Assuming a strong repair,my protocol is as follows: 2 weeks non-weight bearing, 2 weeks partial weight bearing, 2 weeks full weight bearing. Pt is paced in a splint at surgery, and changed to a CAM walker at first post op visit. Equinus position is not used unless necessary. Pt can remove the CAM boot for bathing and sleep after 2 weeks. Pt is instructed in Active range of motion exercises for weeks 2-6. Formal PT is started at week 6.
I can understand that the healing of tissue also depends on the strength of the repair, the amount of tendon lost to injury and degeneration.
At this moment, we are two on this site, we both had complete Achilles tendon rupture, just one day apart. We both had late surgery (5 days after the accident).
I think we can talk about different doctrine around the world here;
- 3 weeks after surgery, the repair is strong, start with physiotherapy and in two steps foot from equines position to normal position
- 3 weeks after surgery, the repair is strong, foot in two steps from equines position to normal position and physiotherapy after next 3 weeks
Anyway, my thought (but I am not a doctor) is that start with physiotherapy 6 weeks after surgery is late.
Best regards,
Jani