Acute Achilles Tendon Rupture Repair Rehab

The Achilles tendon is the biggest and strongest tendon in the human body and is formed by the tendons of the soleus and gastrocnemius muscles which both insert at the calcaneus. We mostly see ruptures of the Achilles tendon in high-impact sports predominantly in the male athlete.

While a scientific review from the year 2017 showed no significant differences in the outcomes of surgical and conservative management the re-rupture rate of conservatively managed tendons was higher and conservative management might not be suitable for every injury depending on its severity. However, there is a clear benefit of an accelerated rehab program including early mobilization versus immobilization as has been researched by Brumann et al. (2014).

In the 1st phase post-surgery, usually lasting about two weeks, the goal should be to properly educate the patient on the expected course. Make sure that the wound heals properly and swelling is under control The patient will likely wear a walker boot with 30° of plantar flexion, but should be able to walk with full weight-bearing. Your aim is going to be to strengthen the surrounding muscles.

So let’s look at what this could look like.

Exercise overview:

• Toe flexion & extension
• Straight Leg Raise
• Clam Shells with and without resistance bands
• Side-lying abductions with or without resistance bands or ankle weights

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If you are interested in early and mid-phase rehab exercises for Achilles tendon rupture repair, check out the posts below:

• Acute Achilles Tendon Rupture Repair Rehab
• Intermediate Tendon Rupture Repair Rehab

Brumann M, Baumbach SF, Mutschler W, Polzer H. Accelerated rehabilitation following Achilles tendon repair after acute rupture–development of an evidence-based treatment protocol. Injury. 2014 Nov 1;45(11):1782-90.

Deng S, Sun Z, Zhang C, Chen G, Li J. Surgical treatment versus conservative management for acute Achilles tendon rupture: a systematic review and meta-analysis of randomized controlled trials. The Journal of Foot and Ankle Surgery. 2017 Nov 1;56(6):1236-43.