What Changes in Weeks 5–6 After Achilles Surgery

Weeks 5–6 represent the shift from protection to controlled loading. The surgical repair is no longer in its most vulnerable stage, but it is still remodeling and not ready for aggressive stress.

During this phase:

• Partial weight bearing progresses toward fuller loading

• Light concentric and eccentric calf work begins

• Closed-chain lower-limb strength increases

• Walking remains in the boot unless otherwise cleared

This is the first phase where the tendon is asked to adapt — carefully.

Introducing Controlled Concentric and Eccentric Loading

At this stage, calf strengthening becomes deliberate and measurable.

You will perform controlled double-leg heel raises and seated calf work with strict range limits. Movements are:

• Slow and controlled

• Limited to plantar grade

• Moderate in effort, not maximal

• Designed to build tolerance, not test strength

Eccentric exposure begins gradually, ensuring the tendon adapts without excessive strain or elongation.

How Weight Bearing Progresses Safely

Weight bearing increases in a structured way, but walking and daily ambulation remain in the boot unless your surgeon has cleared otherwise.

Strength exercises may be performed out of the boot in a controlled environment. However, dorsiflexion is carefully limited and no ballistic push-off is permitted.

The focus is on:

• Symmetry

• Stability

• Controlled load acceptance

• Avoiding reactive swelling

Progression is based on tissue response — not confidence alone.

What This Phase Includes

This 2-week block includes:

• Structured strength sessions (3× per week)

• Controlled concentric and eccentric calf work

• Progressed split squat isometrics and short-range strength

• Hydrotherapy integration (where available)

• Built-in checklists to monitor pain and swelling response

This phase does not include running, plyometrics, single-leg heel raises, or aggressive stretching.

When to Move to Moderate Load Integration

You are ready for the next phase when:

• Full weight bearing in the boot is comfortable

• Calf loading is tolerated without next-day swelling

• Strength exercises feel controlled and symmetrical

• Morning stiffness does not worsen

Ideally, transition to the next stage should coincide with review by your physiotherapist.

Moderate load integration builds on this phase — but only once the tendon demonstrates readiness.