Achilles Repair

‍THE SURGERY

• The surgery involves one long incision over the site of the achilles tendon.
• The achilles tendon ends are identified and sutured together.
• The tube of soft tissue surrounding the repair (paratenon) is closed over the repair.
• The wound is then closed and a boot with 3-4 wedges is placed.

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THE HOSPITAL STAY

• You wake up with bulky bandages and a post op boot with 3-4 wedges.
• Your foot will be elevated overnight and you have antibiotics through a drip.
• Depending on your medical conditions you will either need aspirin or clexane injections to thin your blood for 6 weeks.
• You will be able to touch your foot to the ground only.

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WHEN YOU GO HOME

• You will need medications for pain relief.
• You will need either aspirin or clexane for 6 weeks to prevent blood clots.
• Please leave all dressings intact until your appointment with Dr Graff.
• You will get an appointment for your post op appointment in 2-3 weeks where the dressings will be taken down.
• After this you will be able to shower normally on a shower chair and pat the dressings dry only if you keep your foot pointed down. You will still need the boot for sleeping.

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REHABILITATION

All patients are different. These timelines are only a guide and some patients may progress faster or slower than others.

• You will need a boot with 3-4 wedges for 4 weeks.
• You will have appointments with Dr Graff at 2 weeks and 6 weeks.

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0-2 weeks

• You will be in a boot with 3-4 wedges.
• You will only be allowed to touch your foot to the ground for balance.
• You will need to bag the leg for showers.
• Pain relief: Please take regular Panadol with meals and before bed.
• Please take aspirin 150mg daily or clexane for 6 weeks.

2-4 weeks

• Post op appointment with Dr Graff.
• You will then go back into the boot with 3 wedges another 1-2 weeks.
• You can start weightbearing in the boot.
• You can take the boot off for showers to sit on a shower chair and keep the foot pointed down.
• You can start isometric calf strengthening.
• You can start hip and knee ROM strengthening and lifts with the boot on.

4-6 weeks

• You can remove 1 wedge per week of the boot.
• You can increase to active dorsiflexion to neutral with physiotherapy.
• You can start active theraband inversion and eversion exercises below neutral with physio.
• Continue hip and knee exercises with the boot on will have an appointment with Dr Graff and an xray.

6-8 weeks

• Post op appointment with Dr Graff.
• You can weightbear as tolerated in the boot without wedges.
• Active plantarflexion and dorsiflexion to neutral (pain free) and continue resisted inversion/eversion with foot in neutral.
• Commence proprioception training.

9-12 weeks

• You can wear normal shoes if you are able to fit into them (may still have swelling).
• You can range the ankle past neutral with physio.
• You can start cycling/swimming.

3-6 months

• Post op appointment with Dr Graff.
• You can progress strengthening and range of motion with pain free double leg heel raises and single leg balance with physio.
• From 4 months light jogging can commence if there is no pain.

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.

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WHEN CAN I RETURN TO WORK/SCHOOL?

• Seated work 4-6 weeks.
• Prolonged standing 10-12 weeks.
• Heavy labour work 9-12 months.

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WHEN CAN I RETURN TO SPORT?

• Start sport specific training at 6-8 months.
• Return to sport when leg same as the other side (9-12 months).

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WHEN CAN I DRIVE?

• Left foot 6-8 weeks.
• Right foot 10-12 weeks.

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WHAT CAN GO WRONG?

• Anaesthetic problems.
• Nerve injury.
• Blood clots.
• Infection.
• Stiffness.
• Re-rupture.
• Ongoing pain.
• Further surgery.

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CONTACT

If you want more information, or have any questions or problems, please contact Dr Graff on admin@christygraff.com or please call the rooms on 0493 461 133.