0 – 2 weeks:   
 
  • Non-weight bearing, front slab on ankle
  • Rest and keep leg elevated wherever possible
  • Can perform general, non-weight bearing lower limb strengthening, e.g. straight leg raises, leg extensions, leg curls, hip abduction in side lying etc.
 
2 – 8 weeks:
 
  • Stitches removed, removable front slab applied
  • Remain non-weight bearing
  • Remove front slab three times per day and perform active ankle dorsiflexion to less than neutral, then relax back into plantarflexion
  • Continue general lower limb strengthening
 
8 – 10 weeks:
 
  • Commence weight bearing as tolerated with heel lifts in supportive footwear
  • Commence physiotherapy, focussing on passive and active range of movement
  • No resistance training for calf at this stage
  • Perform scar massage / desensitization
 
10 – 12 weeks:
 
  • Gradually remove heel lifts in shoes
  • Commence calf stretches in standing
  • Commence theraband strengthening of calf
 
12 weeks onward:
 
  • Can commence calf raises from the floor, starting on both feet and slowly increasing weight through operated side as comfort allows
  • Can progress calf strengthening to a step when able to perform 15 single-leg repetitions on the operated leg
  • Aim for dorsiflexion > 8 cm (toe from wall test)
  • Can commence jogging when able to perform 15 single-leg calf raises off the step (normally 6 months post op.)
  • After 6 months can introduce eccentric calf strengthening program to encourage tendon remodelling and increase strength.