Achilles Tendon RuptureThe Surgery Decision
Your kids may have swung on that tree swing a hundred times without a problem, but one day it suddenly falls to the ground. Hopefully, they weren’t hurt! When you look at the rope where it was tied around the branch, you see lots of frayed ends where it broke. As the swing moved back and forth, the rope fibers began tearing, and finally the last few strands gave way and down it came. A similar thing can happen with an Achilles tendon rupture.
The Achilles tendon at the back of your ankle runs down from your calf muscles and inserts into your calcaneus (heel bone). It transfers the force of those muscles to your feet and allows you to point your toes, rise on tiptoe, and push off for each step. Damage to the tendon is usually associated with exercise—walking, running, jumping—and with tight calf muscles that put extra tension on the connector. Over time, this can cause fibers in the tendon to fray, just as the rope did.
A rupture is defined as any sort of break, but when we speak of an Achilles rupture, it is the most drastic form of tendon tear that completely separates it into two pieces.
How to Fix a Torn Achilles
Like all tissues in your body, torn tendons can mend back together on their own. Of course, you need to provide the right conditions for this to happen: immobilization with a cast or brace, so the tendon is not stressed further, and keeping weight off it as much as possible. This type of conservative treatment is usually reserved for milder cases or situations where sedentary lifestyle and less pressure on the tendon makes future injuries less likely.
For complete ruptures, or even for mild tears in people who want to participate in sports and live an active life, surgery for a ruptured tendon is usually recommended. It makes the tendon stronger and better able to propel you forward during the push-off phase of your stride. It also reduces your risk for repeated tears.
Types of Achilles Tendon Rupture Surgery
Two main methods can be used to repair the tendon. In one, the location of the tear is pinpointed with imaging tests and a small incision made at that spot. Needles with sutures are passed through the skin and Achilles tendon and then drawn out through the incision and tied off.
The second involves a larger incision at the back of the lower leg through which we locate the torn ends, stitch them together, and then close the incision.
Both are usually done on an outpatient basis (you go home that day) and under general anesthesia (you are asleep). You will likely be given a nerve block in the area beforehand to control pain after the procedure, and you will have a splint or cast from toes to knee to keep the ankle immobile as the tendon heals. Physical therapy will be needed to recondition your foot and ankle after surgery.
Tips for Preventing Achilles Tendon Ruptures
Since tight calf muscles are a risk factor for Achilles injuries, we encourage you to practice a regular stretching regimen, and to warm up and do dynamic stretches before your activities.
Shoes are also a factor. Make sure yours properly support your feet, and if you have flat feet and overpronation problems, come see us about a pair of custom orthotics that provide the support you need.
If you haven’t been active, don’t dive into a new program too quickly. Gradual increases in the level and duration of your workouts are the best way to avoid Achilles problems and other sports injuries. Even when your exercise routine is well established, sudden changes can cause issues, so take things slowly.
Care for Your Achilles and More in Southern Orange County
Whatever foot problem is causing pain and limiting your ability to be active, you can find answers for it at Southern California Foot & Ankle Specialists in Ladera Ranch, CA. We serve the larger Saddleback Valley with careful diagnosis, commitment to conservative care, and surgical expertise when it is needed. Call us at (949) 364-9255 (WALK) when your feet need help or connect with us online to learn more or schedule an appointment.