Achilles tendon conservative management non-weightbearing

This information will guide you through the next 10 weeks of your rehabilitation. Use the information below to gain a better understanding of your injury and what can be done to maximise your recovery.

 

Healing:

 If confirmed this normally takes approximately 9-10 weeks to heal.
   
Pain and Swelling:

Swelling is often worse at the end of the day. Elevating your ankle will help. Take pain killers as prescribed. Pain and swelling can be on-going for 3-6 months.
                                              

Using your ankle:

 

You must use the boot and wedges and follow the programme below.

Keep the boot on at night and during the day.

You must not put weight through your foot.
   

Personal Hygiene:

 

 

 

 

 

 

You may remove the boot carefully for washing and changing your sock once a day.

Whilst doing this you must, at all costs, keep the toes pointed down, as demonstrated in the picture. 

Avoid any temptation to stretch the calf as this could mean the tendon heals in an elongated position which will affect your overall rehabilitation.
   

Follow up:

 

 

You will see a Foot and Ankle Specialist about 4 weeks after your injury. They will give instruction on the removal of the wedges and check your progress.

If you have not received this appointment within one week please contact your hospital appointment line.

You have also been referred to your local physiotherapy service. They will contact you to make an initial appointment for 9-10 weeks post injury.

This is when your rehabilitation can start. If you do not hear anything within this timeframe, please contact your local department directly.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Area of your injury

If you are worried that you are unable to follow this plan, or have any questions, then please phone the Fracture Care Team for advice.

 

If you are experiencing pain or symptoms, other than at the site of the original injury or surrounding area, please get in touch using the telephone or e-mail details at the top of this letter.

 

 

 

What to expect

  Weeks

  since injury

  Rehabilitation plan

  0-4

 Wear the boot with 5 wedges all the time, including at night.

   X   You should not put weight through your leg when you walk

 Remove the boot once a day to wash your foot and change your sock

   X   Don't stretch your calf muscle.

 You will see a Foot and Ankle consultant 4 weeks after your injury.

  4-8

Remove one wedge from the bottom of the stack each week and replace the top of the stack into the boot

  You can start to weight bear on your leg, as pain allows, and as directed in your consultation.

   X   Don’t stretch your calf muscle

  8 -10

 Remove the last wedge from the boot at week 8.

 Wear the boot alone for a further 2 weeks.

You will have your first physiotherapy session 9-10 weeks after your injury.

 

Information on Deep Vein Thrombosis (DVT) risk and Tinzaparin injections

Due to the nature of this injury, and its rehabilitation, it is required to immobilise the foot in a boot without weight bearing. This places you in a higher risk group for developing a DVT (blood clot) which could potentially have very serious effects.

To reduce this risk of these we have prescribed a course of Tinzaparin (a type of heparin), which is blood thinner. It should be used for the four weeks that you are not allowed to put any weight through your foot. One of the nurses in clinic will have shown you the injection technique and you should try to keep these injections to a regular time of day. If you have any further questions with regards to this, or have a reaction to the medication, please direct this to your GP or district nurse.

The used injections MUST be disposed of safely in the yellow ‘Sharps Bin’ provided. Once full, sharps bins, can be collected from your home and new ones delivered by a specialist service. If you are a resident of Brighton and Hove please Telephone 01273 242077 to arrange collection. If you live outside Brighton please contact your local council’s clinical waste disposal service.

 

Boot advice

Diabetic patients: If you are diabetic please contact us to discuss your boot. This is particularly important if you have problems with your skin. We can provide you with a specialist diabetic boot if required.

Footwear for your uninjured foot: We would recommend choosing a supportive shoe or trainer with a firm sole for your uninjured foot. At the moment you are not allowed to put weight through your injured foot. When you are allowed to put weight through your foot you will notice that the boot you have been given has a thicker sole, by matching this height on the uninjured side you will reduce any stress on your other joints.