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The Achilles tendon is the largest in the human body. The Achilles tendon is made up of the two calf muscles (gastrocnemius and soleus muscles).
The Achilles tendon runs along the back of your leg and ankle and inserts into the back of the heel. It is responsible for helping you lift your foot off the ground when you walk or run.
Unfortunately, this tendon is susceptible to injury, particularly in athletes who put repetitive stress on the tendon. However, ruptures can happen in non-athletes as well during activities like jumping and dancing.
When the Achilles tendon becomes ruptured or torn, surgical repair is often necessary.
Find out the difference between torn and ruptured Achilles tendons in this supplemental post: How Do You Know If Your Achilles Tendon is Torn Or Ruptured?
Symptoms of Achilles Tendon Ruptures
Achilles tendon rupture symptoms usually come on suddenly with a sharp pain in the back of your leg or calf followed by swelling. The pain starts immediately after the injury.
Common Symptoms of Achilles tendon ruptures:
- A “popping” or “snapping” sound during time of injury
- Difficulty moving your ankle or foot to push off when you walk
- Pain that worsens when bearing weight on the affected limb
- Bruising in the ankle and heel
- A palpable defect along the Achilles tendon
- Weakness of the ankle
- Loss of balance
What to Expect- Surgical Procedure
If you and your doctor have decided that surgery is the best course of action for your Achilles tendon rupture, here’s what you can expect from the procedure.
Surgery would be done in the hospital or outpatient surgery center. First, you will be given general anesthesia to keep you comfortable during surgery. Next, your Podiatrist or Orthopedic surgeon will make an incision in the back of your leg, just above the heel bone. Once the incision has been made, your surgeon will repair the ruptured tendon by stitching it back together using a suture (thread).
In some cases, a graft may be necessary to provide additional support to the repaired tendon. The graft may be taken from another part of your body or a donor. Once the graft is in place, your surgeon will secure it with sutures.
If the Achilles rupture defect is very large, your doctor may choose to transfer another tendon in your body (Flexor Hallucis Longus tendon) to the Achilles tendon to provide it with further strength.
Finally, your surgeon will close up the incision with stitches or staples and apply a cast or splint to allow for proper healing. Surgery will take anywhere from 90-120 minutes. You will be discharged home after the surgery.
What to Expect- Recovery
After surgery, it is important to follow your surgeon’s instructions for care and rehabilitation. Depending on the extent of your injury, you will need to wear a cast for six to eight weeks after surgery and remain non-weight bearing during this time. You can use a knee scooter or crutches to help you stay off of your feet.
You can sleep on your back or side while wearing a cast or splint.
When you take a shower, make sure to use a cast protector to prevent the cast from getting wet. You can buy one on Amazon.
Around the 6-8 week mark, if you are healing well, your doctor will allow you to bear weight in a cast boot for several weeks before transitioning into an athletic shoe.
Physical therapy will also be an important part of your recovery process. You will need physical therapy 3 times a week for at least 1 month after the surgery. Physical therapy can help improve strength, decrease pain, and improve balance.
Full recovery after Achilles tendon repair can take anywhere from 3-6 months.
Complications of Achilles Tendon Rupture Surgery- What to Expect
Infection: One of the most common complications following any type of foot surgery is infection. The incision site for Achilles rupture surgery is particularly susceptible to infection because it is located in an area where there is a lot of movement and stress. Not only that, shoe gear can rub on the back of the leg/ankle and cause the surgical incision site to open.
This increases the chance of bacterial Infection. Infections can delay healing. It is important to keep the incision clean and dry to help prevent infection. Avoid wearing any constrictive shoes that rub against your incision site. If you develop any signs or symptoms of infection, such as redness, swelling, or drainage from the incision, you should contact your surgeon immediately.
Nerve Damage: Another possible complication of Achilles rupture surgery is damage to the nerves in the leg. This can cause numbness, tingling, or weakness in the affected area. Nerve damage is usually temporary and will improve with time. However, in some cases, the nerve damage can be permanent.
Blood Clots: Blood clots are another potential complication following foot surgery. Although they are more common after surgeries that involve immobilization, such as hip or knee replacement surgery, they can also occur after Achilles rupture surgery. When your leg is immobilized for weeks, a deep vein thrombosis (DVT) can form.
Blood clots can cause pain, swelling, and warmth in the affected area. They can also lead to more serious complications such as pulmonary embolism (a blood clot that lodges in the lungs) or stroke. If you experience calf pain after surgery, chest pain, or shortness of breath, you should contact your surgeon immediately.
When Can I Drive After Achilles Tendon Rupture?
You can drive when you can bear weight and walk on foot. It can take roughly 6 weeks. If you are still wearing your cast boot and your ankle range of motion is strong, you can switch to wearing a tennis shoe when driving. You should avoid driving with a cast boot on. It’s important to avoid driving when you are taking narcotics.
An Achilles tendon rupture is a serious injury that requires prompt medical attention. If you suspect you may have ruptured your Achilles tendon, it’s best to see your local foot doctor to be evaluated. You may need surgery to ensure a fast recovery.
Have you ruptured your Achilles tendon before? How long did it take to heal? I would love to hear your thoughts. Leave a comment below!
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