PATIENT
EDUCATION

Symptoms

• A sensation of something popping or snapping at the time of injury
• Pain toward the back of the foot and heel
• Tenderness along the calf into the heel and foot
• Swelling in the back of the heel or the foot and ankle
• Stiffness when pointing the toes or flexing the foot
• Inability to stand on feet

What Is an Achilles Tendon Tear?

The Achilles tendon is the strong “rubber band–like” connective tissue that can be felt right above the back of the heel. This tendon connects the calf muscle to the heel bone (calcaneus) and allows you to stand on your toes and push off while jumping. An Achilles tendon tear is an injury that often occurs from overuse (such as running), having tight calf muscles, wearing high heels, and/or having flat feet. It can also occur from disuse and a sudden return to strenuous activities. Achilles tendonitis (pain and swelling due to inflammation of the tendon) can lead to more severe injuries such as an Achilles tear or rupture. When the Achilles tendon is forcibly overstretched due to tight muscles or fast movements, the tendon can partially tear or completely separate (rupture).

Nonsurgical Treatments

Mild cases of Achilles tendon injuries may respond well to nonsurgical treatments such as resting, icing, using a heel lift, taking anti-inflammatories, physical therapy, and/or cortisone injections. In more severe cases of Achilles tendon injuries, wearing a cast or an orthotic may be necessary to prevent further injury and allow the tendon to heal. While nonsurgical treatment can relieve mild cases of the condition or partial tears, surgery may be necessary to repair a ruptured tendon.

Surgical Treatments

Percutaneous Achilles Rupture Repair (Minimally Invasive)

Dr. Tuvi Mendel, orthopaedic surgeon and leader of our Foot & Ankle Center, may perform percutaneous (needle puncture of the skin) surgery as a minimally invasive method of repairing an Achilles tendon rupture. During surgery, several small incisions and sutures are made through the skin to bring the two ends of the torn tendon back together. Once the tendon is approximated, the stitches are tied off, cut short, and pushed in the skin. To give the tendon time to heal, patients are usually required to wear a non-weight-bearing cast for approximately 4 – 6 weeks followed by a weight-bearing cast for approximately 1 month. This minimally invasive technique allows for less soft-tissue dissection, less scarring, and less pain.

Traditional Open Achilles Tendon Repair Surgery

Traditional open surgery involves an incision along the inner part of your lower leg near the site of injury to allow your surgeon to visualize the torn tendon. The ruptured ends are debrided (cleaned up) and sewn back together. Following surgery, patients are required to wear a cast or rigid orthosis to allow the tendon to heal and regain strength. After approximately 4 – 6 weeks, patients may begin active motion and therapy. Patients may return to normal activity usually within 4 – 6 months following surgery.