Achilles Repair: Post Op Protocol

Weeks 0-2

Equinus cast or splint in 15-20° plantarflexion
Toe touch weight bearing

Weeks 2-4

Removable fixed ankle walker with 1” heel lift (4 separate 1⁄4” lifts stacked)
Begin progression to full weight bearing between 3-4 weeks
Patient may remove boot for active plantarflexion (unrestricted) and dorsiflexion to neutral

Weeks 4-8

Remove 1⁄4” heel lift each week with goal of no lift in boot at 8 weeks
May begin progressing dorsiflexion stretching and resisted plantarflexion at 6 weeks

Weeks 8-12

Discontinue boot after 1 week of ambulating with no lift
Progress strengthening, range of motion and proprioception under guidance of physical therapist
Begin eccentric strengthening
Progress to Outdoor Running and strengthening, single leg toe raise at week 12.