back to "General Information"


Phase 1

Weeks 1 and 2
  • Total non weight bearing
  • Keep cast dry
Week 3

Range of Motion Exercise:
  • Plantar flexion and dorsiflexion to neutral, 2 sets of 20 repetitions
  • Inversion and eversion, 2 sets of 20 repetitions
  • Circumduction (both directions), 2 sets of 20 repetitions
  • Keep cast dry
Strength Exercise:
  • Isometric inversion and eversion, 2 sets of 20 repetitions (in neutral)

  • Toe curls with towel and weight
Therapy Adjuncts:
  • Gentle manual mobilization of scar tissue
  • Ice-packs with caution for any open areas of wound
Non weight bearing
  • Put into walker boot when able to get to neutral position comfortably

Phase 2

Weeks 4-6

Weight bearing status:
  • Progressive partial weight bearing to full load by week 6 in walker boot
Range of motion exercise
  • Previous AROM exercise continued
  • Begin gentle passive stretching into dorsiflexion with strap or towel
  • From week 5, passive stretch continues into dorsiflexion with progressively greater efforts,
    knee at full extension and flexed to 35-40 degrees
  • Begin standing calf stretch with knee fully extended and flexed at week 6
Stretch exercise
  • Isometric inversion and eversion, set of 10 repetitions
  • Isometric plantar flexion, set of 10 repetitions
  • One rubber band inversion, eversion, dorsiflexion and plantar flexion,
    sets of 10 repetitions, progress to 3 rubber bands by week 5
  • Stationary cycling to 20 minutes with minimal resistance by week 5
Conditioning Activities
  • Stationary cycling begins, 7-12 minutes minimal resistance
  • Water exercise can begin under totally buoyant conditions with use of a flotation device
  • No weight bearing activities can be done in the water
Therapy adjuncts
  • Manual mobilization of scar
  • Ice packs
  • From week 5, gentle cross fibre massage to Achilles tendon to release adhesions between
    tendon and paratendon
  • Ultrasound, phonophoresis and electrical stimulation may be added for chronic swelling or excess scar formation

Phase 3

Week 6-12

Weight bearing status
  • Full weight bearing in cowboy boots (1-1.5 inch heels)
Range of motion exercise
  • Further progressed with standing calf stretch
Strength exercise
  • Omit isometrics
  • Continue 3 rubber band ankle strengthening in all directions
  • Begin double legged toe raises with body weight as tolerated
  • Balance board exercises are begun for proprioceptive training
Conditioning activities
  • Stationary cycling
  • Treadmill walking
  • Stair master
  • Water exercises in chest deep water
Therapy adjuncts
  • As needed

Phase 4

Week 12 and beyond

Strength exercises
  • Toe taises should progress to use of additional weight at least
    as great as body weight and in the case of athletes, up to 1.5 times body weight
  • Single legged toe raises are begun as tolerated
Conditioning exercises
  • Progress to jogging on a trampoline and then to treadmill running via a walk-run programme
  • Eventually perform steady state outdoor running up to 20 minutes before adding figure eight
    and cutting drills
  • Water exercise performed in shallow water (waist deep)
  • In the water, begin to include hopping, bounding and jumping drills
The completely rehabilitated Achilles tendon repair allows 15-20 degrees of dorsiflexion at the ankle,
and this must be maintained with regular stretching of the gastrocnemius soleus group. Strength and
endurance are developed to pre-injury levels, and continued strength and flexibility work is advised.