Achilles Repair

If you have been having pain in your foot and suspect it is your Achilles tendon, talk to your doctor. The sooner you deal with the problem, the better your outcomes will be.

Injuring your Achilles tendon is painful. This is the largest tendon in your body and is responsible for the movements that your foot makes. If it’s injured, walking becomes difficult and painful.

There are many ways you can damage your Achilles tendon. It is a large tendon and generally will not be injured through normal daily activities. But a sudden large force or pivoting suddenly can cause it to tear. If your foot already naturally turns outward, you are more at risk for this happening. A sudden increase in physical activity can put more strain on your Achilles tendon and cause damage. Another type of damage is called tendinopathy, or tendonitis. This is a degeneration of the Achilles tendon and comes from overuse or unusual stress to the tendon.

If the damage to your Achilles tendon is minor, you may not need treatment and it will heal on its own. Resting, icing and using non-steroidal anti-inflammatory medicines such as ibuprofen may restore your foot to its full function. It is up to you and your doctor to decide if the damage to your Achilles tendon is severe enough to warrant surgical repair.


Non-Surgical Treatment Options

There are several factors that will help your doctor decide if you need surgery. Your age, general health, and the degree of damage will determine if surgery is necessary. If you do not want to undergo surgery or your doctor does not advise it, there are other treatments you can try first. Bear in mind, however, that with larger ruptures, patients who undergo surgery have a more complete recovery.

The most common non-surgical intervention is to cast the foot. This keeps the foot in the correct position to give the Achilles tendon a rest and allow it to heal on its own. The cast will go from your toes to above your knee and will start out by putting your foot in a position in which the toes point downward. The cast will be changed out over the next several weeks, with the position of your foot slowly being moved back to normal. The entire process takes between six and twelve weeks. Heel lifts and physical therapy may be prescribed after the cast comes off to fully restore function to your foot.

Surgery for Achilles Repair

Some repairs for a ruptured Achilles tendon can be done laparoscopically with tiny incisions instead of cutting into the skin with a larger incision. It depends on the scope of the damage. Before surgery, imaging tests such as an x-ray, ultrasound, or MRI will be used to allow the doctor to have a better idea of the scope of the damage and how much repair is necessary.

Spinal sedation is generally used for Achilles repair. This numbs you from the waist down and dissipates quickly once it’s removed. The surgeon makes the incision on the back of your calf and works down to the tendon. Depending on the extent of the damage, he or she may be able to repair the tendon with stitches. If the damage is extensive, the tendon may have to be replaced with a tendon from another part of your foot.

After surgery, you will be in the recovery room for a few hours. Your foot will be in a splint and medication will be given for pain control and swelling. You may also be instructed to elevate your foot and put ice on it. After approximately ten days, the stitches can be removed and if the swelling has subsided, your foot will likely be put in a cast to keep it immobile. Sometimes a removable boot can be used instead of a cast.

After removal of the cast, you may need to have some physical therapy to strengthen the muscles in your foot after being immobile for several weeks. Your physical therapist can instruct you on how to prevent further damage to your Achilles tendon. Strengthening exercises you learn from your therapist can be done at home. It can take four to six months to be back to normal activity after an Achilles repair.


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