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4-Phase Post Procedure Rehab Overview

Phase 1: 1-2 weeks post procedure:

  • Isometric strengthening, muscle activation, and firing of muscle-tendon unit

  • Joint mobilizations and gentle stretching of the muscle-tendon unit

  • Evaluate and treat other regional weaknesses and imbalances in the kinetic chain

  • Desensitization of the tissues with deep tissue and myofascial release work

Phase 2: 2-6 weeks post procedure:

  • Progressive strengthening of the muscle-tendon unit and regional muscles; fix atrophy

  • Controlled low-load, high repetition concentric followed by low load eccentrics

  • Tissue remodeling with deep tissue work in line with collagen fiber orientation of tendon

  • Basic sport-specific skills reintroduced without loading tendon significantly

Phase 3: 6-10 weeks post procedure:

  • More dynamic and balanced concentric and progressive eccentric loading of the tendon

  • Some early sport-specific, less ballistic skill reintegration with moderate tendon loading

  • Likely will need a recovery day after more significant loading

Phase 4: 8-12 weeks post procedure:

  • Return to sport-specific skills in a progressively more dynamic and ballistic fashion

  • Progressively load tendon cyclically (recovery dictates daily vs every other day loading)

  • May begin a phased return to a running program if indicated (separate handout)

  • Game/Activity simulation with a therapist to recreate the environment

**Consider progression to a personal trainer if more training needed prior to returning to sport

**Note: Pain up to 3-4/10 is acceptable so long as it remits on the recovery day