Accessibility Tools

0-2 weeks

Posterior slab/splint; non-weight-bearing with crutches

2-4 weeks

  • Aircast walking boot with 2-cm heel lift*
  • Protected weight-bearing with crutches
  • Active plantar flexion and dorsiflexion to neutral, inversion/eversion below neutral
  • Modalities to control swelling
  • Knee/hip exercises with no ankle involvement; e.g., leg lifts from sitting, prone, or side-lying position
  • Non-weight-bearing fitness/cardiovascular exercises; e.g., bicycling with one leg, deep-water running
  • Hydrotherapy (within motion and weight-bearing limitations)

4-6 weeks

  • Weight-bearing as tolerated*
  • Continue 2-4 week protocol

6-8 weeks

  • Remove heel lift
  • Weight-bearing as tolerated*
  • Dorsiflexion stretching, slowly
  • Graduated resistance exercises (open and closed kinetic chain as well as functional activities)
  • Proprioceptive and gait retraining
  • Modalities including ice, heat, and ultrasound, as indicated
  • Fitness/cardiovascular exercises to include weight-bearing as tolerated; e.g., bicycling, elliptical machine, walking and/or running on treadmill, StairMaster
  • Hydrotherapy

8-12 weeks

  • Wean off boot
  • Return to crutches and/or cane as necessary and gradually wean off
  • Continue to progress range of motion, strength, proprioception

>12 weeks

  • Continue to progress range of motion, strength, proprioception
  • Retrain strength, power, endurance
  • Increase dynamic weight-bearing exercise, include plyometric training
  • Sport-specific retraining

*Patients are required to wear the boot while sleeping.

Patients can remove the boot for bathing and dressing but are required to adhere to the weight-bearing restrictions according to the rehabilitation protocol.

Click here to download Printable Version of Achilles Tendon Rupture Non-Operative Rehabilitation Protocol.