Achilles Tendon Repair

Sutter Health / Palo Alto Medical Foundation · Kevin M. Roth, MD

Weight-Bearing

NWB wks 0-2 with crutches; WB as tolerated in CAM boot with 2 heel wedges wks 2-6 (first wedge removed wk 4, second wk 6); FWB in sneaker wk 6+

Key Restrictions

NWB with crutches wks 0-2; CAM boot worn at all times except showering/PT wks 2-6; NO dorsiflexion past neutral wks 2-6; progressive dorsiflexion 10 degrees/increment (10 deg by wk 8, 20 deg by wk 10, 30 deg by wk 12); jogging 12-14 wks; running/cutting 16 wks; RTS 5-6 months

Timeline & Phases

Phase I (wks 0-2): NWB with crutches, post-op plantar flexion splint, no ROM — hip/knee strengthening as tolerated, towel crunches/toe spreading/toe taps/seated arch doming, SLR/quadsets/sidelying exercises; Phase II (wks 2-6): WB as tolerated in CAM boot with heel wedges, NO dorsiflexion past neutral, PROM/AROM/AAROM ankle (PF to neutral, inv/ev, toe flex/ext) — seated heel raises, isometric DF to neutral, resistance bands (PF/inv/ev), single-leg stance proprioception with front support, STM/scar massage/edema control; Phase III (wks 6-12): FWB in sneaker, progressive DF in 10 deg increments (10 deg wk 8 / 20 deg wk 10 / 30 deg wk 12), full PROM/AROM/AAROM — standing heel raises, single-leg eccentric lowering, step-ups/side steps, balance board; Phase IV (months 3-6): full ROM, progress strengthening/proprioception/gait — light jogging 12-14 wks, running/cutting 16 wks, RTS 5-6 months

Notes

4-phase protocol; heel wedges removed sequentially (first wk 4, second wk 6); progressive dorsiflexion in 10 deg increments through wk 12; Sutter Health / Palo Alto Medical Foundation

Surgeon / Author

Kevin M. Roth, MD

Published

2024