Instructions for AFTER the surgery

  • It is essential for someone to accompany you home and preferably stay with you for 24 hours.
  • No weight on the leg at all, use crutches at all times
  • Leave half plaster clean, dry and intact until first post operative appointment.
  • Elevate operated ankle as much as possible in the first 3-5 days.
  • Move/wriggle toes as much as possible. It will NOT cause harm/damage.
  • You will need to book physio, this should be the same day as your 2 week visit with Dr Sim.
  • Swelling. This is to be expected. Elevate operated ankle as much as possible for the first 3-5 days.
  • Pain. You will receive a prescription for pain medication on discharge. Pain relief medication works best if take REGULARY.
  • Possible temporary numbness and/or tingling of foot and toes.
  • Excessive persistent pain
  • Pus, discharge from wound
  • Fever
  • Excessive pain AND tenderness AND swelling in calf

Should any of these symptoms persist, please contact Dr Sim’s rooms or after hours emergency.

Achilles Tendon Tear Surgical Repair Rehab Protocol

Wound Healing

0-2 WEEKS

  • Leave backslab clean, dry, UNDISTURBED
  • NWB (Non Weight Bearing)

Gentle Range of Motion

2-3 WEEKS

Physiotherapy treatment to commence

Treatment

  • Camboot with 3 heel pads
  • Full weight bearing but use two crutches for balance/stability
  • Remove camboot for washing and aerating the foot

When camboot is removed, NO weight bearing or dorsiflexion

Exercise Suggestions

ROM & Flexibility:

  • Plantarflexion maximally
  • No dorsiflexion
  • Other knee/hip exercises with no ankle involvement

4 WEEKS

Treatment

  • Camboot with 1 heel pad
  • Full weight bearing, wean off crutches if comfortable

Exercise Suggestions

ROM & Flexibility:

  • Plantarflexion maximally
  • No dorsiflexion
  • Exercise bike with camboot ON
  • Gait training and balance exercises with the camboot
  • Other knee/hip exercises with no ankle involvement

Strengthening

5 WEEKS

Treatment

  • Camboot without heel pad, full weight bearing

Exercise Suggestions

  • Plantarflexion maximally
  • Dorsiflex to neutral only
  • Exercise bike with camboot ON
  • Gait training and balance exercises with the camboot
  • Other knee/hip exercises with no ankle involvement

6-8 WEEKS

Treatment

  • Wean off camboot
  • Use of shoes with heel-lift (bilateral) for four weeks

Exercise Suggestions

  • Plantarflexion and dorsiflexion AS TOLERATED
  • Exercise bike wearing the camboot
  • Active ROM
  • Active plantarflexion
  • Gait training and balance exercises
  • Other knee/hip exercises with no ankle involvement

8-10 WEEKS

Treatment

  • Use of shoes with heel-lift (bilateral) until 10 weeks after surgery
  • Compression stocking to prevent swelling

Exercise Suggestions

  • As described above in 6-8 Weeks – increase intensity

It is important that all exercises are performed slowly and carefully

Proprioception and Advanced Strengthening

(learning to sense movement within joints AND the joint’s position)

After 12 WEEKS

Treatment

  • Use of regular shoes after 10 weeks
  • Barefoot after 12 weeks

Exercise Suggestions

  • Intensify the exercises by increasing load
  • Start gentle jog
  • Start with two legged jumps and increase gradually

Return to Sport

  • Return to competitive sport once all goals achieved

AND

  • Physio and Surgeon have declared you fit to do so

Achilles Tendon Tear NON-Surgical Rehab Protocol

  • Camboot with 2cm heel lift
  • NWB (Non Weight Bearing) with crutches
  • Camboot with 2cm heel lift
  • Protected weight bearing with crutches
  • Active full plantarflexion and dorsiflexion to neutral only
  • Modalities to control swelling (eg. compression stocking, ice packs)
  • Knee/Hip exercises as appropriate
  • Camboot with 2cm heel lift
  • WBAT (Weight Bear As Tolerated) with NO CRUTCHES
  • Continue treatment as per 2-4 weeks
  • Camboot
  • Discontinue heel lift
  • WBAT (Weight Bear As Tolerated)
  • Dorsiflexion stretching (past neutral) SLOWLY
  • Graduated resistance exercises (eg. resistance band) in plantarflexion
  • Wean off boot
  • Return to crutches/cane if necessary, then wean off
  • Continue to progress ROM (Range Of Motion), strength, proprioception (Physiotherapist supervision highly recommended)
  • Continue to progress ROM, strength, proprioception
  • Retrain strength, power, endurance
  • Sport specific retraining