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Achilles Rehab Protocol Guide

This document outlines an accelerated rehabilitation protocol for Achilles tendon ruptures over 12+ weeks. It begins with non-weight bearing in a splint or boot with crutches for 0-2 weeks. From 2-4 weeks, partial weight bearing is introduced in a walking boot with heel lift while continuing range of motion exercises. From 4-6 weeks, weight bearing is increased as tolerated while adding resistance exercises and proprioception training. The protocol aims to progress strengthening and return to full activity over the full 12+ week period.

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193 views1 page

Achilles Rehab Protocol Guide

This document outlines an accelerated rehabilitation protocol for Achilles tendon ruptures over 12+ weeks. It begins with non-weight bearing in a splint or boot with crutches for 0-2 weeks. From 2-4 weeks, partial weight bearing is introduced in a walking boot with heel lift while continuing range of motion exercises. From 4-6 weeks, weight bearing is increased as tolerated while adding resistance exercises and proprioception training. The protocol aims to progress strengthening and return to full activity over the full 12+ week period.

Uploaded by

tenun wita
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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www.IndianaTotalTherapy.

com Telephone: 1-877-353-4704

ACCELERATED ACHILLES PROTOCOL


Time Activity
Frame
0-2 weeks Posterior slab/splint; non-weight-bearing with crutches: immed. postop. in surgical group,
after injury in nonop. group
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
Incision mobilization modalities++
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
Incision mobilization++
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 were required to wear the boot while sleeping. +Patients could remove the boot for bathing and dressing
but were required to adhere to the weight-bearing restrictions according to the rehabilitation protocol. ++If, in the
opinion of the physical therapist, scar mobilization was indicated (i.e., the scar was tight or not moving well), the
physical therapist would attempt to mobilize using friction, ultrasound, or stretching (if appropriate). In many cases,
heat was applied before beginning mobilization techniques.

Operative versus Nonoperative Treatment of Acute Achilles Tendon Ruptures: A Multicenter Randomized Trial Using Accelerated
Functional Rehabilitation
Kevin Willits, Annunziato Amendola, Dianne Bryant, Nicholas G. Mohtadi, J. Robert Giffin, Peter Fowler, Crystal O. Kean and Alexandra
Kirkley
J Bone Joint Surg Am. 2010;92:2767-2775, published Oct 29, 2010;.2106/JBJS.I.01401

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