The BEST Way To Get The Most Out Of Your Achilles Recovery

Achilles Tendon Rupture Deficits

As you've probably realized by now, rupturing your achilles sucks.

The recovery process truly is a marathon and will test you in every way immaginable, both physically and mentally. Add in the fact that deficiencies in calf muscle performance remain seven years later, and well, it starts to sound real bleak.

But here's what I tell all my patients. The human body is incredibly adaptable. Despite the long lasting deficits, patient-reported outcome scores (e.g., ATRS) are often high, suggesting patients adjust to their limitations.

Still, we would be foolish to avoid the facts. Data shows how crucial physical therapy truly is and neglecting appropriate strengthening can have persistent effects. The first year following your injury can set the foundation for the rest of your rehabilitation.

Here are some of the best advice from a physical therapist who ruptured his own achilless on how to get the jump start we all need.

Breaking Down Achilles Rupture Tips: What Really Helps?

When the Achilles tendon is injured, the natural instinct is to rest completely and avoid any movement. While rest is important, too much of it can lead to atrophy and muscle weakness.

The key is balance.

Early controlled movement and targeted exercises can promote blood flow and encourage the tendon to heal properly.

Here are six essential tips to keep in mind:

Motion is lotion

Moving your ankle within a pain-free range helps prevent stiffness. Exercises like writing the ABC's with your foot or simply trying to do some ankle pumps go a long way. Stay within your comfort zone and if you feel too much 'stretch' or apprehension, then ease off.

Incorporate strengthening exercises gradually

Begin with isometric exercises (muscle contractions without movement) incrementally. Then progress to longer durations, a wider range, and increase the resistance. You can start these exercises just two weeks after your injury. It doesn't take much effort at all to 'activate' the achilles/calf complex and stimulate tissue remodelilng.

Use compression and elevation to manage swelling

This manages inflammation and speeds up healing. Swelling is a normal part of your body's response to acute trauma; you shouldn't completely avoid it. Simple OTC compressions options from your local pharmacy should suffice. Again, be smart here.

Wear supportive footwear

Wear shoes with a medium to high heel drop (6mm-9mm) when first transitioning out of the walking boot. Higher drops decrease the stress placed on the Achilles.

Load early and often

This is a tough one for patients to accept. I can't emphasize enough the importance of putting weight on your foot (with precautions, of course) more often than you think. Early loading improves the tendon's healing capacity, can prevent re-ruptures, and reduce muscle atrophy.

Listen to your body

Pain is a signal, but not all discomfort means harm. Learn to differentiate between helpful soreness and harmful pain.

These tips are not just theory. They come from years of clinical experience, research, and unfortunately, first hand experience. Following them can make a significant difference in how quickly and fully you recover.

Prioritize Early Loading and Controlled Mobilization for Achilles Recovery

How long will this take?

One of the most common questions is: When will I be able to walk again?

The answer varies from person to person. Some younger, more active, and athletic individuals might have an easier time reaching full weight bearing than others. Not to mention, other psychosocial factors (family support, fear of movement, pain) can also influence how quickly you return to walking normally.

My biggest advice is to encourage early weight bearing, early and often. I'm not suggesting you go from 0-100 real quick, far from it. However, I strongly recommend you be proactive and mindful in progressing the amount of weight you place on your affected leg each week. Use your crutches to find the sweet spot, so to speak, and trust that the walking boot is doing its job.

After surgery, the timeline usually looks like this:

1. First 2 weeks: The foot is immobilized in a cast or boot, and weight-bearing is typically not allowed.

2. Weeks 2 to 6: Gradual introduction of partial weight-bearing with crutches or a walking boot.

3. Weeks 6-8: Transition to full weight-bearing as tolerated, often with physical therapy guidance.

4. After 8 weeks: More active rehabilitation, including strengthening, balance exercises, graded exposure to activity.

   
   

In some cases, walking with a normal gait might take a few months. So remember, patience, patience, patience.

If you want to explore detailed, personalized guidance, my achilles recovery protocol has helped many patients get back to who they were.

Nutrition and Lifestyle

Healing isn’t just about what you do with your ankle. Your body needs the right fuel and environment to repair tissues efficiently. Here are some nutritional and lifestyle tips that can support your Achilles recovery:

• Eat a balanced diet rich in protein: Protein provides the building blocks for tissue repair.

• Include anti-inflammatory foods: Such as berries, leafy greens, and omega-3 fatty acids.

• Avoid NSAIDS: Consistent NSAID use after rupture may be linked to poorer functional recovery, and their impact on tendon healing remains uncertain.

• Stay hydrated: Water is essential for cellular function and healing.

• Avoid smoking and excessive alcohol: Both can impair blood flow and delay recovery.

• Get enough sleep: Rest is when your body does most of its healing work.

  
  

Small changes in your daily habits can have a big impact on your recovery timeline.

Staying Motivated and Managing Anxiety During Recovery

One of the most underrated aspects is how mentally draining this injury can be. I found myself becoming irritable, angry. and frustrated by the simplest tasks. Seriously, you realize how you take even walking to the kitchen to pour yourself a glass of water for granted.

Surround yourself with a positive support system, hobbies, or projects that can help keep you occupied. I used the time to pick up my viola again, puzzles were fun. Oh, and plenty of Assassin's Creed. I was so thankful that I had a close group of friends in Alaska that helped me with groceries, meal prepping, some mild house chores, etc. My mom even flew over from the east coast and having her for a couple months when I could barely walk made all the difference.

Also, I find that the Reddit Achilles thread is a great source of information, personal experiences, and advice. It's a great community that constantly lifts each other up.

It may sound cliché, but try your best to maintain a positive mindset. Take it one day at a time and celebrate all the small victories. No one is denying the fact that this injury is brutal. Nothing can prepare you for that moment.

However, it WILL pass. In the meantime, try to keep the following in mind:

• Set realistic, short-term goals: Celebrate small victories like increased range of motion or walking a few steps without pain.

• Keep a recovery journal: Writing out your feelings can help you vent and provide a fresh perspective.

• Stay connected with your support network: Friends, family, or support groups can offer encouragement.

• Practice mindfulness or relaxation techniques: These can reduce stress and improve your overall well-being.

• Focus on what you can control: Like following your rehab plan and maintaining a healthy lifestyle.

  
  

Taking Charge of Your Achilles Recovery Journey

Achilles recovery is not just about healing a tendon; it’s about reclaiming your independence and confidence. Some days will feel more challenging than others, but I promise you that there's light at the end of the tunnel. From my experience and talking with many patients, the first eight weeks are the hardest. Once you get out of that dreaded walking boot, it feels like the ankle cuffs are coming off and each milestone from there will come quicker and quicker.

If you want to learn more or get personalized support, check my achilles recovery page on how to get started.

Your journey might be tough, but with the right strategies, it’s absolutely possible to come back stronger and more resilient than before. Keep moving forward - one step at a time.

Resources:

Brorsson, A., Silbernagel, K., Olsson, N., & Helander, K. (2018). Calf Muscle Performance Deficits Remain 7 Years After an Achilles Tendon Rupture. The American Journal of Sports Medicine, 46, 470 - 477. https://doi.org/10.1177/0363546517737055.

Franco, V., Grotts, J., Lin, J., Fong, M., & Vasquez, M. (2019). Non-Steroidal Anti-Inflammatory Drug Use and Recovery after Achilles Tendon Rupture. Muscle Ligaments and Tendons Journal. https://doi.org/10.32098/mltj.03.2019.02.