Achilles Tendon Debridement Rehab Protocol
Keys to Success
Patients who are treated non-surgically must take added caution because suture fixation makes surgical repair more robust than nonsurgical treatment.
It is important to avoid dorsiflexion the Achilles tendon beyond neutral in the first 6 weeks of treatment, after which the patient may begin controlled progressive stretching.
The healing tendon is vulnerable, and care must be taken to avoid sudden loading of the Achilles tendon during activities of daily living (eg, ascending stairs) because it can result in rerupture.
Gradual return to low-impact activities may commence at 2 months after injury. High-impact activities (eg, soccer, football, rugby) may be considered after 4-6 months if the ability to perform a single-limb heel rise is demonstrated.
NWB with crutches/ walker
Straight leg raises, open chain terminal knee extension, hamstring stretching, toe AROM
PWB with crutches/ walker
Scar mobilization if incision fully healed; AROM may begin @ 3 weeks; STM of calf; continue Phase I exercises
WBAT with crutches
Add towel stretches for calf; sitting BAPS board Levels 1-3; gentle theraband strengthening (DF, IN, EV)
Wean from boot
WBAT; wean from crutches
Gentle standing gastroc/soleus stretching; general lower extremity strengthening
SLS exercises; progress lower body strengthening exercises; gentle stair stretching
Begin agility and sport-like exercises