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Criteria for Return to Running After Surgical Repair of Acute Achilles Tendon Rupture: A Modified Delphi Consensus
Maxime Gaspar1,2, Nicola Maffulli3,4, Geoffrey Memain5
1Fédération Française de Football, Centre Médical Clairefontaine, Clairefontaine en Yvelines, France. mgaspar@fff.fr.
Sports Medicine (Auckland, N.Z.)
|July 26, 2026
Summary
Experts reached consensus on seven key criteria for returning to running after Achilles tendon rupture surgery. These include pain absence, functional mobility, and psychological readiness, guiding post-operative recovery.
Area of Science:
- Orthopedic Surgery
- Sports Medicine
- Rehabilitation Science
Background:
- Achilles tendon ruptures show a rising incidence, necessitating clear post-surgical recovery guidelines.
- Current literature lacks evidence-based criteria for safe return to running post-surgery.
- Standardized criteria are crucial for optimizing patient outcomes and preventing re-injury.
Purpose of the Study:
- To establish expert consensus on criteria for resuming running after surgical Achilles tendon rupture repair.
- To provide a framework for clinicians to guide patients through the return-to-running phase.
- To address the gap in evidence-based guidelines for post-operative Achilles tendon rehabilitation.
Main Methods:
- A modified Delphi study involving 35 international Achilles tendon experts.
- Three rounds of மதிப்பீடு using a five-point Likert scale to achieve 75% consensus.
- Evaluation of 16 clinical criteria relevant to return-to-running readiness.
Main Results:
- Consensus was achieved on eight criteria: seven for inclusion and one for exclusion (calf circumference symmetry).
- Included criteria encompass absence of pain, functional milestones (tiptoe walking, heel raises), and psychological readiness.
- Key criteria include pain-free daily activities, pain-free rehabilitation, limping-free gait, single-leg heel raises, single-leg balance, and psychological readiness.
Conclusions:
- An expert-validated consensus on return-to-running criteria after Achilles tendon rupture surgery has been established.
- These criteria offer a foundation for clinical decision-making but require prospective validation.
- Further research is needed to refine these criteria and assess their impact on functional recovery.
