The Achilles tendon connects the calf muscles to the heel bone. It transmits the force needed for plantarflexion, which is essential for walking, running, and jumping. Surgery is typically performed to repair an acute rupture of the Achilles tendon, where the tendon tears completely. It may also be recommended for chronic tendinopathy, a condition of degeneration and pain that has not improved with conservative treatments.
Factors Affecting the Recovery Duration
The total recovery time for Achilles tendon surgery is a range that fluctuates widely based on several patient and injury-specific variables. A patient’s overall health plays a significant role, as comorbidities like diabetes or a history of smoking can slow down healing. Age is another factor, with older patients often requiring a slower progression through rehabilitation.
The nature and extent of the original injury also influence the timeline; a complete rupture generally demands a longer recovery than a partial tear. The specific surgical technique used can impact the initial recovery phase. An open repair involves a single, larger incision, while a minimally invasive approach uses several smaller cuts, which may be associated with a quicker initial recovery. If the surgeon needed to use a tendon from another part of the foot to reconstruct the damaged Achilles, the recovery may be more extended.
The Immediate Post-Surgical Phase
The initial recovery period, often lasting two to four weeks, focuses on maximal protection of the surgical site. The ankle is immobilized in a splint or specialized boot, holding the foot in a pointed-down position to keep tension off the healing tendon. Complete non-weight bearing is mandatory, requiring the use of crutches or a knee scooter for mobility.
Strict elevation of the leg is emphasized during this protective phase to manage swelling and pain, promoting wound healing. Wound care and monitoring are performed closely, with suture removal generally occurring around the two-week mark. Once the incision is closed, the patient transitions from a non-removable splint to a removable walking boot, which may contain heel wedges that keep the foot pointed slightly down.
Rehabilitation Milestones and Timeline
The formal rehabilitation phase begins as early as two weeks post-surgery, focusing on a careful, progressive return to function. Around weeks two to six, the initial goal is to protect the repair while slowly regaining controlled range of motion (ROM) in the ankle. Weight-bearing typically begins at this stage, often starting with touchdown or partial weight-bearing in the specialized boot. The foot remains positioned with heel wedges to prevent over-stretching the tendon.
Between six and twelve weeks, physical therapy intensifies as the patient progresses toward full weight-bearing. The heel wedges are gradually removed to increase the dorsiflexion angle (movement of the toes toward the shin). The focus shifts to strengthening exercises, beginning with light, pain-free isometric contractions and progressing to seated heel raises. By the end of this period, the patient usually transitions out of the protective boot and into regular supportive footwear, often with a temporary heel lift.
The advanced strengthening phase, spanning roughly three to six months, concentrates on restoring the power and elasticity of the tendon-muscle unit. Exercises advance to include standing bilateral and then single-leg calf raises, balance training, and gait retraining. The goal is to safely reintroduce controlled loading and prepare the leg for higher-impact activities.
Full Return to Activity
The final stage of recovery, which is clearance for high-impact activities, typically occurs between six and twelve months after surgery. A full return to running, jumping, and competitive sports is only permitted when specific functional criteria are met, not merely based on time elapsed. The primary requirement is achieving significant strength symmetry. The surgical leg must demonstrate at least 90% of the strength of the uninjured leg, often measured through single-leg hop tests and calf raise repetitions.
Jogging on flat surfaces may be introduced around five months if the patient has achieved 70% of the non-involved leg’s strength based on single-limb calf raises. High-level plyometrics and sport-specific training generally begin around six months, ensuring the repair can withstand dynamic movement forces. The ability to drive is typically restored much earlier, often within four to six weeks, once the patient is off prescription pain medication and can safely control the foot and ankle.