Achilles Tendon Repair

Phase I (Weeks 0-2)

1. Weightbearing: Non-weightbearing using crutches
2. Brace: Patient in plantarflexion splint
3. No formal PT

Phase II (Weeks 2-6)

1. Weightbearing: As tolerated in CAM Walker Boot with heel wedges in place (first wedge removed at 4 weeks, second wedge removed at 6 weeks); discontinue crutch use
2. Brace: CAM Walker Boot at all times except showering and when working with PT
3. Range of Motion
   • PROM / AROM / AAROM of the ankle from full plantarflexion to neutral (no dorsiflexion past neutral)
   • Inversion / eversion
   • Toe flexion / extension
4. Therapeutic Exercises
   • Seated heel raises
   • Isometric dorsiflexion to neutral
   • Resistance bands for plantarflexion, inversion, and eversion
   • Proprioception exercises – single-leg stance with front support to avoid excessive dorsiflexion
   • Soft tissue mobilization, scar massage, desensitization, and edema control

Phase III (Weeks 6-12)

1. Weightbearing: Full weightbearing in sneaker
2. Range of Motion
   • PROM / AROM / AAROM of the ankle with progressive dorsiflexion
   • Increase dorsiflexion in 10° intervals
   • 10° by post-op week 8, 20° by week 10, 30° by week 12
3. Therapeutic Exercises
   • Standing heel raises
   • Single-leg eccentric lowering
   • Step-ups and side steps
   • Proprioception exercises – balance board

Phase IV (Months 3-6)

1. Progress strengthening, proprioception, and gait training activities
2. Begin light jogging at 12–14 weeks
3. Running and cutting at 16 weeks
4. Return to sports at 5–6 months