Rehabilitation and Return to Sports after Achilles Tendon Repair.
William Marrone, Robert Andrews, Aaron Reynolds and 3 others
PMID 39246413WHAT IT FOUND
This commentary outlines a phased, criterion-based rehabilitation protocol for athletes after Achilles tendon repair.
It recommends early weight-bearing and mobilization, using blood flow restriction to maintain strength, and strict monitoring of tendon elongation to guide safe return to sport.
Key findings
01The authors recommend a criterion-based progression that considers individual factors and healing biology, rather than fixed timelines.
02Early functional rehabilitation including weight-bearing and mobilization is recommended regardless of whether the treatment was surgical or non-operative.
03Blood flow restriction training is suggested to help reduce atrophy and preserve lower extremity strength after surgery.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
This is a commentary and narrative review, so it does not present new data or prove that these specific protocols lead to better outcomes than other approaches. Many of the recommendations, particularly regarding blood flow restriction and specific strength benchmarks for return to sport, are based on the authors' clinical experience or extrapolated from other injuries like ACL reconstruction. The paper acknowledges that there is poor understanding of the ideal battery of return-to-sport testing after Achilles tendon repair, meaning the suggested tests are not validated specifically for this population. Timelines for progression are highly variable and depend heavily on individual patient factors and surgeon preference, so the specific week ranges provided should not be treated as rigid rules.
Declared interests
The authors mention the SpeedBridge technique by Arthrex but do not declare any specific financial conflicts of interest or funding sources in the provided text.
The easy way to misread this
Do not treat the specific timelines and strength benchmarks in this commentary as evidence-based standards of care. The authors state that return-to-sport testing protocols are poorly understood and that many recommendations are based on clinical expertise and extrapolation from other injuries, rather than direct evidence from Achilles tendon repair studies.