Achilles surgery involves repairing the large tendon at the back of the ankle, often after a rupture or severe injury. This procedure aims to restore the tendon’s integrity and function, allowing individuals to regain mobility and strength. This article outlines what to expect during recovery, including pain management, mobility limitations, and the timeline for returning to daily activities.
The Initial Days After Surgery
Immediately following Achilles surgery, patients typically experience pain and discomfort as anesthesia and any nerve blocks begin to wear off. A long-acting local anesthetic may provide initial relief, but pain medication, often including narcotics, will be prescribed. Pain can peak on the first or second day as swelling increases.
The surgical site will be covered with a dressing or splint to immobilize the foot and protect the repaired tendon. The foot is usually positioned with the toes pointed slightly downward (plantarflexion) to reduce tension on the healing tendon. Managing swelling is important for pain control and healing. Elevating the foot above heart level, especially during the first 48 hours, is recommended to minimize swelling. Applying ice packs can also help reduce inflammation and discomfort, even through the dressing or splint.
Navigating Recovery Stages
The recovery from Achilles surgery progresses through distinct phases, each with specific goals and mobility restrictions. The initial protective phase (0-2 weeks) focuses on safeguarding the surgical repair. During this time, the foot is typically immobilized in a splint or cast, and individuals remain non-weight-bearing, relying on crutches or other mobility aids. The first follow-up appointment often occurs around 10-14 days post-surgery for wound assessment and suture removal.
Around two weeks post-surgery, patients often transition to a removable walking boot, sometimes with heel lifts, which allows for gradual adjustments in ankle position. This marks the early healing phase, extending up to 6 weeks. Partial weight-bearing may be initiated during this period, though the specific timing and amount depend on the surgeon’s protocol. The boot typically remains in place, often with the foot still in a plantarflexed position, and gradually adjusted towards a neutral position over several weeks.
The functional recovery phase generally starts around 6 weeks and can last until 12 weeks or beyond. During this time, formal physical therapy usually begins, and the goal is to gradually transition out of the walking boot. Patients may start wearing regular shoes, sometimes with heel lifts, as they work towards normalizing their gait. The exact timeline for progression through these stages can vary based on individual healing, surgical technique, and the specific rehabilitation protocol followed.
Physical Therapy and Regaining Strength
Physical therapy is a fundamental component of Achilles surgery recovery, guiding the rehabilitation process to restore function. Therapy typically begins after the initial protective phase, often around 2 to 6 weeks post-surgery, focusing on controlled mobilization and range of motion. Early exercises might include gentle active dorsiflexion within the boot’s limits and pain-free isometric ankle exercises, such as pushing against a resistance band. These initial movements help prevent stiffness and promote circulation without overstressing the healing tendon.
As the tendon gains strength, physical therapy progresses to include a wider range of motion exercises and gradual strengthening. This involves exercises like seated calf raises and eventually standing heel raises to build calf muscle strength. Balance exercises, starting with static balance and progressing to more dynamic movements, are also incorporated to improve stability. The therapist guides the patient through increasing loads and complexities, ensuring the exercises are appropriate for the healing stage.
The goals of physical therapy include restoring the full range of motion in the ankle, building muscle strength in the calf and surrounding leg muscles, and improving overall balance and proprioception. Therapists also work on gait training to help patients regain a normal walking pattern. Consistency with the prescribed exercise program is important for optimal recovery and long-term outcomes.
Returning to Regular Activities
The return to regular activities after Achilles surgery is a gradual process that extends beyond the initial rehabilitation phases. Patients typically begin with light daily activities, such as walking without support, once cleared by their surgeon and physical therapist. Driving can usually be resumed when the affected foot is no longer in a boot, and the individual can safely operate vehicle pedals, which may take several weeks to months.
Light exercise, like stationary cycling or swimming (once the incision is fully healed), may be introduced in the later stages of recovery, often around 3 to 6 months post-surgery. Returning to more strenuous activities, such as running or sports, requires significant strength, balance, and the ability of the tendon to withstand higher loads. This typically occurs much later, often around 6 months to a year or more after surgery, depending on the sport’s demands and individual progress. The process emphasizes listening to the body’s signals and avoiding activities that cause pain or discomfort to prevent re-injury.