Do I Need Physical Therapy After PTTD Surgery? The Essential Guide

Yes, physical therapy is essential—not optional. You won’t get the best results from your surgery without proper rehabilitation. PT helps you heal correctly, regain strength, and return to your activities safely.

What to Expect in Physical Therapy

Your rehabilitation will be broken into phases:

Early Phase (Weeks 2-6)

• Gentle range of motion exercises
• Ankle pumps to encourage circulation
• Non-weight bearing exercises
• Swelling management techniques
• Pain control strategies

During this phase, you’re protecting the surgical repair while preventing stiffness and blood clots.

Middle Phase (Weeks 6-12)

• Gradual weight bearing progression
• Strengthening exercises for the posterior tibial tendon and surrounding muscles
• Balance training to rebuild proprioception
• Gait training to restore normal walking patterns

This is when you’ll transition from crutches to walking normally again.

Late Phase (Months 3-6)

• Building strength in the foot and ankle
• Functional training for daily activities
• Sport-specific exercises (if you’re an athlete)
• Gradual return to normal activities

Most people see significant improvement during this phase, but full recovery can take up to a year.

How Many PT Sessions Will You Need?

Most people do:

• 12 to 24 sessions over 3 to 6 months
• 2 to 3 times per week initially
• Tapering frequency toward the end as you progress

Your therapist will create a plan based on your specific needs and healing rate.

Can You Do PT at Home?

Your physical therapist will give you a home exercise program (HEP). Doing these exercises consistently is critical to your recovery.

Think of it this way: in-clinic PT + dedicated home exercise = best results. Skipping either one compromises your outcome.

Why PT Matters So Much

Without physical therapy:

• You may not regain full range of motion
• Strength imbalances can develop
• You’re at higher risk of re-injury
• Gait abnormalities can become permanent
• You won’t return to activities as quickly or safely

PT guides your recovery step by step, making sure you don’t do too much too soon—or too little for too long.

The Bottom Line

Plan on physical therapy after PTTD surgery. It’s not optional—it’s a crucial part of getting your money’s worth from the surgery and returning to the activities you love. Commit to the process, do your home exercises, and you’ll see better outcomes.