Achilles Tendon Repair
What Is Achilles Tendon Repair?
Achilles tendon repair is the surgical treatment for a completely torn Achilles tendon, in which the torn ends of the tendon are reattached to restore the connection between the calf muscles and the heel bone. This connection is essential for pushing off the ground when walking, running, or jumping, and a fully ruptured Achilles tendon will not reliably heal back to its normal length and strength without the ends being brought back together.
When Is Achilles Tendon Repair Needed?
Achilles tendon repair may be recommended for:
- Younger, more active patients or competitive athletes hoping to return to running or jumping sports
- Patients who want to minimize the risk of the tendon healing in an elongated, stretched-out position, which can lead to lasting weakness
- Certain tear patterns that are less likely to heal well with immobilization alone
Nonsurgical treatment, involving a period of immobilization in a boot, remains a reasonable option for many patients, particularly those with lower activity demands, so the decision between surgery and nonsurgical care is individualized based on age, activity goals, and the specific tear.
How Is Achilles Tendon Repair Performed?
The torn ends of the tendon are identified and reapproximated using strong sutures, restoring the tendon to its normal length and tension. This can be performed through a traditional open incision along the back of the ankle, or through a smaller, minimally invasive approach using several small incisions, which some surgeons prefer for its potentially lower risk of wound-healing problems. In either technique, the goal is the same: firmly reconnecting the tendon ends so they can heal back together at the correct length.
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Recovery After Achilles Tendon Repair
Recovery follows a gradual, staged process, since the tendon needs significant time to heal and regain strength:
- A period of immobilization in a boot immediately after surgery, initially with the foot pointed downward to protect the repair
- The boot is progressively adjusted over several weeks to bring the foot back toward a neutral position as the tendon heals
- Weight-bearing is typically introduced gradually, guided by the surgeon’s specific protocol
- Physical therapy begins once early healing is confirmed, focusing first on regaining motion, then on rebuilding calf strength
- Return to running and higher-impact sports generally isn’t considered until around 6 months or later, once strength testing confirms the repaired tendon can handle the demands of the activity
Following the boot and weight-bearing protocol closely in the early weeks is especially important after Achilles repair, since the tendon is vulnerable to re-rupture if progressed too quickly.
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Dr. Palsis specializes in the treatment of knee, shoulder, and sports injuries.