Your Achilles may be the longest and strongest tendon in your body—it has to be, considering the daily pressures and stresses it must face—but it’s not invincible. While Achilles tendinitis is a well-known overuse injury that causes pain in the tendon, the Achilles can also tear or snap partially or entirely. Known as an Achilles tendon rupture, this is a significant injury that needs to be addressed quickly.
Besides the obvious and often severe pain that accompanies the injury, you may find it difficult or impossible to stand on your toes or to bend your injured foot downward, a necessary component of “pushing off” when you walk. There may be lots of swelling as well.
Why Your Tendon Tears
Most Achilles ruptures occur during athletic activity, during a sudden spike in pressure or stress on the tendon. Maybe you’re out for a run, or playing a little pickup basketball, and suddenly feel (or even hear) a snap, followed by immediate, severe pain. An awkward fall can also cause a rupture.
Although a rupture can happen to anyone, middle-aged men—particularly “weekend warriors” who may be packing lots of activity into gaps in their work schedule—are the prime targets. That’s because tendons weaken and become less flexible as they age and may no longer be able to handle high-impact stresses, especially if you haven’t properly prepared your body for new, stressful activities.
To Operate, or Not to Operate?
That’s really the question, isn’t it? Both treatment methods can be successful, though there are advantages and disadvantages to each approach. Although the final decision is one you’ll have to discuss with Dr. McSpadden based on his evaluation and recommendation, we can offer a little bit of insight into each option.
In the non-surgical approach, the doctor will immobilize the foot via a cast or boot, often with inserted wedges that will help you keep your heel raised—that will reduce stress on the tendon. Then, in time, the body’s natural healing processes repair the damage.
The main advantage to this route is that it bypasses the standard risks associated with surgery, making it especially advantageous to those with complicating conditions (such as diabetes) that make infection a bigger concern. However, the recovery period will probably last longer, the tendon may ultimately be weaker or more prone to re-rupture than one that has been surgically repaired, and a tendon that re-ruptures may ultimately be more difficult to treat (surgically or otherwise).
Surgical Tendon Repair
If you choose surgery, the doctor will make an incision near the rupture site and stitch the Achilles back together. If damage is severe, it may be necessary to graft other tendons to the area to reinforce it. Surgery is generally more likely to produce a satisfactory result more quickly, and reduces the risk of injury recurrence. However, like any surgery, there’s always a risk of infection or nerve damage, and the larger the incision, the more significant the risk.
Ready for Rehab
Regardless of the treatment method selected, the repaired tendon will require physical therapy and rehabilitation in order to regain lost strength, improve range of motion, and protect against a recurrence of the injury. That said, it’s important to go slow at first and not try to do too much, too soon. Dr. McSpadden will provide you with the necessary instructions or you’ll need, or connect you with the right professionals, to pursue a safe, healthy rehab program.
Although exact recovery times are always variable depending on the severity of the injury and the health of the individual, most people are able to make a complete return to their previous activity levels in about 4 to 6 months.
If you’ve ruptured your Achilles, you’ll need expert help on your side. Dr. Keith McSapdden is passionate about sports injury care. He’ll help you make an informed choice about your treatment options and get you back on your feet and in the game as well as possible. To schedule an appointment, please contact us online or by dialing 512-593-2949.