What is an Achilles?
The Achilles tendon is the largest, strongest tendon in the human body. Tendons are long, tough cords of tissue that connect muscle to bone. The Achilles tendon is located in the back of the heel and connects the heel bone to the calf muscle. It helps a person walk, run and jump. The Achilles tendon is able to endure stress, but sometimes injury can occur to the tendon when it is overly stressed. The achilles tendon must withstand very high forces, especially when jumping and landing. For example, a force equal to eight times your own body weight acts on the Achilles tendon when running.
What causes an Achilles Tear or Rupture?
Sports injuries are the most common cause of ruptures of the Achilles tendon. Also, achilles tendons are especially susceptible to tearing in males in their mid-30s. Men account for about 80% of Achilles tendon ruptures. A majority of my patients who have suffered an achilles rupture have been this age group playing basketball.
Other causes include:
- Running uphill;
- Running on a hard surface;
- Quickly changing speeds from walking to running;
- Playing sports that cause you to quickly start and stop.
Symptoms of Achilles tendon rupture include the following:
- A pop or snap when the tendon tears
- Severe pain in back of the ankle, making it difficult to walk
- Swelling and discoloration
- Tenderness
- Inability to rise on the toes
- A gap in the back of the ankle where the tendon ends separated after the tear.
What is an Achilles Repair surgery?
Surgery is recommended for those who are young to middle-aged and active and is an outpatient procedure, meaning you can go home the same day. The surgeon will make an incision through the skin and muscle of your calf to reach the damaged part of your achilles tendon. Then, the ruptured tendon is sewn together to repair and in some cases a tendon from a different muscle is used to help repair. Afterward, the leg is put into a splint cast or walking boot. Healing is nearly complete in about 4 to 6 months. However, it can take up to a year to return to sports fully.
In some cases, achilles repair surgery will not be recommended or necessary. In this case your foot and ankle are flexed downward in a cast or boot. The cast or a boot will stay on anywhere from 8 to 12 weeks. Physical therapy will follow.
What to expect from physical therapy after an Achilles Surgical Repair?
Rehabilitation for an Achilles tendon rupture helps you regain strength and flexibility in the tendon and leg.
Your rehab program may include:
- Stretching and flexibility exercises.
- Strengthening exercises.
- Endurance activities, such as riding a stationary bicycle.
- Coordination and/or agility training.
Physical Therapy usually starts while you are still in your walking boot. You will be able to remove your boot during physical therapy and do gentle exercises under their supervision and following a specific protocol. Progressions into full weight bearing and ability to strengthen it do not typically start until around week 8.