After an Achilles tendon rupture, most patients require surgical repair. But how does physical therapy aid in recovery? Here’s a detailed explanation!
How Soon Can You Exercise After Achilles Tendon Repair Surgery?
Following Achilles tendon repair surgery, patients typically need 6 to 9 months of physical therapy to regain most of their mobility. If they wish to return to sports or more intense activities, it usually takes 9 to 12 months for full recovery.
Recovery Stages After Achilles Tendon Surgery
Patients typically undergo 6 to 9 months of physical therapy after Achilles tendon repair surgery. The rehabilitation process is divided into four key stages. Initially, therapy focuses on wound protection, followed by muscle strengthening and gait training to restore mobility. Below are the four rehabilitation stages and their respective physical therapy treatments:
Stage 1: Physical Therapy (Weeks 1-2 Post-Surgery)
This is the maximum protection phase, where therapy primarily focuses on:Wound protection, Pain and swelling reduction, Tendon healing support, Preventing deep vein thrombosis (DVT) or thromboembolism
For the first 5 days, the ankle is immobilized with a cast, positioned at approximately 30-degree plantar flexion. Patients must use crutches and avoid putting weight on the affected foot. Once the cast is removed, patients transition to a CAM boot with heel lifts to reduce strain on the Achilles tendon.
Exercise Therapy
Physical therapists assist patients with ankle exercises, ensuring movements are pain-free. Static isometric exercises are introduced to maintain joint mobility and prevent muscle atrophy through low-intensity training.
Stage 2: Physical Therapy (Weeks 2-6 Post-Surgery)
During this phase, therapy continues to protect and support healing, while gradually strengthening the ankle and improving its range of motion. The goal is to achieve 0-degree dorsiflexion (when the foot is fully straightened) and begin reducing heel lift height in the CAM boot. Patients also work towards walking without crutches.
Exercise Therapy
Passive exercises to restore ankle mobility, including dorsiflexion and plantarflexion movements. Active exercises such as toe raises, inversion, and eversion to improve range of motion without pain.
Strength Training (Weeks 4-5)
Resistance band exercises focusing on plantarflexion, dorsiflexion, inversion, and eversion to rebuild muscle strength.
Balance Training
Patients start with seated exercises on a balance board, progressively increasing difficulty. If progress is good, patients transition to standing balance exercises on the board.
Manual Therapy
Scar tissue mobilization techniques help improve tissue flexibility and reduce stiffness around the surgical site.
Stage 3: Physical Therapy (Weeks 7-12 Post-Surgery)
At this stage, the primary focus is to restore full ankle mobility and strengthen the affected leg. The goal is to walk normally without a heel lift and achieve normal dorsiflexion of the ankle.
Exercise Therapy
Dorsiflexion stretching is emphasized. Patients perform Towel Stretch exercises by looping a towel around the foot and gently pulling it to improve ankle flexibility.
Strength Training
Standing Calf Raises: Patients use their body weight to strengthen the calf muscles for daily movements. If strength is insufficient, Seated Calf Raises are used instead. Bridge Exercise: Helps strengthen the core and glute muscles to support overall movement.
If progress is good, bodyweight squats are introduced, and gradual weight is added over time.
Balance Training
Single-leg balance exercises on a balance board to improve stability. Perturbation Training is incorporated, where external forces or movements challenge balance, increasing difficulty.
Functional Training
Daily activity simulations help patients regain mobility and confidence. Common exercises include: Stair climbing, Reverse treadmill walking, Stationary cycling.
This phase helps restore functional movement and prepare patients for more demanding activities in the next stage.
Stage 4: Physical Therapy (Week 13 and Beyond)
The goal of this final stage is to fully restore the affected leg’s strength and function, ensuring that the patient can resume normal daily activities without limitations and return to sports. At this point, physical therapy is mostly conducted in a gym setting, with patients taking an active role in their own training.
Strength Training
Patients engage in progressive resistance exercises to enhance lower limb and core strength using eccentric training techniques. Common exercises include: Weighted Squats, Leg Press, Lunges (Forward Lunge), Weighted Standing Calf Raises
For patients aiming to return to sports, therapists introduce explosive movements and agility drills to improve power and responsiveness. Exercises may include: Box Jumps, Single-Leg Hops, Jump Squats, Lateral Movement Drills.
When Can You Return to Sports?
Patients can typically resume sports 9 to 12 months after surgery, but only after a thorough assessment by a physical therapist. Key factors such as joint mobility, jumping ability, balance, and running performance must be evaluated, ensuring at least 90% symmetry between both legs before returning to athletic activities.
Professional Post-Surgery Support for Achilles Tendon Recovery
Rehabilitation after Achilles tendon surgery is crucial for restoring mobility. OneEssential provides specialized post-surgery support to help patients regain their full range of motion and strength, often exceeding pre-injury levels.
For athletes, our expertise has helped many professional athletes in Hong Kong return to peak performance after Achilles tendon surgery. We offer personalized, one-on-one rehabilitation programs, designed to gradually rebuild strength and flexibility, ensuring a safe and efficient recovery back to sports and daily activities.