This is the moment you've been waiting for: life without the boot. Weeks 10-12 mark a pivotal transition in your Achilles rupture recovery. You'll be learning to walk in regular shoes, starting structured physiotherapy, and beginning the active rebuilding of your calf strength. It's exciting, nerve-wracking, and absolutely crucial to get right.
The Big Transition - Leaving Your Boot Behind
When Is It Safe to Stop Wearing the Boot?
Evidence-based protocols recommend beginning boot removal around weeks 11-12 (not week 8-10). This is based on force-based criteria rather than time alone.
Why the Delay?
Readiness criteria (your specialist will assess):
- Ability to do seated calf raises with 0.8-1x body weight on your knee
- This creates ~2x body weight force in the Achilles tendon
- Tendon has developed enough strength to tolerate walking
- Swelling is well-controlled
- You feel confident and ready
The Principle
More aggressive loading early in safe positions (plantarflexion), but more cautious with immobilization time. This prevents elongation while building strength.
Boot Weaning Protocol
| Day | Activity |
|---|---|
| Day 1 | Wear shoes indoors for 1-2 hours, boot rest of time |
| Day 2-3 | Increase to 3-4 hours in shoes |
| Day 4-5 | Majority of day in shoes |
| Day 6-7 | Full transition to shoes during day |
| Night | May still use night splint for additional protection |
Your First Steps in Regular Shoes
Those first steps out of the boot are momentous - and often wobbly.
What to expect:
- Your ankle will feel stiff and weak
- Walking will feel strange and uncertain
- You may have a limp initially
- Your calf will fatigue quickly
- Some anxiety is completely normal
First steps guidance:
- Start indoors on a flat, familiar surface
- Have something to hold onto nearby (furniture, wall)
- Take short, slow steps
- Focus on heel-to-toe motion
- Stop and rest when you feel fatigued
- Tightness in the Achilles area
- Weakness when pushing off
- Mild discomfort (NOT sharp pain)
- Ankle stiffness
- Calf fatigue
- Sharp pain
- Sensation of "giving way"
- Popping or snapping
- Significant increase in swelling
- Unable to bear weight
Choosing the Right Footwear for Transition
Your first shoes after the boot are important. The wrong choice can cause problems.
- Heel-to-toe drop: 10mm or more (NOT flat shoes)
- Heel cushioning: Good shock absorption
- Heel counter: Firm support at the back
- Fit: Snug but not tight, with room for heel lifts
- Closure: Laces preferred for adjustable fit
- Sole: Slightly firm, not too flexible
Good options: Running shoes (Asics, Brooks, New Balance), walking shoes with good support, athletic trainers with cushioned heels.
Do
- •Running or walking shoes with 10mm+ heel drop
- •Shoes with firm heel counter
- •Lace-up shoes for adjustable fit
- •Consider adding 0.5-1cm gel heel lift initially
Don't
- •Completely flat shoes (ballet flats, Converse)
- •High heels
- •Flip flops or sandals
- •Slip-on shoes without back support
- •Minimalist/barefoot shoes
- •Going barefoot
Using Heel Lifts
Consider adding a 0.5-1cm gel heel lift initially. This eases the transition from the boot's heel elevation. Gradually reduce/remove over 2-4 weeks.
Starting Physiotherapy
What to Expect at Your First Session
Your first physiotherapy session sets the foundation for your rehabilitation.
Initial assessment includes:
- Discussion of your injury, treatment, and recovery so far
- Measurement of ankle range of motion
- Assessment of calf muscle strength and size
- Evaluation of your walking pattern (gait)
- Discussion of your goals and timeline
What your physio will be looking for:
- How much dorsiflexion (upward movement) you have
- How much plantarflexion (downward movement) you have
- Calf muscle atrophy (shrinkage) compared to the other leg
- Any compensatory movement patterns
- Your confidence and psychological readiness
Goals for Early Physiotherapy (Weeks 10-12)
- Protected walking - Use heel wedge, reduced step length. Elongation can still happen in first weeks of walking
- Begin calf activation - Continue building on early strengthening work. Target: 1.2x body weight seated isotonic
- Improve balance - Rebuild proprioception (body awareness) in the ankle
- Normalise gait - Correct any limping or compensatory patterns
- Build confidence - Psychological recovery is part of physical recovery
- Heel wedge: Use a heel lift initially (0.5-1cm), eases transition, gradually reduce over 2-4 weeks
- Reduced step length: Use step-to gait on unaffected side, shorter steps reduce force through tendon
- Partial weightbearing: If you can't push off properly, you're not ready. Use crutches until gait is normal
Why this matters: The tendon needs protection until it's developed enough strength. Protected walking prevents elongation.
What goals are NOT for this phase: Heavy calf strengthening, running or impact activities, sports-specific training, aggressive stretching (avoid for up to a year), maximum range of motion.
The Importance of Consistency
Rehabilitation success depends heavily on consistent effort.
- Attend ALL scheduled physiotherapy appointments
- Complete your home exercises DAILY (or as prescribed)
- Don't skip sessions because you're "feeling fine"
- Don't overdo it because you're "feeling good"
- Follow the progression your physio sets - don't freelance
Common Mistake
Key Exercises for This Phase
- Sit with injured leg extended straight
- Loop a towel around the ball of your foot
- Gently pull the towel towards you
- Stop when you feel a MILD stretch - not pain
- Hold for 30 seconds, repeat 3-5 times
Key: Be VERY gentle - no aggressive stretching. You're looking for mild tension, not maximum stretch.
- Sit in a chair with feet flat on floor
- Slowly lift your heels off the ground
- Squeeze your calf muscles at the top
- Lower slowly with control
- Repeat 15-25 times, 2-3 sets
Progression: Start with body weight only, add light weight on knees as strength improves.
- Stand facing wall or counter for balance
- Feet shoulder-width apart
- Slowly rise onto your toes (both feet)
- Hold at top for 1-2 seconds
- Lower slowly with control
- Repeat 15-20 times, 2-3 sets
Progression: Equal weight → shift more to injured leg → eventually single-leg (later phase).
- Plantarflexion: Loop band around foot, push foot down against resistance, 15-20 times
- Inversion/eversion: Anchor band to side, push foot against resistance, 15-20 times each direction
- Start with light resistance (yellow or red Theraband)
- Stand near a wall for support
- Lift uninjured leg slightly
- Balance on injured leg
- Hold for 10-30 seconds, repeat 5 times
Progressions (later): Eyes closed, unstable surface like a pillow, adding arm movements.
- Walk slowly in front of a mirror
- Focus on heel strike first
- Roll through the foot smoothly
- Push off gently with the toes
- Equal stance time on each leg
Key: Slow and deliberate initially. Aim for symmetry. Gradually increase speed.
What NOT to Do - Critical Mistakes to Avoid
Warning
Do
- •Follow your physiotherapist's guidance exactly
- •Progress gradually and patiently
- •Listen to your body - rest when needed
- •Wear appropriate supportive footwear
- •Continue exercises even when feeling better
Don't
- •Don't stretch aggressively - let range of motion return naturally
- •Don't walk barefoot - always wear supportive shoes
- •Don't do single-leg activities until cleared by physio
- •Don't ignore pain - mild discomfort is okay, pain is not
- •Don't rush - this phase sets the foundation for everything
FAQs for Weeks 10-12
Summary: Your Weeks 10-12 Checklist
- Get specialist clearance for boot removal
- Follow graduated boot weaning protocol
- Purchase appropriate transition footwear
- Use heel lifts initially (gradually reduce)
- Start physiotherapy
- Begin home exercise programme
- Practice protected walking
- Do exercises DAILY as prescribed
- Monitor for warning signs
- Be patient - this is a marathon, not a sprint
