Accelerated Rehab Program
In an acute Achilles Tendon Rupture, there are two options:
- Surgical repair with accelerated rehab protocol.
- Accelerated rehab protocol without surgery.
Please note that whether or not you have surgery, you will be recommended to go onto this protocol.
You must strictly elevate the foot above the level of the heart 23 hours a day for the first 2 weeks.You will be required to wear a “moon” boot for up to 10 weeks. This boot is to remain on at all times during this period except when undertaking exercises with your Physiotherapist.
You will be allowed to start some weight bearing after about 3-4 weeks in your boot.You will require crutches for up to 8 weeks.You can expect to start sport specific training at 3 months. We generally recommend taking 6-12 months off from serious running and explosive “push off” type sports such as running.
A physio should lead you through your rehabilitation program after surgery.
This table is a guide and changes may be required depending on your progress.
| Week | Exercises | Crutches | Footwear | Weight bearing |
|---|---|---|---|---|
| 0-2 | Physio guided passive range of motion no more than neutral. Open chain strength exercises for quads, hamstrings, glutes hip flexors. | Yes | Plaster Cast <span style="text-decoration:underline;">or</span> CAMBOOT with 30mm heel lift <span style="text-decoration:underline;">or</span> VACOPED (3) plus wedge sole for 1st week. Plaster Cast <span style="text-decoration:underline;">or</span> CAMBOOT with 20mm heel lift <span style="text-decoration:underline;">or</span> VACOPED (2) plus wedge sole for 2nd week. | Non-weight bearing |
| 2-4 | Begin physio guided active range of motion ankle exercises from week 3-4. Continue strength exercises as above including gentle closed chain quads, hamstrings, glutes. Can commence light isometric calf exercises at low resistance and reps, no stretching beyond 10° plantar flexion. | Yes | CAMBOOT with 30mm heel lift <span style="text-decoration:underline;">or</span> VACOPED (3) plus wedge sole for 2nd week. CAMBOOT with 20mm heel lift <span style="text-decoration:underline;">or</span> VACOPED (2) and wedge sole for 3rd week. | Touch weight bearing (10% body weight) initially building to partial weight bearing (50% BW) by 4th week. |
| 4-6 | Hydrotherapy may begin if wound healing is adequate. Gentle calf stretching with a towel (not body weight). Light concentric and eccentric calf raises with heel lift and progression to resisted ankle movements (not past plantar grade). Closed chain weight bearing quads, hamstrings, glutes, calf strengthening with physio guidance. | Yes | CAMBOOT with 10mm heel lift <span style="text-decoration:underline;">or</span> VACOPED at (1) with <b>flat sole</b> for 4th week Transitioning towards plantargrade until boot is completely removed. | Partial weight bearing transitioning towards full weightbearing |
| 6-8 | Hydrotherapy Begin gait and ankle proprioception retraining. Moderate load close/open chain calf strengthening to plantar grade only. Continue hip and knee strengthening as necessary. | Yes | CAMBOOT with no heel lift <span style="text-decoration:underline;">or</span> VACOPED at (0) with flat sole | Partial weight bearing transitioning towards full weightbearing |
| 8-10 | Hydrotherapy, stationary cycling. Higher level proprioception training. Independent gait. | No | CAMBOOT with no heel lift <span style="text-decoration:underline;">or</span> VACOPED at (0) with flat sole | Full weightbearing |
| 10-12 | Cont. high load ankle, knee, hip Strengthening (can be performed independently). Low level calf plyometric exercises (fast CRs, tip toe Walking). **No hopping, jumping, running. May begin walking, light jogging after 12 weeks, swimming, cycling. Can begin upper limb sports specific training eg. Shooting basketball, tennis shots from standing start, contralateral kicking small. | No | Regular footwear | Full weight bearing |
| 12-32 | Moderate load plyometrics at 12 weeks with supervision (double leg jumps, skipping). May begin sports specific training drills: if returning to contact sport only controlled outcome drills ie. No tackling, sudden unexpected change of direction, jumping without in air contact etc until cleared by surgeon and physio. Progression of calf stretching past plantar grade. | No | Regular footwear | Full weight bearing |
If you have any questions please do not hesitate to contact Mr Goldbloom’s rooms on 0493 051 985.
The Accelerated Rehabilitation Program has been developed by Mr Goldbloom in conjunction with Physiotherapists Brodie Leonard-Shannon and Brendan Mason from Back in Motion, Aspendale Gardens.
