Achilles Tendon Repair

Post operative program for Achilles tendon repair

Week 1

Your leg will be in a half plaster cast for the first 2 weeks after surgery

Mobilise on crutches non weight bearing on the injured leg

When resting, the leg is to be elevated with the foot above the height of the hip

Do not let your leg hang down for more than a few moments at a time

Move your toes frequently during the day

Weeks 3 to 6

The wound will be checked at about 2 weeks from surgery

If all is well then the plaster will be exchanged for a removable Aircast pneumatic walking boot.  This will be fitted by a physiotherapist and has internal heels (up to 3) to support your foot as the heel will not rest flat to the floor initially.

During these weeks the internal heels are removed one by one to allow your heel to come closer to the floor.  This will be supervised by the physiotherapist

The boot can be removed to allow physiotherapy, washing and at night.   It must be worn for all weight bearing through the injured leg

Toe exercises should continue regularly.  The foot can now be turned in and out.  The ankle can be moved up and down but it must not move to more than a right angle to the tibia (lower leg)

Movements up and down at the ankle are to be performed by you only without resistance (this is called active movement).  Do not stand on the foot without the boot to try and force the foot into a more normal position

Weeks 6 to 10

Gradually during this phase the movements of the ankle will increase to allow movement beyond a right angle.  Initially this will be just you trying to pull the foot up and increasingly the physiotherapist will start to add some pressure to the movements and try to stretch out the ankle range of movement (this is called passive movement)

Continue moving the remainder of the foot joints regularly

You should continue to wear the boot when walking

Week 10 to 12

The boot can now be removed when walking

Continue exercising the ankle and foot joints to maximum range of motion

Week 12+

Strengthening work can now begin.  Each patient will progress at a different rate depending on their individual circumstances.  Toe standing is the first exercise to try to start building up strength.

The physiotherapist will outline a program of rehabilitation suitable for you

The end point of recovery is broadly between 6 and 12 months from injury