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Treatment of Torn Achilles Tendon

Options for Treatment of an Achilles Tendon Rupture

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Updated June 11, 2012

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

There are several options for torn Achilles tendon treatment. There is not necessarily a best treatment, just a best option for each individual. Therefore, you should discuss the pros and cons of different treatment options for a torn Achilles tendon with your doctor.

Torn Achilles Tendon Treatment: No Surgery

Traditionally, non-surgical treatment was reserved for individuals who live sedentary lifestyles or who may have problems with surgical wound healing. However, more recent studies have shown than most patients can consider non-surgical treatment of a torn Achilles tendon, and expect results similar to those who might opt for surgery. Some studies have shown that patients who have non-surgical treatment have a higher chance or re-injury (re-rupture) of the tendon, and perhaps a more difficult time for athletes returning to sports.

Nonsurgical treatment of an Achilles tendon rupture is accomplished by casting or bracing the Achilles tendon for several months. The foot starts in a pointed position, which helps bring the torn ends of the tendon together, and over time the foot is gradually brought upwards. Most often the ankle is immobilized for a total of 8 to 10 weeks, and then motion and strengthening exercises are started.

Torn Achilles Tendon Treatment: Surgery

Surgery is also an option to treat an Achilles tendon rupture, a procedure called an Achilles tendon repair. Performing Achilles tendon repair involves an incision along the back of the ankle. Usually the incision is made just to the side of midline so shoes will not rub on the site of the scar. The torn ends of the Achilles tendon are identified and strong sutures are placed in both ends of the tendon. These strong sutures are then tied together to repair the tendon.

Torn Achilles Tendon Treatment: Surgery Complications
The most common and worrisome complications following an Achilles tendon repair are problems with wound healing. The skin over the Achilles tendon sometimes does not heal well. Therefore, careful wound management is of utmost important following surgical repair of an Achilles tendon rupture. Other potential problems include infection, ankle stiffness, and re-rupture of the tendon.

Torn Achilles Tendon Treatment: Rehab

Rehabilitation following Achilles tendon repair is a controversial topic. Traditionally, patients were casted after surgery for a period of 4 to 8 weeks, and after that time, were allowed to gently begin moving the ankle.

More recently, some surgeons have advocated for a more rapid progression and return to activity. The goal of accelerated rehabilitation is to prevent muscle atrophy and joint stiffness that worsens the longer the joint is immobilized. If a solid repair is attainable, patients may not be casted at all, and allowed to begin motion soon after surgery. These patients will use a removable boot when walking for several weeks.

Sources:

Chiodo CP, et al. "Diagnosis and Treatment of Acute Achilles Tendon Rupture" J. Am. Acad. Ortho. Surg., August 2010; 18: 503 - 513.

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