Achilles Tendon Rupture - Post Surgery Advice

Anatomy

​Tendon Rupture

The Achilles tendon is where your calf muscle joins the heel bone. It helps point your foot downward, and generates a push-off force for walking.

It can be ruptured by sudden force onto the foot or ankle. This can be during a forceful push off action in sports or a simple miss of a step. The tendon becomes weaker with age thereby becoming more prone to rupture.

Once an Achilles rupture has been diagnosed, there are two treatment options:

• Surgery - Repair & sew ends of tendon together
  
• Conservative - Allow tendon to heal naturally, resting in a brace

The treatment choice for your specific condition will be discussed by your doctor.

All progressions are approximations and should be used as a guide only. Progression will be based on the individual patient’s presentation, which is assessed throughout the treatment process.

Advice (Weeks 0 - 6)

Aims

• Manage your swelling and pain
  
• Protect the foot; allow time for tendon healing

Do

• Expect a degree of pain and swelling
  
• Ice regularly (at least thrice a day, 20mins) to control the swelling
  
• Elevate foot while seated
  
• Elevate foot on stool and pillows while sitting and lying down
  
• Wriggle your toes regularly
  
• Take painkillers and medication as prescribed
  
• Discuss with your physiotherapist how to maintain overall fitness
  
• Keep your leg in a cast, or a boot with wedges at all times
  
• Use a walking aid to move around
  
• Wear socks, stockings or tubigrip before putting on the boot
  
• Perform the set of specific exercises prescribed by your physiotherapist three times a day or as otherwise instructed

Do NOT

• Stand and put weight through the affected leg for the first 2 weeks
  
• Stand or walk too much for the first 2 weeks to help reduce swelling
  
• Forcefully stretch your ankle by pointing your toes up till instructed by your physiotherapist
  

Advice (Weeks 6 - 12)

Aims

• Continue to manage your swelling and pain
• Regain full range of movement of your ankle
• Regain a normal walking pattern
• Regain normal muscle strength, proprioception, balance and coordination for daily activities

Do

• Continue to ice to lessen pain and swelling
  
• Perform the set of specific exercises prescribed by your physiotherapist three times a day or as otherwise instructed
  
• Do pace and regulate your activities as advised by your physiotherapist
  

Advice (months 3 - 6)

Aims
Gradual return to activities and sports as approved by your physiotherapist and doctor

Do
Discuss with your physiotherapist about your return to sports and the sports specific rehabilitation that would be appropriate

Notify your doctor if...

• Your incision seems more swollen, warm, red or painful
  
• You have reduced sensation or change in the colour of your toes
  
• Your calf (back of your lower leg) is swollen, hard, warm or painful to the touch

Related:

• Foot & Ankle - Achilles Tendon Rupture: Post Surgery Advice [PDF]