Insertional Achilles Tendon Debridement

Orthopaedic Associates of Maine

Weight-Bearing

NWB until 4 wks; FWB in boot by 6 wks; transition to supportive shoe at 8 wks

Key Restrictions

Short leg splint (ankle neutral) 10-14 days, then short leg cast to 4 wks; no active or passive ankle ROM phase I; avoid aggressive dorsiflexion and resisted plantarflexion phase II; no barefoot walking; no plyometrics until phase IV; discontinue boot at 8 wks; night splint DC at 6 wks; no return to high-impact until cleared by MD and PT; 90% calf strength required for discharge

Timeline & Phases

Phase I (Wks 0-4: NWB, splint/cast, no ankle ROM), Phase II (Wks 4-6: AROM PF/inv/ev, FWB in boot by wk 6), Phase III (Wks 6-12: shoe at 8 wks, CKC, proprioception), Phase IV (Wks 16-24+: plyometrics, jogging 16-20 wks, RTS)

Notes

Includes Achilles debridement, calcaneal bone spur excision, and tendon reattachment with suture anchors; jogging ~16-20 wks once single leg heel raise with good mechanics; 90% calf strength vs uninvolved for discharge