Achilles Tendon Repair Aftercare Instructions
A day-by-day recovery guide for achilles tendon repair: what to expect, how to care for yourself, and when to call. Free to read and print.
What to expect
Footwear Guidelines
- •Wear the surgical boot/shoe as directed until cleared
- •Transition to stiff, supportive shoes with a wide toe box
- •Supportive athletic shoes are ideal during recovery
- •Custom orthotics may help prevent recurrence
Achilles Tendon Repair recovery, day by day
Immediate Aftercare
- ELEVATE your foot above heart level as much as possible (aim for 90% of the time)
- Keep the surgical boot/cast/splint on at all times
- Ice behind the knee or around (not directly on) the surgical site: 20 min on, 20 min off
- Non-weight-bearing: use crutches, knee scooter, or wheelchair. Do NOT put weight on the surgical foot.
Pain Management
- Take pain medication on schedule for the first 48-72 hours. Do not wait for pain to get bad.
- Swelling is the #1 cause of pain. Elevation is your best treatment.
- Keep the ankle in the position set by your surgeon. Do NOT flex the foot.
Wound Care & Mobility
- First post-op visit for bandage change and wound check
- Continue non-weight-bearing or limited weight-bearing as directed
- Keep the foot dry. Cover with a plastic bag for showering.
- Swelling will peak around day 3-5. This is normal. Keep elevating.
Transition
- May transition from cast to walking boot with heel wedges.
- Begin gentle range-of-motion exercises as directed
- Physical therapy starts (gentle stretching, no push-off yet)
- Follow up for X-rays to confirm healing
Return to Activity
- Gradual return to running/sport. Typically 4-6 months post-surgery.
- Some swelling at end of day can persist for 6-12 months. This is normal.
- Custom orthotics may be recommended for long-term support
- Full healing of bone takes 6-12 months even after return to activity
When to call your provider or 911
- •Toes turn blue, white, or are numb for more than a few hours
- •Severe pain not controlled by medication
- •Calf pain, swelling, or warmth (sign of blood clot)
- •Fever above 101°F
- •Wound has foul smell, pus, or increasing redness
- •Cast or boot feels too tight or causes skin breakdown
When in doubt, call your clinic. For a medical emergency, call 911.
Recovery milestones
- Day 7
Post-op visit
Wound check, bandage change, X-ray
- Day 14
Suture removal
Sutures/staples removed
- Day 42
Weight-bearing begins
Cleared to bear weight in surgical boot
- Day 84
Return to regular shoes
Transition to supportive footwear
- Day 120
Expected recovery
Resume normal activities
For clinics
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