Massachusetts General Brigham Sports Medicine
Rehabilitation Protocol for Achilles Rupture Repair
This protocol is intended to guide clinicians through the post-operative course for Achilles tendon repair. This protocol is
time based (dependent on tissue healing) as well as criterion based. Specific intervention should be based on the needs
of the individual and should consider exam findings and clinical decision making. The timeframes for expected outcomes
contained within this guideline may vary based on surgeon’s preference, additional procedures performed, and/or
complications. If a clinician requires assistance in the progression of a post-operative patient, they should consult with
the referring surgeon.
The interventions included within this protocol are not intended to be an inclusive list. Therapeutic interventions should
be included and modified based on the progress of the patient and under the discretion of the clinician.
Considerations for the Post-operative Achilles tendon repair program
Many different factors influence the post-operative Achilles tendon rehabilitation outcomes, including type and location
of the Achilles tear and repair. Consider taking a more conservative approach to range of motion, weight bearing, and
rehab progression with tendon augmentation, re-rupture after non-surgical management, revision, chronic tendinosis,
and co-morbidities, for example, obesity, older age, and steroid use. It is recommended that clinicians collaborate
closely with the referring physician regarding intra-operative findings and satisfaction with the strength of the repair.
If the patient develops a fever, unresolving numbness/tingling, excessive drainage from the incision, uncontrolled pain
or any other symptoms you have concerns about, the referring physician should be contacted.
PHASE I: IMMEDIATE POST-OP (0-3 WEEKS AFTER SURGERY)