An Achilles tendon rupture can be treated non-surgically or surgically repaired. Your consultant will discuss the options and help you decide the most appropriate treatment for you, taking into account your symptoms and factors like your age and level of physical activity. Non-operative treatment may be possible if the torn ends of the tendon are close together because this can allow the tendon to heal at the correct length, once the calf is placed in a plaster cast or brace for a couple of weeks.
This avoids the need for surgery but does carry a marginally increased chance of reoccurrence of the tendon rupture, and the tendon may not be as strong as it was prior to the injury. Non-surgical treatment requires early diagnosis to place the ankle in the correct position for healing and very specific rehabilitation. These are of critical importance for the success of non-surgical treatment.
Surgical Achilles tendon repair will normally be performed as a day case and will require a general anaesthetic, as well as a local anaesthetic block. This is an injection of local anaesthetic into the back of the knee around the nerves. This is performed under image guidance and helps to minimise post-surgical pain. Using minimally invasive techniques to reattach the tendon ends together can hasten recovery and reduce the chance of the tendon rupture recurring. Physically active, younger individuals are usually good candidates for this procedure.
Your foot will be in plaster after your operation. You will be given crutches and can usually go home the same day. You should not put any weight through your leg during the first two weeks following surgery. After this period, your cast will be removed and you will be given a supportive boot to wear for the next six to eight weeks and you will begin rehabilitation with a physiotherapist.
You can usually drive within three months, earlier if your car is automatic and your surgery was on your left foot. At this point you will be able to return to your usual fitness routine, whilst continuing with your rehabilitation programme as advised by your physiotherapist.
You are likely to be able to return to work in sedentary job within a month, within four months if you have a manual role.
For more details about recovering from Achilles tendon repair, read our downloadable patient information leaflet.
Six months after surgery there should be very little swelling and you may be able to start returning to high-level sport.
Within a year, your Achilles tendon should be fully repaired and you will be able to participate fully in your previous sport and fitness activities.