0-2 weeks
NWB in splint
2-6 weeks
Walkabout boot gradually decreasing plantarflexion 10 degrees per week such that neutral is accomplished by 6 weeks.
Exercise 4-5 times per day:
Active plantarflexion out of boot 30 repetitions as outlined below:
- Week 2 - no resistance
- Week 3 - Yellow theraband
- Week 4 - Red theraband
- Week 5 - Red theraband
- Week 6 - Blue theraband
- Week 7 - Black theraband
2-4 weeks:
Partial weight bearing starting at 10%, increasing 5% per week, up to 20% as tolerated. Begin open chain hip strengthening.
4-8 weeks:
Progress weight bearing 20% per week (as tolerated), to full weight bearing at 8 weeks post op. Continued use of walkabout boot.
8 weeks:
Begin gentle flexibility into dorsiflexion, inversion, eversion and plantarflexion. Begin seated heel lifts, progressing to WB performance in standing. Begin light double leg closed chain strengthening (i.e. wall squats and leg press). May begin stationary bike.
12 weeks:
Discontinue use of walkabout boot. Progress single leg closed chain strengthening as tolerated. Begin proprioception and single leg balance.
16 weeks:
Begin one legged heel lifts. Continue to progress closed chain strengthening and proprioceptive exercises.
24 weeks:
Functional progression to recreational and sport-related activities as tolerated.
