Your Guide to Achilles Tendon Surgery Recovery: How Physical Therapy Gets You Back on Your Feet

An Achilles tendon rupture is a serious injury—but with the right recovery plan, you can regain strength, mobility, and confidence. At Pain & Performance Coach in Hillsboro (OR), we guide active adults and athletes through every phase of healing after Achilles surgery.

Whether you’re a runner, gym-goer, weekend warrior, or just want to get back to walking pain-free, this step-by-step guide shows how physical therapy helps you recover safely and fully.

What Is the Achilles Tendon?

Your Achilles tendon is a thick, rope-like structure that connects your calf muscles to your heel. It plays a key role in walking, running, and jumping—but when torn, it loses its ability to spring and support you.

Surgical repair is often needed for active individuals. But recovery doesn’t stop with stitches. That’s where physical therapy makes all the difference.

PHASE-BY-PHASE RECOVERY + MILESTONES

Phase 1: Protection & Healing (0–2 weeks post-op)

Goal: Allow wound healing and protect the surgical site

🔹 What happens:

• You’ll wear a boot or cast with your foot pointed downward

• No weight on the leg (crutches or scooter)

• Focus on rest, swelling control, and gentle exercises for hips/thighs

🔹 What we do in therapy:

• Teach you how to move safely

• Begin gentle strength work for upper leg

• Introduce blood flow restriction therapy (BFRT) if cleared

✅ Milestones to reach before moving on:

• Incision healed with no signs of infection

• Minimal swelling and pain

• Able to do basic hip/knee movements without pain

• Orthopedist/podiatrist clearance to begin partial weight bearing

Phase 2: Early Mobility & Weight Bearing (2–6 weeks)

Goal: Begin walking again—in a safe, controlled way

🔹 What happens:

• Start walking in a boot with heel lifts (50–100% weight)

• Use BFRT to slow muscle loss

• Begin gentle ankle exercises (no stretching)

🔹 What we do in therapy:

• Restore calf activation and muscle control

• Monitor ankle range of motion

• Track tendon tightness to avoid over-stretching

• Begin stationary cardio (bike or upper body ergometer)

✅ Milestones to reach before moving on:

• Walk 100% weight-bearing in the boot with minimal pain

• Ankle movement returns to neutral (not beyond)

• No signs of tendon elongation

• Confidence and balance while walking with boot

Phase 3: Strength Building & Gait Training (6–12 weeks)

Goal: Restore walking mechanics and begin strength training

🔹 What happens:

• Transition from boot to shoe with heel lifts

• Begin structured strength program (bodyweight to light resistance)

• Focus on calf, glutes, and core control

🔹 What we do in therapy:

• Introduce standing heel raises, squats, and low-impact mobility

• Add resistance (with BFRT or light weights)

• Gait retraining with mirror, treadmill, or overground drills

✅ Milestones to reach before moving on:

• Walk in shoes without a limp

• Perform double-leg heel raises with decent height

• Ankle range of motion within functional limits

• Able to stand, squat, and climb stairs without major compensations

Phase 4: Advanced Strength & Movement Control (12–24 weeks)

Goal: Build full lower body strength and control during dynamic movements

🔹 What happens:

• Start plyometric (jump-based) drills, banded hops, and single-leg strength work

• Improve endurance with stair climbing, elliptical, or running drills

• Progress heel raises to single-leg with full height and control

🔹 What we do in therapy:

• Continue strengthening at more advanced levels

• Restore balance and joint control during agility drills

• Work on reintroducing high-speed movements

✅ Milestones to reach before moving on:

• Perform 10+ single-leg heel raises with full height

• Able to jog on a treadmill or AlterG treadmill without pain

• Symmetrical movement patterns during squats/lunges

• Strength within 80–90% of non-injured side

Phase 5: Return to Sport or Full Activity (24+ weeks)

Goal: Safely return to running, sports, or high-level activities

🔹 What happens:

• Transition back to field, court, or gym-based movements

• Resume sport-specific training with reduced injury risk

• Monitor loading, symmetry, and movement quality

🔹 What we do in therapy:

• High-speed agility, sprint, and change-of-direction work

• Jump testing and performance metrics (e.g., force plate testing)

• Custom reconditioning plans for sport or work

✅ Milestones to reach before full clearance:

• 90%+ strength symmetry (measured with force plate and dynamometer testing)

• No pain during running or jumping

• Confidence and full range of motion in injured limb

• Successful completion of sport-specific or job-specific testing

Don’t Skip Rehab—Get the Help You Deserve

✔️ Full recovery from Achilles surgery takes 6–9 months
✔️ Without proper rehab, strength loss and tendon lengthening can hold you back
✔️ Early, guided therapy = better long-term outcomes

At Pain & Performance Coach, we work with patients across Hillsboro, Beaverton, Aloha, and Portland. You’ll receive expert care, modern techniques like BFRT and force testing, and a step-by-step plan to get you moving again.