Achilles Tendon Repair Rehabilitation Protocols

16 Achilles Tendon Repair rehabilitation protocols from 13 institutions, published 2019–2025. Weight-bearing progressions vary by institution — compare them in the table below before selecting a protocol.

Compare by institution

Institution	Weight-Bearing	Key Restrictions
iOrtho	NWB in splint/Achilles boot wks 0-3; PWB with 3 wedges starting wk 4 (25% BW/week…	Do not dorsiflex past 0 deg until wk 8; no overt calf stretching until 6 months post-op; no IASTM directly on…
Lahey Hospital & Medical Center	NWB 0-6 wks (plaster splint wks 0-2, fiberglass cast wks 2-6); WBAT in boot with heel…	No passive dorsiflexion wks 8-12 (active DF only); heel lifts in boot wks 6-12 with gradual removal…
Mammoth Orthopedic Institute / Sierra Park PT	NWB x4 weeks in splint/cast; WBAT 4-6 weeks in CAM boot with heel lift; FWB weaning from…	No over-stressing repair (forceful PF while in DF position); no impact activities until Phase V (3-6 months)
Ohio State University Wexner Medical Center	NWB days 0-14; WBAT in protective device at post-op wk 2; full D/C boot and heel lifts by…	No aggressive stretching of Achilles or gastroc-soleus complex before 12 wks; risk factors: age 30-50, male…
Orthopaedic Associates of Maine	NWB 3-4 wks; FWB in boot by 6 wks; therapy begins 4 wks postop	No active or passive dorsiflexion past neutral until 8 wks; remove heel wedges starting 6 wks; discontinue…
Orthopedic & Sports Medicine Specialists (OSMS)	NWB in short leg cast or plantarflexed boot Phase I; partial WB in walker boot in PF…	Rest and elevation between ADLs Phase I; heat before exercise, ice after in Phase III; single leg…
Orthopedic & Sports Medicine Specialists (OSMS) — Early…	NWB in short leg cast or PF boot Phase I; protected WB in walker boot PF position with…	Boot required while sleeping through Phase III; rest/elevation between ADLs Phase I; jogging/running and…
SAM Health	NWB 0-2 wks; boot NWB 2-4 wks, WBAT 4-6 wks; wean boot ~wk 8; running 20+ wks	DF to 0 deg only initially; no aggressive DF stretch; no impact until 16 wks criteria met; ATRA monitored
Sanford Health — Achilles Tendon Repair	NWB in post-op splint; CAM boot with wedging: wk 2-4: 25% BW 2" wedge, wk 4-6: 50% 1"…	AROM only PF/DF x 6 wks (no PROM); limit DF to neutral x 6 wks; no ballistic motions (running, plyometrics)…
SOMOS (Society of Military Orthopaedic Surgeons)	Wks 1-2: TDWB (0-10% BW) in post-op splint with heel lift → WBAT; Wks 3-4: WBAT ¼" heel…	CAM boot for all ambulation; limit DF to 0° until 6 weeks; heel lift progression wks 1-6 (½" → ¼" → 1/8"); no…
Sutter Health / Palo Alto Medical Foundation	NWB wks 0-2 with crutches; WB as tolerated in CAM boot with 2 heel wedges wks 2-6 (first…	NWB with crutches wks 0-2; CAM boot worn at all times except showering/PT wks 2-6; NO dorsiflexion past…
University Hospitals	NWB w/ crutches 0-2 wks; PWB in boot w/ heel lifts wks 2-4; WBAT in boot by 4 wks; boot…	No active or passive dorsiflexion past neutral for 8 wks (greatest tendon elongation risk 2-6 wks post-op)…
University of Virginia Orthopaedic Surgery	NWB weeks 0-2; PWB with crutches progressing to FWB by weeks 3-4; FWB in boot weeks 4-8…	Equinus cast 15-20° plantarflexion weeks 0-2 (posterior plaster splint if swelling severe); boot with 1" heel…
UW Health Sports Medicine	TDWB in boot (NWB for Dr. Williams) x 2 wks; WBAT in boot by ~wk 6; wean boot at wks 6-8	Boot locked in PF 20-30° x 2 wks; surgeon-specific PF angle progression (Baer vs. Scerpella/Spiker/Williams)…
UW Health Sports Medicine — Insertional Achilles Tendon Repair	Not extractable (PDF content image-based)	Avoid over-stressing repair (no large sagittal movements, no forceful PF in dorsiflexed position, no…
UW Health Sports Medicine — PARS Achilles Tendon Repair…	NWB x 4 wks; PWB progressing to FWB by wk 6; boot until 9-10 wks (per MD clearance); heel…	Boot: 20° PF at wk 2, 10° PF at wk 3, neutral at wk 4 with 2 heel lifts; no ankle DF past neutral until min…