PT Resources

Achilles Tendon Repair

 

ACHILLES TENDON REPAIR

 

Rehabilitation Protocol

General Considerations:

  • Time frames mentioned in this protocol should be considered approximate with actual progression based on clinical presentation and physician direction.
  • Patient usually NWB for 3-4 weeks
  • PT usually begins 4 weeks post-op
  • Monitor the incision scar and tendon scar for mobility, implement regular soft tissue mobilization to avoid fibrosis
  • No running, jumping or ballistic movements for 6 months

Phase I (4-6 weeks):

  • Gait training with patient in bivalve cast or walking boot progress from NWB to PWB and finally to FWB
  • Soft tissue mobilization for scar tissue and modalities as indicated

Exercises:

  • AROM
  • Theraband exercises
  • Calf stretch (seated, pain free)
  • Seated calf raises
  • Straight leg raises
  • Seated BAPS
  • Well leg stationary bike
  • Aquatic exercise including deep well exercises
  • Progress to Phase II when
  • Physician indicates
  • Ambulating FWB without assistive device
  • Plantarflexion, inversion and eversion ROM equal bilaterally
  • Dorsiflexion ROM is neutra

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Phase II (6-12) weeks

  • Gait training, if in bivalve cast discharge at 6 weeks and progress to shoe with heel lift, if in walking boot discharge at 8 weeks and progress to regular shoe
  • Soft tissue mobilization for scar tissue

Phase I (4-6 weeks):

  • • Gait training with patient in bivalve cast or walking boot progress from NWB to PWB and finally to FWB
  • Soft tissue mobilization for scar tissue and modalities as indicated

Exercises:

  • Standing Gastrocnemius and Soleus stretch
  • Stationary bike (heel push only until 8 weeks)
  • Standing calf raises (approximately 8 weeks) )
  • Minisquats (bilateral to unilateral)
  • Closed chain step exercises (step ups progress to step downs)
  • Proprioceptive training (single leg balance challenged as able)
  • Leg press (bilateral to unilateral)

Progress to Phase III when:

  • Physician indicates
  • Dorsiflexion ROM equal bilaterally
  • Unilateral stance equal bilaterally
  • Minisquats (bilateral to unilateral)
  • Gait normalized

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Phase III (12 weeks – discharge)

  • One leg PREs (as tolerated)
  • Lunges (multi directional and walking)
  • Unilateral calf raises (approximately 16 weeks)
  • Outdoor biking )
  • Jogging (approximately 16-20 weeks, cleared by MD)
  • Agility drills (approximately 16-20 weeks, cleared by MD)

Discharge criteria:

  • Physician indicates
  • Long term goals achieved)
  • Patient personal goals achieved

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