As discussed in an earlier post, the Achilles tendon is the largest tendon in the body. Even so, because of it’s poor blood supply and the potential forces generated within the tendon during activities, it is susceptible to tearing. Achilles tendon ruptures most often occur while running and jumping. They can also occur from a number of other activities, such as landing from a fall from a height. Most often these injuries occur in males between the ages of 30-50. When you tear your Achilles tendon, it can be disabling. That’s why treatment is so important. Achilles tendon rupture treatment comes in two types: Nonoperative and operative.
Achilles Tendon Rupture Treatment: Nonoperative Treatment
Many tendons have a relatively good potential to heal without surgery. The Achilles tendon is one of those. If the ruptured ends of the torn tendon are approximated to one another very quickly after the injury and then the ankle is immobilized with the foot in a toe down position for approximately two months, the tendon will usually heal. In fact, the healing rate is similar to the surgical approach.
The problem with this treatment, however, is that typically there is a delay in initiating treatment. By delaying approximation of the two ends, blood clot and ultimately scar develops between the ends of the torn tendon. Additionally, maintaining the ankle fixed in a toe down position for the necessary time is often difficult and hard to sustain. Both of these problems often lead to a thinner healed tendon and therefore higher rerupture rates. Furthermore if the tendon tear does not heal, the tear gap can widen. This makes later surgery more difficult and less predictable.
Achilles Tendon Rupture Treatment: Operative Treatment
Operative Achilles’ tendon rupture treatment provides lower rerupture rates but comes with risks not seen when surgery is avoided. The surgery is usually performed as an outpatient procedure. It requires either an approximately 6 cm incision centered over the injury site or multiple smaller incisions, depending on the technique used. The postop recovery is similar to that for the nonoperative Achilles’ tendon rupture treatment. Although, since the ends of the tendon are securely tied to one another with strong stitches, the ankle can be freed from immobilization and moved earlier.
Most sports medicine doctors will recommend surgical Achilles’ tendon rupture treatment for younger, active people. For more sedentary, older patients or those with other illnesses that make surgery risky, non operative treatment may be offered.