The TayCo® Acute XAB ankle brace provides an optimal balance of support, comfort, and functionality for patients recovering from anterior tibial tendon reconstruction. Unlike traditional in-shoe braces, which many patients find restrictive and uncomfortable, the Acute XAB Brace attaches externally to the shoe, avoiding direct pressure on the foot while still offering excellent stability.
For anterior tibial tendon tears, Dr. Strasser uses the Acute XAB Brace locked in dorsiflexion to provide additional support in dorsiflexion, which is crucial in protecting the repair and preventing excessive strain on the healing tendon. This positioning helps offload the anterior tibial tendon while still allowing for a controlled, natural gait.
Patients frequently report that the Acute XAB Brace feels more natural to wear, as it allows for improved comfort while walking, standing, and performing daily activities. By keeping the ankle securely positioned at neutral with added dorsiflexion support, it helps reduce strain on the healing tendon and effectively relieves pain.
Additionally, because the Acute XAB Brace stabilizes the ankle without excessively limiting natural movement, patients are more compliant with wearing it throughout the recovery process. This contributes to a smoother transition from immobilization to full activity while still providing the protection needed for tendon healing.
Postoperative Rehabilitation Protocol for Augmented Anterior Tibial Tendon Reconstruction with Gastroc Recession
Phase 1: Immobilization & Protection (Weeks 0-4)
Week 0-2:
- Immobilization: Posterior splint, non-weight-bearing (NWB)
- Weight-bearing: Strict NWB with crutches/knee scooter
- Therapy Focus:
- Elevation and icing to control swelling
- Toe range of motion (ROM) exercises to prevent stiffness
- Core and upper body conditioning
Week 2-4:
- Immobilization: Transition to a short leg cast, still NWB
- Weight-bearing: Continue NWB
- Therapy Focus:
- Continue swelling management
- Hip and knee ROM and strengthening
- Avoid ankle movement to protect the repair
Phase 2: Transition to Weight-Bearing (Weeks 4-8)
Week 4-8:
- Immobilization: Transition from cast to a CAM boot
- Weight-bearing: Partial weight-bearing (PWB) in the boot, progressing to full weight-bearing (FWB) over 2-3 weeks as tolerated
- Therapy Focus:
- Gentle active-assisted ankle dorsiflexion/plantarflexion ROM
- Avoid forced dorsiflexion to protect the repair
- Seated ankle isometrics (excluding dorsiflexion)
- Begin light open-chain strengthening for proximal muscles (hip/knee)
Phase 3: Progressive Strengthening & Mobilization (Weeks 8-16)
Week 8-12:
- Immobilization: Transition from the boot to a Acute XAB ankle brace locked at neutral
- Weight-bearing: Full weight-bearing in Acute XAB Brace
- Therapy Focus:
- Begin gentle dorsiflexion stretching (avoiding over-lengthening the repair)
- Seated theraband exercises for dorsiflexion (low resistance)
- Closed-chain balance exercises (double-leg stance)
- Initiate low-impact functional activities (bike, seated proprioception drills)
Week 12-16:
- Brace Use: Acute XAB Brace remains on for all activities
- Therapy Focus:
- Progressive dorsiflexion strengthening
- Single-leg balance and proprioception drills
- Bodyweight closed-chain exercises (mini squats, step-ups)
- Light agility drills (marching, controlled walking drills)
Phase 4: Return to Functional Activities (Weeks 16-24+)
Week 16-24:
- Brace Use: Continue TayCo Acute XAB Brace for outdoor activities
- Therapy Focus:
- Progressive return to functional strengthening
- Controlled impact activities (light jogging, agility drills)
- Sport/work-specific drills as tolerated
- Continued proprioception and neuromuscular training
Week 24+ (6 months post-op):
- Return to full activities as tolerated
- Brace Use: Discontinue brace unless needed for high-risk activities
- Continue strengthening and balance training to ensure optimal recovery
Important: This protocol is a general guideline. All patients should follow the specific instructions provided by their surgeon. Always consult your physician before beginning or progressing with rehabilitation exercises.
