📆 Post-Op Protocol – Week by Week Back to Life

❓ Simple Definitions

Dorsiflexion: Movement of the foot upward (toward the shin). This movement must be avoided initially to protect the repair.
Plantarflexion: Movement of the foot downward (as when standing on tiptoes).
Gastrocnemius / Soleus: Calf muscles that feed into the Achilles tendon – important for strength & stability.
Compex: Electrical muscle stimulation for targeted activation.
AchilloTrain: A specialized brace to stabilize and offload the Achilles tendon.
Stabilometry / Cybex: Testing methods to assess muscle strength, balance, and motor control.
Hypertrophy training: Muscle building through targeted strength exercises (e.g., machines or barbell).
VACOped / Ortho shoe: Specialty shoe to fix the foot angle and protect the repair.

No dorsiflexion (bending the foot upward is forbidden)
Special shoe (Künzli Ortho) with 4 cm wedges: plantarflexion/dorsiflexion set to 30°/30°/0° for 3 weeks, then 30°/20°/0°
Support brace and ventral equinus splint at night
15 kg partial weight-bearing for 2 weeks, then gradual increase
Foam roller or AchilloTrain brace to support wound healing
Compression stocking (possibly only on the left leg)
Manual therapies: elevation, lymphatic drainage, compression, possibly Bemer mat
Isolated activation of gastrocnemius & soleus (e.g., with Compex)
Gait training using underarm supports, coordination exercises (no dorsiflexion!)
Begin basic endurance: bike ergometer (pedal midfoot), venous return training

No forced dorsiflexion
No jogging
Gait analysis after week 12
Transition from special shoe to regular sports shoe (with inserts/wedge if needed)
Continue wearing AchilloTrain
Begin hypertrophy training as next step

No contact sports or activities involving rotation
Biomechanical tests: gait analysis, pressure measurement, stabilometry, Cybex (after weeks 24 & 52)
Reactive strength training, plyometrics, sport-specific drills