Achilles Tendon Repair Protocol: The Recovery Timeline, Week by Week
Dr. Rob Letizia PT, DPTShare
Medically reviewed by Dr. Rob Letizia, PT, DPT · Doctor of Physical Therapy, 25+ years treating spine & orthopedic conditions · Last reviewed 2026-10-26
You have had your Achilles tendon repaired. You are in a splint or a boot with wedges stacked under your heel, and the questions start: when can I put weight on it, when do the wedges come out, when can I walk in a shoe, and when can I run again? The honest answer is that running usually comes back at around six months, and full sport later. The order matters more than the speed: protect the repair, load it gradually in the boot, walk normally, and only then build the calf for running.
This guide lays out the week-by-week path from two published surgical protocols, shows where they disagree, and names the rule we use before anyone runs. Your surgeon's protocol always comes first. This is the map that helps you read it.
What is the Achilles tendon repair protocol?
Four stages: protect, load in the boot, walk out of the boot, then build and return. In the University of Kansas Health System Achilles repair protocol, the leg is non-weight-bearing in a splint for two weeks, then goes into a walking boot with a 5-cm heel lift; the wedges come out in steps between weeks 4 and 12, running starts at 6–9 months, and return-to-sport testing begins at 9 months. The Inland Orthopaedic Achilles repair protocol follows the same order on a slower early schedule: no weight on the foot until week 5, and no running or pivoting until 6 months.
Progress through each stage is set by your surgeon's boot, wedge, weight-bearing and motion instructions, not by the calendar alone. The dates below are typical ranges, not promises.
Achilles Tendon Repair Recovery Timeline: Week by Week
| Weeks after surgery | Boot and weight-bearing | What you are doing | Still off-limits |
|---|---|---|---|
| Weeks 0–2 | Splint, no weight on the leg, crutches | Controlling swelling, moving the hip and knee, getting around safely | Any weight through the foot; stretching the calf |
| Weeks 2–6 | Walking boot with heel wedges. Weight is added in steps: from week 2 in a faster protocol, from week 5 in a conservative one | Gentle ankle motion inside your surgeon's limits; hip, knee and core strength; bike or upper-body cardio | Pushing the ankle up past the limit your surgeon set; walking without the boot |
| Weeks 6–12 | Wedges come out one at a time; full weight in the boot, then weaning out of it into a shoe with a small heel lift | Normal walking again, resistance-band ankle work, double-leg heel raises once fully weight-bearing | Barefoot walking; weight-bearing calf stretches; running |
| Weeks 12–24 | Shoes, then no heel lift | Single-leg heel raises, balance, step and slant-board work; low-impact cardio | Running, jumping and pivoting |
| Month 6 onward | None | Return to running once you pass the criteria, then plyometrics and sport-specific work | Full sport before your return-to-sport testing and your surgeon's clearance |
Sources: University of Kansas Health System Achilles repair protocol; Inland Orthopaedic Achilles repair protocol. These are typical milestones from published protocols, not a prescription. Your surgeon's settings and dates come first.
Weeks 0–2: what happens right after Achilles surgery?
The repair is protected in a splint with no weight through the leg, on crutches (University of Kansas Health System Achilles repair protocol; Inland Orthopaedic Achilles repair protocol). The goals are to control swelling, get around safely, including on stairs, and keep the hip and knee working. Some surgeons do not start formal physical therapy until later: the Inland protocol does not begin PT until at least week 5 (Inland Orthopaedic Achilles repair protocol).
Weeks 2–6: when can I put weight on my foot after Achilles repair?
This is where protocols differ most. In the University of Kansas protocol you move into a walking boot with a 5-cm heel lift at week 2 and start partial weight-bearing on crutches, adding about a quarter of your body weight each week; by weeks 4–6 one wedge level comes out and you advance to full weight in the boot and off the crutches (University of Kansas Health System Achilles repair protocol). In the Inland protocol you stay non-weight-bearing in a boot with three 1-inch heel wedges through week 4, then start partial weight-bearing at week 5, adding 25–50 lb a week (Inland Orthopaedic Achilles repair protocol).
Ankle motion is limited in this window. The Kansas protocol allows active motion up to a neutral ankle (University of Kansas Health System Achilles repair protocol); the Inland protocol allows no upward bend past 5 degrees below neutral at weeks 2–4 and not past neutral until week 6 (Inland Orthopaedic Achilles repair protocol). The tendon is still healing, so this is not the time to stretch the calf.
Weeks 6–12: when do the heel wedges and the boot come off?
The wedges come out one at a time, and the boot follows. In the Kansas protocol, the second wedge level comes out at weeks 6–8 with weight-bearing as tolerated in the boot; at weeks 8–12 the boot comes off for sleeping, the last wedge comes out, and you wean out of the boot into a sneaker with a 1-cm silicone heel cup, worn for six weeks, with no barefoot walking or sandals (University of Kansas Health System Achilles repair protocol). In the Inland protocol you are fully weight-bearing in the boot with two wedges by week 8, one wedge comes out at weeks 8–10 and the last at weeks 10–12, and the boot stays on for walking in the community until week 12 (Inland Orthopaedic Achilles repair protocol).
The work in this phase is walking normally again, resistance-band ankle exercises, and double-leg heel raises once you are fully weight-bearing (University of Kansas Health System Achilles repair protocol). Weight-bearing calf stretches stay off the list, to avoid overlengthening the tendon (Inland Orthopaedic Achilles repair protocol).
Week 12 onward: when can I do single-leg heel raises?
Between weeks 12 and 24, double-leg heel raises progress to a step or slant board, then to single-leg calf raises, with balance work on less stable surfaces (University of Kansas Health System Achilles repair protocol). Low-impact cardio such as cycling, rowing, swimming, the elliptical and the stair machine comes back around weeks 12–14 in the Inland protocol, with no running or high-impact work yet (Inland Orthopaedic Achilles repair protocol). The single-leg heel raise is the honest measure of where your calf is, and it is usually further behind than people expect.
When can I run after Achilles tendon repair?
Not before about six months in both protocols, and only when you meet the criteria. The Kansas protocol starts running at 6–9 months, after a functional test above 90% on every test, equal ankle motion and 25 single-leg heel raises (University of Kansas Health System Achilles repair protocol). The Inland protocol allows no running or pivoting until six months, with return-to-sport testing of at least 90% of the uninvolved limb (Inland Orthopaedic Achilles repair protocol).
An international panel of 35 Achilles experts agreed on seven criteria before running after surgical repair (Gaspar et al., Sports Medicine 2026):
- no pain in daily life;
- no pain during or after rehab sessions;
- walking without a limp;
- able to walk on tiptoes;
- able to do ten single-leg heel rises;
- good single-leg balance;
- feeling psychologically ready to run.
The panel itself says these need prospective validation before they can be used as decision rules (Gaspar et al., Sports Medicine 2026). A 2026 review of 34 studies on athletes after Achilles repair found that none defined a measured criterion for returning to sport (Busà et al., Sports Health 2026). That is the case for judging readiness on what the calf can do, and confirming the timing with your surgeon.
The 10-Heel-Rise Running Rule
No running until you pass all seven consensus criteria, including ten single-leg heel rises on the repaired side, and your surgeon has cleared you. Ten is the floor, not the finish line: your surgeon's protocol may ask for more, like the 25 in the Kansas protocol, and that higher number is the one you work to. A calf that cannot lift you ten times on one leg is not ready to absorb running, whatever month it is.
The 6-Month Achilles Repair Return Protocol
- Protect (weeks 0–2): splint, no weight on the leg; swelling control, hip and knee work.
- Load in the boot (weeks 2–6): walking boot with heel wedges; weight added in steps; ankle motion inside your surgeon's limits.
- Walk out of the boot (weeks 6–12): wedges out one at a time, then a shoe with a heel lift; normal walking; double-leg heel raises.
- Build the calf (weeks 12–24): single-leg heel raises, balance, low-impact cardio.
- Run and return (month 6 onward): running once you pass the 10-Heel-Rise Running Rule and your surgeon's test, then plyometrics and sport-specific work.
Milestones from the University of Kansas Health System Achilles repair protocol and the Inland Orthopaedic Achilles repair protocol; running criteria from Gaspar et al., Sports Medicine 2026.
Printable version: Download The 6-Month Achilles Repair Return Protocol (PDF), a two-page handout with the phases, the check-in points and the red flags to bring to your surgeon or therapist.
Red flags after Achilles tendon repair
- A new pop with a sudden loss of push-off: contact your surgeon promptly.
- A wound that opens or drains, or increasing redness, warmth or pain at the incision: contact your surgeon promptly.
- A marked, unexpected worsening in pain or function: contact your surgeon.
- Calf swelling, warmth or tenderness: get a prompt medical assessment, as it can be a blood clot.
- Chest pain or shortness of breath: this is an emergency. Call 911.
Started with an AI assistant? Bring the plan in.
ChatGPT, Gemini and Claude will usually give you a sensible phased outline and tell you to follow your surgeon's protocol, and that is right. What none of them can do is count your single-leg heel raises, watch you walk out of the boot, or tell you whether you are ready for the next wedge to come out. If an assistant has given you a plan, bring it in with your surgeon's protocol, and we will match the two week by week.
Frequently asked questions: Achilles tendon repair recovery
What is the physical therapy protocol after Achilles tendon repair?
Most protocols run in four stages: protect the repair in a splint (weeks 0-2), load it gradually in a walking boot with heel wedges (weeks 2-6), wean out of the boot and normalize walking (weeks 6-12), then build calf strength and prepare to run (week 12 onward). The details, such as when weight-bearing starts and when each wedge comes out, differ between surgeons, so the protocol your surgeon gives you overrides any general timeline.
How long is recovery after Achilles tendon repair?
Plan on about six months before running and longer for full sport. The University of Kansas Health System protocol starts running at 6-9 months and return-to-sport testing from 9 months; the Inland Orthopaedic protocol allows no running or pivoting until 6 months after the injury. Walking normally in a shoe usually comes back around weeks 8-12.
When can I walk without the boot after Achilles surgery?
Usually between weeks 8 and 12. In the University of Kansas Health System protocol the boot comes off for sleeping at weeks 8-12 and you wean out of it as tolerated, into a sneaker with a 1-cm heel cup for six weeks. The Inland Orthopaedic protocol keeps the boot for walking in the community until 12 weeks. No barefoot walking or sandals while you are still using the heel cup.
When can I run after Achilles tendon repair?
Not before about six months in the two protocols reviewed here, and only once you meet the criteria. An international expert panel agreed on seven criteria before running, including no pain in daily life or during rehab, walking without a limp, walking on tiptoes, ten single-leg heel rises, good single-leg balance and feeling psychologically ready (Gaspar et al., Sports Medicine 2026). The panel notes these still need validation, and many surgeons set a higher bar.
How many single-leg heel raises should I do before running after Achilles repair?
At least ten, by expert consensus (Gaspar et al., Sports Medicine 2026). Some surgical protocols ask for more: the University of Kansas Health System protocol asks for 25 single-leg heel raises, equal motion and a functional test above 90% before running. Your surgeon's test is the one that counts.
Why do Achilles repair protocols disagree?
Because the safe pace depends on the repair: the surgical technique, the tissue and the surgeon's preference. One protocol may start partial weight-bearing at week 2 while another keeps you off the foot until week 5. A 2026 review of 34 studies found that none defined a measured criterion for returning to sport (Busà et al., Sports Health 2026), which is why progress should be judged on what the calf can do, not on the date alone.
When should I call my surgeon after Achilles repair?
Call promptly for a new pop with a sudden loss of push-off, a wound that opens or drains, or a marked unexpected worsening. Calf swelling, warmth or tenderness needs prompt medical assessment because it can be a blood clot. Chest pain or shortness of breath is an emergency: call 911.
Physical therapy after Achilles repair in Wayne and Northern New Jersey
Spectrum Therapeutics of NJ is a one-on-one physical therapy clinic in Wayne, serving Passaic County and Northern New Jersey, led by Dr. Rob Letizia, PT, DPT. After an Achilles repair we work from your surgeon's protocol, progress each stage on what your calf can actually do, and keep in touch with your surgeon at each phase change. See our foot and ankle rehabilitation page and our post-surgical rehabilitation page. If you have any Medicare plan, including Medicare Advantage and Medigap, a doctor's prescription is required.
