Achilles Operative Repair

0-2 Weeks

  • No weight bearing
  • Splint in gravity equinus

2-4 Weeks

  • If skin healed, boot and 25% weight bearing week 2, 50% weight bearing week 3
  • Sutures out, incision check, new steri strips
  • Boot with 2 wedges

4-6 Weeks

  • 75% weight bearing week 4, 100% weight bearing week 5 (slow this progression if painful)
  • Remove steri strips
  • Boot with 1 wedge

6 Weeks

  • Weight bearing as tolerated.
  • Boot with 1 wedge until week 7
  • Boot with no wedges after week 7
  • Wean off of crutches as tolerated.
  • Begin practicing single limb stance out of boot in controlled environment with therapist.
  • No night splinting needed
  • Work on active ROM ankle, subtalar joint.
  • Start light weight resistance band
  • Start gentle seated belt stretch

12 Weeks

  • Out of boot to regular shoes
  • Start double-limb heel raise
  • When able to perform double-limb heel raise, graduall shift toward single-limb heel raise

After 12 Weeks, Milestone-based

  • ONLY When able to perform single limb heel raise –> Start stair calf stretch (if still feels stiff)
  • When close to symmetric heel height with single-limb heel raise with uninjured side –> Plyometrics/Running