Achilles Tendon Rupture Rehabilitation Protocols

4 Achilles Tendon Rupture rehabilitation protocols from 4 institutions. Weight-bearing progressions vary by institution — compare them in the table below before selecting a protocol.

Compare by institution

Institution	Weight-Bearing	Key Restrictions
Massachusetts General Hospital — Repair	NWB on crutches in splint wks 0-1; NWB in Achilles boot with 3 wedges wks 2-3; WBAT in…	Avoid over-elongation of Achilles; conservative approach for augmentation, re-rupture, revision, chronic…
Saint Louis University (SLUCare) — Non-Operative	NWB on crutches wks 0-2; WBAT with crutches in boot wks 2-4; progress to FWB (crutches…	Plaster cast or rigid boot with foot in 20 deg plantarflexion and 3 wedges (22/16/10 mm), boot 24 hrs/day wks…
Sanford Health — Achilles Tendon Rupture (Non-Operative)	NWB in cast (max plantar flexion) x 2 wks; boot with 40° heel lifts: 25% WB wk 2-3, 50%…	Must begin within 48 hours of injury; avoid DF past neutral x 8 wks; avoid tendon stretching x 6 months; no…
University of Colorado Anschutz (CU) — Repair	NWB in splint wks 0-2; TDWB in boot wks 2-4; WBAT in boot wks 5-6; FWB wk 7+; boot D/C wk…	No ankle/foot ROM wks 0-2; PROM limited to DF 0 deg with knee flexed to 90 wks 2-4; no passive Achilles…