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