Achilles Tendon Repair Rehabilitation Protocol

PHASE I: WEEK 0-2

Weight Bearing

  • Non-weight bearing using crutches

Splint/ Boot

  • Post-op plantar flexion splint at all times

ROM

  • None

Therapeutic Exercise

  • Hip, knee ROM as tolerated

PHASE II: WEEK 2-6

Weight Bearing

  • Weight bearing as tolerated in CAM Walker boot
  • Discontinue crutch use

Splint/ Boot

  • CAM Walker boot with heel wedges in place (first wedge removed at 4 weeks, second wedge removed at 6 weeks)
  • Worn at all times except for showering and in PT

ROM

  • PROM/AROM/AAROM of the ankle from full plantar flexion to neutral (NO DORSIFLEXION PAST NEUTRAL), Inversion/ Eversion, Toe Flexion/Extension

Therapeutic Exercise

  • Seated heel raises
  • Isometric dorsiflexion to neutral
  • Resistance bands for plantar flexion/inversion/eversion
  • Proprioception exercises - single leg stance with front support to avoid excessive dorsiflexion
  • Soft tissue mobilization/scar massage/desensitization/edema control

PHASE III: WEEK 6-12

Weight Bearing

  • Full weight bearing in sneaker

Splint/ Boot

  • None

ROM

  • PROM/AROM/AAROM of the ankle - progressive dorsiflexion - 10 degree intervals (10 degrees of dorsiflexion by post-op week 8, 20 degrees by week 10, 30 degrees by week 12)

Therapeutic Exercise

  • Standing heel raises
  • Single leg eccentric lowering
  • Step-ups, side steps
  • Proprioception exercises - balance board

PHASE IV: MONTH 3-6

Weight Bearing

  • Full weight bearing

Splint/ Boot

  • None

ROM

  • Full ROM

Therapeutic Exercise

  • Progress with strengthening, proprioception, and gait training activities
  • Begin light jogging at 12-14 weeks
  • Running and cutting at 16 weeks
  • Return to sports at 5-6 months

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