Our torn Achilles rehabilitation program is based around three stages. The first is allowing your tendon to heal, then restoring normal mobility and strength before a gradual return to full fitness.
The following guidelines are for information purposes only. We recommend seeking professional advice before attempting any self-treatment.
How long will Achilles rupture rehabilitation take?
A complete rupture of the Achilles tendon is a serious injury and rehabilitation should be a very gradual process taking 6 to 9 months.
The speed at which a particular patient progress with the rehabilitation exercises varies. Timescales indicated are only a rough guide. It is important you work under the supervision of a qualified professional.
This follows a similar pattern to that of the surgical approach, although takes a lot longer.
Your doctor applies a plaster in a plantarflexed position (toes and foot pointing down). Sometimes, after four weeks they apply a new cast with less plantar flexion. After 8 weeks the tendon has usually healed.
Surgical approach to torn Achilles rehabiltiation
Most Achilles tendon ruptures are treated surgically, especially with young athletes or active people. The following is an example of a rehabilitation and exercise program for a complete achilles tendon rupture. We recommend seeking advice from your own surgeon before attempting any rehabilitation exercises.
Week 1 to 8
Apply a plaster case after surgery. No stretching or exercise, just rest and let it heal. You may be able to work your upper body, or focus on another aspect of your sport.
Try to do something positive and stay in some kind of routine that you would if you were fully fit. It will certainly help your state of mind.
Week 8 onwards
Stage 1 – range of motion and flexibility.
Place heel raises (1-2cm) in shoes to take some of the pressure off the Achilles tendon.
Sports massage techniques and ultrasound can aid torn Achilles rehabilitation by helping to realign the new fibres in line with the tendon.
Active stretching. Pull your toes upwards to stretch the Achilles tendon. Very gently at first and gradually build up. If active stretches are not painful then you can beging passive stretches. This involves someone or something assisting in the stretching process.
When a full range of motion has returned (the ruptured leg is as flexible as the other leg) then a gradual strengthening programme can start.
Balance exercises should also be introduced as the sense of balance and positioning is often decreased after tendon or ligament ruptures and if not re-gained, can lead to future injuries. Wobble boards (balance boards) are great for this.
Sports massage plays a part in the rehabilitation of this injury by improving blood flow to the area, helping the muscles relax and become more supple.
Stage 2: Strengthening for torn Achilles rehabilitation
You must take great care when starting strengthening exercises for an Achilles rupture. There is a fine line between strengthening the tendon and re-injuring it.
You can start strengthening exercises as soon as they can be tolerated. It may be a full month after the cast comes off before exercises can begin.
The athlete may feel a little pain when you first start these exercises. If the pain is intolerable then do not continue.
Gradually each day the pain should be less. The athlete should not attempt to increase the level of exercise until there is no pain during or after the exercises.
The strengthening exercises must be done after a gentle warm-up and stretch. The muscles can be warmed up by raising the heels up and down on the toes while seated. Heat applied directly to the tendon for example by a hot water bottle can also help.
Flexibility training must be continued throughout.
Remember to apply cold therapy or ice after exercise, this will help keep inflammation down.
Avoid explosive or ballistic movements or this may lead to a re-rupture.
Torn achilles rehabilition – returning to full fitness
When the patient has gone at least a week without pain then they may begin to return to training. If they feel pain when returning to training then stop. Begin each training session with a walk to warm-up followed by stretching.
- 1: walk 4 minutes jog 2 minutes repeat four times
- 2: rest
- 3: walk 4 minutes jog 3 minutes repeat three times
- 4: rest
- 5: walk 3 minutes jog 4 minutes repeat 4 times
- 6: rest
- 7: walk 2 minutes jog 6 minutes repeat 4 times
Continue this gradual progression until you can confidently run and resume normal training.
How long until I am back to full fitness?
- Most athletes can expect to be out of competition for 6 to 9 months after surgery.
- This is increased to 12 months if the Achilles was immobilized in plaster instead of operated on. There is also a greater risk of re-injury if the athlete does not have the surgery.