Achilles Tendon Rupture Recovery Timeline: Week-by-Week Guide
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Week 1
Week 1: Initial Injury and Trauma Splint
- Initial Injury
- Immediate medical attention is crucial after an Achilles tendon rupture. If you suspect you have ruptured your Achilles, see our guide: Is My Achilles Ruptured?
- Accurate assessment of the injury severity is important to rule out other injuries, such as a calf muscle tear.
- Temporary immobilization with a plaster cast or trauma splint.
- Emergency Care (A&E)
- Initial pain management. The initial "snap" is painful, but this usually subsides quickly.
- Trauma splint or plaster cast application to keep the foot in a tip-toe position.
- You will likely be given crutches to help you walk.
- Blood thinning medicine may be advised to prevent a blocked vein (thrombosis).
- Medical Assessment
- Physical examination to assess the injury.
- Specialist referral for further care.
Weeks 1-3
Weeks 1–3: Trauma Splint and Treatment Decision
- Specialist Consultation
- Detailed examination to confirm the diagnosis of an Achilles tendon rupture.
- Imaging (usually an ultrasound scan) may be recommended to ensure the tendon ends are close together. This helps determine if surgery is an option.
- Treatment Decision
- Non-surgical treatment (most common): The foot is held in a tip-toe position with a boot to allow the tendon ends to heal naturally.
- Surgical treatment (some cases): Surgery may be considered if there's a gap between the tendon ends. The goal is to bring the ends together, but it doesn't make the tendon stronger or speed up recovery. Learn more about the Achilles Tear Treatment Pathway.
- Initial Recovery Phase
- Boot fitting and adjustment to ensure the foot is in the correct position. A night splint may be used to maintain proper foot position during sleep, if the boot is uncomfortable.
- Learning to use crutches for balance while walking.
- Non-weight bearing or partial weight-bearing as advised by your healthcare provider.
Weeks 4-6
Weeks 4–6: Recovery Progress with Night Splint
- Recovery Progress
- Regular medical review to monitor healing.
- Boot adjustments may begin to allow for a greater range of motion, gradually reducing the tip-toe position. This is usually done by removing wedges from the back of the boot.
- If difficulty sleeping in the boot, a night splint may be used to maintain proper foot position during sleep. This helps address the common complaint of sleeping in a heavy boot.
- Mobility
- Continue following medical guidance for weight-bearing and movement. Walking in the boot is generally encouraged.
- Gradual progression of mobility exercises as advised by your physiotherapist. Physiotherapy typically starts around 9-10 weeks after the injury.
Weeks 7-9
Weeks 7–9: Continued Care and Monitoring
- Continued Care
- Regular monitoring of your Achilles tendon's healing progress.
- Following the established treatment plan closely, including boot adjustments.
- Adjustments to the treatment plan as needed, based on your progress and your healthcare provider's assessment. Learn more about the options at Achilles Tear Treatment Pathway.
- Continue using the night splint for comfortable sleep.
Weeks 10-12
Weeks 10–12: Starting Rehabilitation
- Rehabilitation Begins
- Starting physiotherapy to regain strength and flexibility. The focus is on building calf muscle strength.
- Transitioning from the boot to more regular footwear, typically around 10 weeks.
- Following a guided exercise program tailored to your specific needs. Avoid vigorous stretching exercises, even if the tendon feels tight. For a detailed look at the recovery process, see our guide: Torn Achilles Recovery.
Weeks 13-25
Weeks 13–25: Progressive Recovery and Strengthening
- Progressive Recovery
- Increasing activity levels gradually, under the guidance of your physiotherapist.
- Continuing to follow physiotherapy guidance to ensure proper healing and regain strength.
- Building strength and endurance in the calf and surrounding muscles. This is a crucial phase for long-term recovery.
Week 26+
Weeks 26+: Return to Activity and Long-Term Recovery
- Return to Activity
- Gradual return to normal activities, including sports and exercise, following medical advice. Most rehabilitation programs aim for a return to sport around 6 months.
- Individual progress varies, so listen to your body and avoid pushing yourself too hard.
- Understanding Life After Achilles Rupture is key to maintaining long-term health and preventing re-injury. The healed tendon will likely remain thicker than before, and the calf muscle may be slightly smaller.
- Be mindful of avoiding re-rupture. Follow all instructions carefully, especially during the early stages of recovery.
Notes
Important Notes
- Recovery timelines are approximate and can vary significantly depending on individual factors, such as age, overall health, and the severity of the injury.
- Always follow your healthcare provider's specific guidance and instructions. This timeline is a general guide, not a substitute for personalized medical advice.
- Attend all scheduled follow-up appointments to monitor your progress.
- There is NO SUCH THING as a partial tear of the Achilles tendon. Assume you have a complete rupture until a specialist has assessed your injury.
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Buy NowFrequently Asked Questions (FAQs)
What happens in the first week after an Achilles rupture?
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.
When do I need to make the decision between surgical and non-surgical treatment?
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.
When can I switch from the boot to a night splint?
Around weeks 4-6, if you're having difficulty sleeping in the boot, your healthcare provider may recommend switching to a night splint. The night splint is lighter than the boot and helps maintain proper foot position during sleep while ensuring the tendon continues to heal correctly.
When does physiotherapy typically begin in the recovery process?
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.
How long until I can return to sports after an Achilles rupture?
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.
What are the key milestones in Achilles rupture recovery?
Key milestones include: Week 1 (initial treatment and immobilization), Weeks 1-3 (treatment decision), Weeks 4-6 (possible transition to night 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).
What precautions should I take to prevent re-rupture during recovery?
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.
How do I know if my Achilles is healing properly?
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.