Achilles Tendon Surgery May Help Your Pain

Your body usually lets you know when something is wrong, and its warning siren is pain. You might wake up the morning after a long hike and notice stiffness and aching behind your ankle. You might hear a snap and feel intense pain as you make a dash to the basket for a layup. The cord at the back of your ankle might feel tender when you squeeze on the sides. These are all symptoms of problems with the tendon that connects your heel bone to your calf muscles, and some conditions may require Achilles tendon surgery to heal properly.

What’s Your Problem?

There are five common issues that can occur with your Achilles, and most of them have to do with stress from overuse or poor conditioning.

  •  Inflammation can occur at the point where the Achilles inserts into the heel bone (insertional tendinitis). Often this happens because a bone spur has formed at that spot and the tendon rubs over it.
  • The outer sheath of the tendon may become inflamed from overuse—which simply means that you keep doing activities that irritate it and don’t allow enough downtime for your body to repair the damage.
  • The protective sac of fluid (bursa) that acts as cushion between bone and tendon can become inflamed with repetitive movement (called retrocalcaneal bursitis).
  • The tendon can gradually deteriorate or form scar tissue (called tendinosis). This can happen as you age or from repeated running, jumping and landing. It makes the tissue weak and prone to injury.
  • A weakened tendon can rupture—partially or completely—making it hard or impossible to rise up on your toes, climb stairs, or jump.

What Can Surgery Do for a Damaged Achilles?

 Painful achilles

We don’t usually recommend surgery unless conservative therapies don’t bring relief from your pain or renewed function in the Achilles. These may include anything from rest, icing, and pain medication, to ultrasound treatment, physical therapy (both stretches and strengthening exercises), or custom orthotics to correct foot alignment issues. If none of these work, surgery may be the answer.

If the problem is tendinosis, we can remove the damaged part of the tendon and repair it, sometimes with a tendon graft from elsewhere in your body. If insertional tendinitis is causing your pain, we can shave off the spur and repair the connection to the bone. The bursa can be removed if you have frequent bouts of bursitis pain. The Achilles can be lengthened, as well as tight calf muscles that often contribute to your painful issues, to reduce the stress on the tendon. A ruptured tendon can be stitched back together again.

These surgeries are normally done under general anesthesia, and we may use regional pain blocks as well. You will be face down during the procedure, as they are done from the back of the ankle. Some procedures require a long incision; others, such as repairing a rupture, are sometimes done with several small ones. The incisions are stitched closed, your leg bandaged, and a splint or surgical boot is fitted in place to hold the ankle stable and allow healing.

You will need to be non-weight bearing for several weeks or even months after surgery, and total recovery may take around six months. Following removal of the cast or splint, you will need to start reconditioning the tendon and joint to function fully again.

Let Our Texas Foot Specialist Advise You

Achilles tendon surgery has some risks, but conservative therapy does too, in that repeat injuries can occur more often. Let Keith McSpadden, DPM evaluate your Achilles issues and inform you of your treatment options. If surgery is the best option, you can rest easy knowing we have the training and experience to perform it to the highest standards. Contact North Austin Foot & Ankle Institute at our office in Cedar Park, TX at (512) 593-2949 or in Round Rock at (512) 960-4290, and let your healing begin.