Achilles Tendon Rupture Recovery Timeline 2025: Week-by-Week Guide (Surgical & Non-Surgical)

In the first week, you'll need immediate medical attention. You'll likely visit A&E where they'll provide initial pain management, apply a trauma splint or plaster cast to keep your foot in a tip-toe position, and give you crutches. Blood thinning medicine may be prescribed to prevent thrombosis. A specialist referral will be arranged for further care.

The treatment decision is typically made during weeks 1-3 after consulting with a specialist. They'll perform a detailed examination and may request imaging (usually ultrasound) to check if the tendon ends are close together. Non-surgical treatment is most common, where the foot is held in a tip-toe position with a boot. Surgery is mainly considered if there's a significant gap between the tendon ends.

Around weeks 4-6, if you're having difficulty sleeping in the boot, your healthcare provider may recommend switching to a splint. The splint is lighter than the boot and helps maintain proper foot position during sleep while ensuring the tendon continues to heal correctly.

Physiotherapy typically starts around weeks 10-12. This is when you'll begin transitioning out of the boot and start a guided exercise program focused on building calf muscle strength. It's important to follow your physiotherapist's guidance and avoid vigorous stretching exercises, even if the tendon feels tight.

Most rehabilitation programs aim for a return to sports around 6 months (week 26+). However, this varies by individual and depends on your progress through rehabilitation. The focus during weeks 13-25 is on progressive strengthening and building endurance in the calf muscles, which is crucial for safe return to sports activities.

Key milestones include: Week 1 (initial treatment and immobilization), Weeks 1-3 (treatment decision), Weeks 4-6 (possible transition to splint), Weeks 10-12 (starting physiotherapy and transitioning from the boot), Weeks 13-25 (progressive strengthening), and Week 26+ (gradual return to normal activities including sports).

To prevent re-rupture, strictly follow your healthcare provider's instructions, especially during the first 12 weeks when the tendon is most vulnerable. Don't remove the boot unless instructed, avoid unsupported walking, and don't rush the rehabilitation process. When starting physiotherapy, avoid aggressive stretching and follow your exercise program carefully.

Your healthcare provider will monitor healing through regular check-ups, particularly during the first 9 weeks. Signs of proper healing include decreased pain, ability to bear weight as advised in your boot, and gradual improvement in movement when permitted. However, remember there is NO SUCH THING as a partial tear - always follow your specialist's guidance for proper healing assessment.