Achilles tendon rupture treatment without surgery using Aircast boot and wedges
Rehabilitation after achilles tendon rupture This document gives you information about what to expect from your early recovery. It is also intended as a guide for your longer-term rehabilitation after Achilles injury, which you can use in conjunction with a physiotherapist from around 8 weeks after injury. 1-2 weeks after injury
You will be seen in the clinic and changed to a removable boot with wedges.
You may start to walk on the repair in the boot with wedges.
You should not remove the boot at night.
Keep your knee, hip and toes moving.
You should be taking blood thinning medication to prevent blood clots until 4 weeks after injury.
You do not need other physio at this stage.
You may remove the boot each day from 2 to 8 weeks after injury to bathe your foot, whilst keeping your toes pointed down.
2 weeks to 8 weeks after injury
Increase your walking, you do not need to use crutches if you are comfortable without.
Continue to use the boot at night.
Continue blood thinning medication (dalteparin) until 4 weeks after injury.
If you start with 5 wedges in your boot, remove one each week from the start of week 3, so there are none left at 8 weeks.
If you start with 2 larger wedges in your boot, remove one at the start of week 4 and one at the start of week 8.
You will be reviewed in the clinic at between 6 and 8 weeks after injury.
8 weeks to 12 weeks
You should be wearing your boot when walking.
You may start physiotherapy to begin strengthening the calf muscle.
Avoid stretching the calf muscle before 12 weeks after injury.
Physio should focus on achieving a foot which can be comfortably placed flat to the floor. You should avoid strength work.
12 weeks to 14 weeks
You may be back in your normal shoes, but avoid completely flat shoes for another 6 weeks.
Physio should focus on weightbearing stretches, gait re-education and light
strengthening exercises e.g. seated calf raises or cautious theraband use.
You should avoid isolated single leg strength work.
14 weeks to 20 weeks
Continue to avoid single leg calf raises and impact activity (such as running).
Physio should focus on supported strengthening with exercises such as bilateral calf raises, cycling and walking (no incline), hamstring curls, small range lunges.
Commence proprioceptice exercises such as single leg standing.
20 weeks to 8 months
Work on regaining normal movement.
Aim for achieving gastroc strength of 80% of the other side.
Return to jogging/running.
Work on increasing endurance and return to sport-specific activity.
Avoid single leg heel raises until 6 months post-injury.