Accelerated (vacoped) Rehabilitation For Achilles Ruptures

TIME

IMMOBILISATION

REHABILITATION

0-2 WEEKS

Non Weight Bearing

IMMOBILISE IN PLASTER

• STRICT ELEVATION 1 WEEK
• CLINIC REVIEW AT 2 WEEKS

• Maintenance of other limbs

2-4 WEEKS

Weight Bearing in Vacoped

Gentle Mobilisation

CHANGE TO VACOPED ACHILLES

• LOCKED IN FULL PF.
• FULLY WEIGHTBEARING
• WEAR 24 HRS A DAY.
• CAN TAKE OFF WHEN SITTING.
• ↑ DF RANGE BY 1 NOTCH PER WEEK (5PER WEEK)

PHYSIOTHERAPY STARTS

• Soft tissue massage
• Passive ROM
• Gentle Active

4-8 WEEKS

Early Active Rehab

Limited WB

• REMOVE WALKER AT NIGHT.
• DORSIFLEXION ↑ 5’ PER WEEK.
• THEREFORE ‘FOOT FLAT’ AT 8 WEEKS

• Active PF with Theraband
• Seated heel raises
• ROM 0’ DF maximum
• Full PF, inversion and eversion
• Proprioception/balance etc

8-12 WEEKS

WB Rehab

Progressing through to daily function and NWB sports

DISCARD VACOPED AND CHANGE TO FLAT SHOE WITH 1CM HEEL RAISE FOR 4 WEEKS

• Gait re-education
• Gentle WB dorsiflexion stretch (lunge position)
• Ecc/Con loading (bilat to single.
• Emphasise ecc phase)
• Single stairs
• Progress to upslope and downslope.
• NWB aerobic exercises - e.g. cycling
• (push with heel, not toes).
• Monitor inflam. signs and rehabilitation
• Discard crutches when DF 10’

12-16 WEEK

Progressive exercise

NORMAL SHOES.

• Jogging progressing to fast acc. & deceleration.
• Directional running / cutting
• Pylometrics. e.g. toe bouncing upwards
• / forwards /directional

16-20 WEEKS

PROGRESS TO FULL SPORTS