Component		Procedure	Duration and frequency	Comments
Range of motion
Achilles tendon stretch, nonweight-bearing		Use a towel to pull foot toward face.	Pain-free stretch for 15 to 30 seconds; perform five repetitions; repeat three to five times a day.	Maintain extremity in a nongravity position with compression.
Achilles tendon stretch, weight-bearing		Stand with heel on floor and bend at knees.	Pain-free stretch for 15 to 30 seconds; perform five repetitions; repeat three to five times a day.
Alphabet exercises performed		Move ankle in multiple planes of motion by drawing letters of alphabet (lower case and upper case).	Repeat four to five times a day.	Exercises can be in conjunction with cold therapy.
Muscle strengthening
Isometric exercises		Resistance can be provided by immovable object (wall or floor) or contralateral foot.	For each exercise, hold 5 seconds; do 10 repetitions; repeat three times a day.	Strengthening exercises should only be done in positions that do not cause pain.
	Plantar flexion	Push foot downward (away from head).
	Dorsiflexion	Pull foot upward (toward head).
	Inversion	Push foot inward (toward midline of body).
	Eversion	Push foot outward (away from midline of body).
Isotonic exercises		Resistance can be provided by contralateral foot, rubber tubing or weights.	For each exercise, hold 1 second for concentric component and perform eccentric component over 4 seconds; do three sets of 10 repetitions; repeat two times a day.	Emphasis is placed on the eccentric component; exercises should be performed slowly and under control.
	Plantar flexion	Push foot downward (away from head).
	Dorsiflexion	Pull foot upward (toward head).
	Inversion	Push foot inward (toward midline of body).
	Eversion	Push foot outward (away from midline of body).
	Toe curls and marble pickups	Place foot on a towel; then curl toes, moving the towel toward body.	Two sets of 10 repetitions; repeat two times a day.	Toe curls can be done throughout the day, at work or at home.
		Use toes to pick up marbles or other small object.
	Toe raises, heel walks and toe walks	Lift body by rising up on toes. Walk forward and backward on toes and heels.	Three sets of 10 repetitions; repeat two times a day; progress walking as tolerated.	Strengthening can occur from using the body as resistance in weight-bearing position.