Achilles Tendon Rupture

  • Medical Author: Steven S. Bhimji, MD, MSc, PhD
  • Medical Editor: William C. Shiel Jr., MD, FACP, FACR
    William C. Shiel Jr., MD, FACP, FACR

    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

What are possible complications of an Achilles tendon rupture?

If a complete rupture of the Achilles tendon is treated nonsurgically, the risk of re-rupture is anywhere from 20%-40%. However, newer data indicate that the risk is much lower. Repeat surgery for Achilles tendon rupture is usually associated with poor results.

Other complications related to surgery include skin sloughing, wound infection, nerve damage, and a protracted recuperation period.

What is the recovery time for an Achilles tendon rupture?

Once the cast is removed, the initial therapy is passive exercises to regain mobility in the ankle joint. After several weeks, more strenuous resistance exercises are incorporated. This is then followed by gait training exercises after about two to three months following the initial treatment. Return to routine activities usually occurs at four to six months. The recovery phase is dependent on the patient's motivation, desired activity levels, and the quality of the physical therapy program.

What rehabilitation exercises are recommended following an Achilles tendon rupture?

Some type of rehabilitation is necessary after injury to the Achilles tendon. For patients with partial rupture who are managed conservatively, rehabilitation should be started once the pain has diminished. Patients who undergo surgical repair of the Achilles tendon do not need physical therapy during the acute phase of healing, but it is highly recommended once the incision has healed

Aggressive physical therapy is the key to recovery. After the cast is removed, the ankle is gently massaged and mobilized to reduce stiffness. After two weeks, active exercises are undertaken. A total of 12-16 weeks of active physical therapy is required for the best results. The ability to return to the previous physical activities is dependent on the motivation and quantity of rehabilitation.

Many exercises can be undertaken following Achilles tendon repair. The exercises usually begin once the pain has subsided. The initial exercises include calf muscle stretching, with and without weights on the foot.

Once flexibility is obtained, strengthening exercise with the knee in extension and flexion are done. Both isotonic and isometric exercises are utilized to regain muscle strength. Once the individual is totally pain free, sport-specific exercises are started. A warm-up is highly recommended prior to any exercise. Jogging, jumping, and sprinting are encouraged for all athletes.

In individuals who develop pain after exercise, a night splint may be worn to help relax the tendon.

Medically Reviewed by a Doctor on 2/19/2016

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