At Penn Orthopaedics, we are experts in treating every type of injury to the Achilles tendon, including Achilles tendon rupture and Achilles tendinitis.
The Achilles tendon is a strong, fibrous band of tissue that connects the muscles in the back of your calf to your heel bone. We rely on the Achilles tendon to bear stress needed for walking, running and performing any recreational activities. When the Achilles tendon becomes inflamed, ruptured or injured, it can be extremely painful and greatly interfere with daily activities and quality of life.
Our multidisciplinary team of orthopaedic surgeons and sports medicine physicians is highly experienced in the treatment and management of Achilles tendon injuries. We are involved in robust research to help further advance treatments for Achilles tendon reconstruction and repair. We offer individualized treatment plans that take into account your activity level and medical history, so you can get back to activities that you enjoy as soon as possible.
Meet the team of experts who specialize in Achilles injuries treatment
Types of Achilles Tendon Injuries
There are two different types of Achilles injuries: acute Achilles rupture and chronic Achilles tendinitis. Achilles rupture means that your Achilles tendon has torn, and Achilles tendinitis means your Achilles tendon has swelled up.
When the Achilles tendon ruptures or tears, you may hear a pop and then feel a sharp pain at the back of your ankle that radiates up your lower leg. An Achilles rupture can occur as a result of age, overuse and other underlying problems, such as arthritis that weakens the tendon and makes it susceptible to tears and injury.
If you have Achilles tendinitis, injury or overuse of your Achilles tendon has caused inflammation and swelling. The tendon may become thicker and harden. We characterize tendinitis in two ways, depending on where it is located.
If you’ve been diagnosed with non-insertional Achilles tendinitis, it means there are small tears or injury to the middle of your tendon, which is causing inflammation and pain.
Insertional Achilles tendinitis, on the other hand, occurs in the area where the tendon meets the heel. Bone spurs, or bony growths in the heel, commonly occur with Achilles tendinitis.
Achilles Tendon Injuries Treatment Options
At Penn Orthopaedics, we first use non-invasive treatments to relieve the symptoms of Achilles injuries. We treat each type of Achilles injury differently. When non-surgical treatments do not effectively alleviate pain, a combination of surgical and non-surgical techniques may be used. If you have a more serious tear or injury to your Achilles tendon, your doctor may recommend Achilles tendon repair surgery.
Our orthopaedic surgeons have expertise in the latest advancements to repair acute and chronic Achilles injuries, including minimally invasive microsurgical techniques.
Chronic Achilles Tendinitis Treatment
Chronic Achilles tendinitis due to overuse can be painful and debilitating. Non-surgical techniques can help treat chronic Achilles tendinitis.
Some therapies and medications for Achilles tendinitis we may recommend include:
- Modifying your daily activities
- Anti-inflammatory medications
- Corticosteroid injection
- Custom orthotics (shoe inserts)
- Icing the area
- Physical therapy: Under the supervision of your doctor or physical therapist, exercises that stretch the calf and heel may help.
- Shock wave therapy: High-energy shock wave impulses stimulate blood flow in the foot, promote healing of tissues and help reduce pain.
Chronic Achilles Tendinitis Surgery
- Debridement of the Achilles Tendon: During the debridement procedure, we remove damaged portions of the Achilles tendon and repair the tendon with small stitches. We also remove any bone spurs, or tiny projections along the edges of your bones, which may have developed with the damage to your tendon. We use special hardware, such as metal or plastic anchors, to help hold the Achilles tendon in place. After debridement, you will likely need to wear a boot or cast for several weeks to help the tendon and tissues heal.
- Minimally Invasive Surgery: Patients with chronic insertional Achilles tendinitis that stems from the lower portion of the tendon who have not found relief from conservative management may be candidates for minimally invasive Achilles tendinitis surgery. The procedure entails a small incision on the side of the heel, which allows the surgeon to adjust the angle that the Achilles tendon meets the heel bone in order to relieve tension. Patients spend about 4 weeks on crutches after the procedure, followed by weight bearing and physical therapy. You can expect to return to normal activity around 3 months.
- Tendon Transfer: When the Achilles tendon is too damaged and unhealthy, it may require partial removal. In these cases, an Achilles tendon transfer is necessary. The tendon in the big toe is moved. The new tendon placement helps strengthen the damaged tendon while still allowing the big toe to move.
How to Treat a Ruptured Achilles Tendon
Our orthopaedic surgeons offer a protocolized, evidence-based, non-surgical 12-week physical therapy program to treat acute Achilles rupture. The program requires patients to follow a very specific and defined treatment plan that involves casting, booting and aggressive rehabilitation therapy.
Therapy may include:
- Modifying your activities, resting more frequently, and wearing a walking boot or a cast
- Anti-inflammatory medications
- Corticosteroid injection
- Icing the area
Ruptured Achilles Tendon Repair Surgery
In some cases, surgery may be performed in conjunction with non-surgical techniques. Achilles tendon rupture repair surgery entails making an incision in the back of the lower leg and reattaching the torn tendon. If the tendon is badly torn, a tendon transfer may be necessary.
Ruptured Achilles Recovery
Your recovery will vary depending on the severity of your condition. Most patients with an Achilles tendon injury require up to a year of physical therapy and rehabilitation before they experience the best results. You should speak with your doctor about what recovery may mean for you.