Achilles Reconstruction

Achilles Reconstruction Information Sheet

What is Achilles Reconstruction?

  • The surgery involves one long incision over the site of the Achilles tendon.
  • As the gap is too big for a direct repair, the gap will be closed by stretching the tendon and/or using a synthetic tendon and a tendon transfer from the big toe to improve blood supply.
  • The wound is then closed, and a boot with 3-4 wedges is placed
A person 's feet are standing on a purple yoga mat.

The Hospital Stay

  • You wake up with bulky bandages and a post op boot with 3-4 wedges.
  • You will be given blood-thinning medication to prevent clots, antibiotics to help prevent infection and vitamin C for wound healing.
  • You will be able to touch your foot to the ground only.
  • Buying a second-hand knee scooter pre-operatively (you can search online) and practising at home before surgery can be helpful; please bring it to the hospital with you. It is easier to use a knee scooter than crutches.


‍When You Go Home

  • You will need medications for pain relief; regular paracetamol (2 tablets four times a day) is recommended, as well as strong painkillers, especially at night before bed. These can have side effects of drowsiness, nausea and constipation, and other tablets to help with these side effects may be required.
  • You will need antibiotics, blood thinners and vitamin C.
  • You will need a shower chair and bags to keep the boot dry.
  • You will need to attend your post op appointment in 2-3 weeks, where the wounds will be checked.
  • After this, you will be able to shower with a shower chair as long as your foot is pointing to the ground.

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Achilles Reconstruction Rehabilitation

All patients are different. These timelines are only guides; some patients may progress faster or slower than others. The rehab may also be slower if both feet have surgery simultaneously.


0 - 2 Weeks

  • You will be in a boot with 3 wedges or a backslab to keep the foot pointed down for 2-3 weeks.
  • You will only be allowed to touch your foot to the ground for balance.
  • You will need to bag the leg for showers.
  • Elevate your foot for most of day.
  • Pain relief: Please take regular paracetamol with meals and before bed; you may need stronger painkillers as well, especially before bed.
  • Please take antibiotics, blood thinners and vitamin C as prescribed.


2 - 6 Weeks

  • Post op appointment for a wound review
  • You can take the boot off for showers to sit on a shower chair and keep the foot pointed down
  • Start partial weightbearing in boot with wedges at 3 weeks; 20% of body weight
  • This can increase to 100% of body weight at 6 weeks
  • Active range of motion can be performed with the foot pointing down


6-9 Weeks

  • At 6 weeks, remove one wedge
  • At 7 weeks, remove one wedge
  • At 8 weeks, removal one wedge
  • Continue 100% weightbearing in the boot
  • Exercise hip and knee with the boot on
  • Range of motion to neutral and isometric calf strengthening


10-12 Weeks

  • Wean out of the boot at 10 weeks into sneakers
  • Always wear shoes, even inside
  • Increasing rehabilitation for range of motion past neutral and concentric strengthening


3-6 Months

  • Avoid lunges/squats or any painful exercises
  • Double heel raises as tolerated
  • Balance and proprioception with wobble board
  • Standing work is tolerated


6-12 Months

  • When the leg feels back to normal and the same as the other leg, you can start sport-specific training and heavy labour work.


When can I return to work/school?

  • Seated work 4-6 weeks
  • Prolonged standing 4-6 months
  • Heavy labour work 9-12 months


When can I return to sport?

  • Start sport-specific training at 6-12 months
  • Return to sport when leg is the same as the other side (6-12 months)

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When can I drive?

  • Left foot: 6 weeks (if driving an automatic car)
  • Right foot: 10-12 weeks without the boot

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Achilles Reconstruction Risks

While the procedure is generally safe, potential risks include:

  • Anaesthetic problems
  • Wound/scar problems
  • Nerve/tendon/vessel injury
  • Blood clots
  • Infection
  • Stiffness
  • Re-rupture
  • Ongoing pain/swelling
  • Chronic Regional Pain Syndrome (CRPS)
  • Further surgery


Contact Us

If you have any questions or problems, please contact