Achilles Tendon Repair

iOrtho

Weight-Bearing

NWB in splint/Achilles boot wks 0-3; PWB with 3 wedges starting wk 4 (25% BW/week progression); wean one wedge/week (wks 5, 6, 7); FWB boot no wedges wk 8; sneaker with 1cm heel lift wks 9-10; wean heel lift wks 11-12

Key Restrictions

Do not dorsiflex past 0 deg until wk 8; no overt calf stretching until 6 months post-op; no IASTM directly on tendon until wk 16; no running until months 6+; LE functional tests >=90% for RTS

Timeline & Phases

Phase I (Wks 0-3 immediate), Phase II (Wks 4-6 intermediate), Phase III (Wks 7-8 late), Phase IV (Wks 9-10 transitional), Phase V (Wks 11-12 transitional), Phase VI (Months 3-6 advanced), Phase VII (Months 6+ RTS)

Notes

More conservative for re-rupture, revision, tendon augmentation, chronic tendinosis, or comorbidities; Shoe Leveler for uninvolved side throughout boot phase; outcome measures: ATRS, PRRS

Published

August 2024