Table of ContentsView AllTable of ContentsAchilles Tendon RuptureDo I Need Surgery?Nonoperative TreatmentWhat to Expect
Table of ContentsView All
View All
Table of Contents
Achilles Tendon Rupture
Do I Need Surgery?
Nonoperative Treatment
What to Expect
AnAchilles tendon ruptureis a traumatic injury that can cause significant disability after it occurs. This condition typically happens without warning and can make it challenging to walk or bear weight through your leg.
While many people end up having their tendon surgically repaired after a tear, this is not always necessary. In fact, a significant number of people may actually be able to rehabilitate their ankle without undergoing a procedure.
This article will discuss Achilles tendon rupture, when surgery may be needed, the effectiveness of nonoperative treatment, and what to expect from nonoperative treatment.
Oleg Breslavtsev/ Getty Images
What Is an Achilles Tendon Rupture?
Your Achilles tendon is a thick, fibrous band of tissue that connects two calf muscles (the soleusandthe gastrocnemius) to the heel of your foot. This important structure is both the thickest and strongest tendon in the human body.
Huge amounts of force are transmitted through the Achilles on a daily basis. It makes activities like going up on your tiptoes, walking, running, and jumping possible.Additionally, because each of the calf muscles plays an influential role in keeping your balance, an intact Achilles is critical to maintaining stability while you’re on your feet.
While a partial tear in this area may have mild or even no symptoms, a complete rupture can cause significant disability because of the Achilles’ many critical functions.
A ruptured Achilles can impact anyone. That said, several groups are more likely to experience this condition than others.
For example, men tear their Achilles at a higher rate than women. In particular, males in their 30s, 40s, and 50s are at a higher risk. In addition, “weekend warriors” who participate in higher-demand sports, like basketball or tennis, that involve a lot of running, cutting, or jumping have a higher rate of injury.
Because a ruptured Achilles has a significant impact on your function, treatment is imperative to get you back to your normal tasks.
While asurgical repairof the torn tendon is frequently performed, research suggests this may not always be necessary.In fact, because of how this tendon heals after a rupture, many people can successfully recover from this injury without a procedure.
How Effective Is Nonoperative Treatment?
Nonoperative treatment is an effective (and in some cases better) option for some people after an Achilles tear.
Research has shown that individuals who are treated nonoperatively after a rupture have similar range of motion in their ankles as people who undergo a procedure.In addition, they are able to return to their prior functional levels and athletic activities as well as their surgical counterparts.
People who have a surgical repair have less chance of re-rupturing their tendon than people who treat their injury nonoperatively.
Also important to note is the fact that treating a tear with a procedure results in a higher risk of other complications, mainly due to the possibility of post-surgical infection.Because there are pros and cons to both treatment approaches, it is best to speak to your orthopedic surgeon about which option is right for your situation.
What Nonoperative Treatment Entails
Once you have decided to treat your tear nonoperatively, your physician can help you find a physical therapist who will guide you through the doctor’s rehabilitation protocol. While the specifics can vary from surgeon to surgeon, several hallmark rehab components are typically present.
Casting is usually the first step in treating an Achilles tear without surgery. Your foot is pointed in a downward position in the cast to increase the likelihood that the gap in the tendon heals correctly.
After several weeks, the cast is removed and a walking boot is worn in its place. Generally, a heel lift is placed in the boot to reduce the strain on the healing tendon.
After several weeks, your doctor will permit you to transition into a shoe. When this occurs, initial calf strengthening and balance exercises are usually also initiated. It is important to progress these carefully and with the guidance of a therapist to ensure the integrity of the healing Achilles.
Calf stretching may also be introduced (usually 12 weeks or more after the initial injury), though it is important not to over-stretch this area. Once you have sufficient strength in your calf muscles, your doctor may clear you to begin higher-level tasks like running or jumping. In total, your entire rehabilitation can take up to six months or longer.
Summary
An Achilles tendon rupture can significantly affect your ability to walk or run. Surgical repair may be done, but there are also nonoperative options. A cast and then a walking boot may be used. After a few weeks, you may graduate to a shoe and begin exercises with a physical therapist.
4 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.University of Michigan Health.Achilles tendon problems.Ecker TM, Bremer AK, Krause FG, Müller T, Weber M.Prospective use of a standardized nonoperative early weight bearing protocol for Achilles tendon rupture: 17 years of experience.Am J Sports Med. 2016;44(4):1004-1010. doi:10.1177/0363546515623501Deng S, Sun Z, ZhangC, Chen G, Li J.Surgical treatment versus conservative management for acute Achilles tendon rupture: a systematic review and meta-analysis of randomized controlled trials.The Journal of Foot and Ankle Surgery. 2017;56(6):1236-1243. doi:10.1053/j.jfas.2017.05.036Ochen Y, Beks RB, HeijlM van, et al.Operative treatment versus nonoperative treatment of Achilles tendon ruptures: systematic review and meta-analysis.BMJ. 2019;364:k5120. doi:10.1136/bmj.k5120
4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.University of Michigan Health.Achilles tendon problems.Ecker TM, Bremer AK, Krause FG, Müller T, Weber M.Prospective use of a standardized nonoperative early weight bearing protocol for Achilles tendon rupture: 17 years of experience.Am J Sports Med. 2016;44(4):1004-1010. doi:10.1177/0363546515623501Deng S, Sun Z, ZhangC, Chen G, Li J.Surgical treatment versus conservative management for acute Achilles tendon rupture: a systematic review and meta-analysis of randomized controlled trials.The Journal of Foot and Ankle Surgery. 2017;56(6):1236-1243. doi:10.1053/j.jfas.2017.05.036Ochen Y, Beks RB, HeijlM van, et al.Operative treatment versus nonoperative treatment of Achilles tendon ruptures: systematic review and meta-analysis.BMJ. 2019;364:k5120. doi:10.1136/bmj.k5120
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
University of Michigan Health.Achilles tendon problems.Ecker TM, Bremer AK, Krause FG, Müller T, Weber M.Prospective use of a standardized nonoperative early weight bearing protocol for Achilles tendon rupture: 17 years of experience.Am J Sports Med. 2016;44(4):1004-1010. doi:10.1177/0363546515623501Deng S, Sun Z, ZhangC, Chen G, Li J.Surgical treatment versus conservative management for acute Achilles tendon rupture: a systematic review and meta-analysis of randomized controlled trials.The Journal of Foot and Ankle Surgery. 2017;56(6):1236-1243. doi:10.1053/j.jfas.2017.05.036Ochen Y, Beks RB, HeijlM van, et al.Operative treatment versus nonoperative treatment of Achilles tendon ruptures: systematic review and meta-analysis.BMJ. 2019;364:k5120. doi:10.1136/bmj.k5120
University of Michigan Health.Achilles tendon problems.
Ecker TM, Bremer AK, Krause FG, Müller T, Weber M.Prospective use of a standardized nonoperative early weight bearing protocol for Achilles tendon rupture: 17 years of experience.Am J Sports Med. 2016;44(4):1004-1010. doi:10.1177/0363546515623501
Deng S, Sun Z, ZhangC, Chen G, Li J.Surgical treatment versus conservative management for acute Achilles tendon rupture: a systematic review and meta-analysis of randomized controlled trials.The Journal of Foot and Ankle Surgery. 2017;56(6):1236-1243. doi:10.1053/j.jfas.2017.05.036
Ochen Y, Beks RB, HeijlM van, et al.Operative treatment versus nonoperative treatment of Achilles tendon ruptures: systematic review and meta-analysis.BMJ. 2019;364:k5120. doi:10.1136/bmj.k5120
Meet Our Medical Expert Board
Share Feedback
Was this page helpful?Thanks for your feedback!What is your feedback?OtherHelpfulReport an ErrorSubmit
Was this page helpful?
Thanks for your feedback!
What is your feedback?OtherHelpfulReport an ErrorSubmit
What is your feedback?
