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/eversion.- Proprioception exercises – single leg stance with front support to avoid excessive dorsiflexion.- Soft tissue mobilization/scar massage/densensitization/edema control.

Phase III (Weeks 6-12)

1. Weightbearing: Full weightbearing in sneaker.
2. Range of Motion – PROM/AROM/AAROM of the ankle – progressive dorsiflexion – 10° intervals (10° of dorsiflexion 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, side steps.
   - Proprioception exercises – balance board.

Phase IV (Months 3-6)

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