee immobilization is not recommended because it results in stiffness and may lead to other muscle or joint problems, further prolonging an athlete's return to activity.

Consultations

Consultation with a physical medicine and rehabilitation specialist or an orthopedic specialist is recommended, particularly for Stage I cases that do not respond to conservative treatment and more severe cases (Stages II, III, and IV)

Recovery Phase

Physical Therapy

An in-depth, stage-specific description of a conservative therapy program is described above. In brief, in the recovery phase, the athlete and therapist should work to restore pain-free joint range of motion and muscle flexibility, symmetric strength in the lower extremities, and joint sensation. Sport-specific training, including high-level sport specific exercises, should then be initiated.

Consultations

Consultation with a physical medicine and rehabilitation specialist or an orthopedic specialist is recommended, particularly for Stage I cases that do not respond to conservative treatment or more severe cases (Stages II, III, IV).

Surgical Intervention

Surgical intervention is indicated for stage IV, and refractory stage III tendinopathy as noted above.

Maintenance Phase  

Rehabilitation Program 

Physical Therapy

An in-depth, stage-specific description of a conservative therapy program is described above (see Acute Phase). Briefly, once in the maintenance phase, the athlete should complete a sport-specific training program before returning to competition. The physician and physical therapist can assist the athlete in determining when to return to competition based on the patient's symptoms, current physical examination findings, and functional test results. Once the athlete returns to play, he or she must work to maintain gains in flexibility and strength. 

Consultations

Consultation with a physical medicine and rehabilitation specialist or an orthopedic specialist is recommended, particularly for Stage I cases that do not respond to conservative treatment or more severe cases (Stages II, III, IV).

Surgical Intervention

Surgical intervention is indicated for stage IV disease. See Acute Phase above.

MEDICATION

Non-steroidal anti-inflammatory drugs are often used for pain and inflammation control. Drugs in this category include naproxen (Naprosyn, Aleve), ibuprofen (Motrin, Advil) and others. These should be used per the doctor’s instruction and according to label directions. People with certain conditions should not use these medications. Your doctor will help you know if these drugs are right for you.

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