Surgery to repair a torn (ruptured) Achilles tendon is conducted on an outpatient basis using a local anesthetic. It involves making an incision or cut in the back of the leg above the heel to access the torn tendon.
The surgery involves suturing the ruptured ends of the tendon back together and applying a splint for a couple of weeks while the tendon heals followed by gradual transition back to weightbearing. Surgery may be delayed for about one week after the rupture to let the swelling go down. If treatment is delayed longer and there is a large gap between tendon ends, additional procedure may be required.
After surgery, we typically follow a modified contemporary protocol (see below reference). This post operative protocol may be modified on an individual patient basis.
Achilles Tendon Rupture Protocol
Time Frame | Activity |
0-2 Weeks | Splint, non-weight-bearing with crutches |
Ice and elevate to control swelling | |
2-4 Weeks | CAM boot with heel lift (2cm) |
Protected weight-bearing with crutches | |
Ice and elevate to control swelling | |
Hip/knee exercises with no ankle involvement | |
4-6 Weeks | Weight-bearing as tolerated |
Continue 2-4 week protocol | |
Active ankle range of motion to neutral | |
6-8 Weeks | Remove heel lift, remain in CAM boot |
Weight-bearing as tolerated | |
Begin physical therapy | |
Scar massage | |
8-12 Weeks | Wean off boot |
Continue physical therapy |
* Patients required to wear boot while sleeping, remove only for showering with caution.
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