Medically Reviewed by Paul J. Weatherby, MD

The Achilles tendon is one of the strongest tendons in the body, connecting the calf muscles to the heel bone. It plays a key role in walking, running, and jumping. Because it bears a lot of stress during these activities, the Achilles tendon is also prone to injury. When a severe injury occurs, Achilles repair surgery may be necessary to restore function and relieve pain.

Most Achilles repairs are needed after the tendon ruptures or tears. Ruptures often happen during sports or activities that involve sudden starts and stops, such as basketball, tennis, or sprinting. These injuries are common in middle-aged or active adults. Other conditions that may require surgery include Achilles tendonitis, which is chronic inflammation caused by overuse, and partial tears, which can cause pain and difficulty moving.

An Achilles rupture is a devastating injury and usually causes sudden, sharp pain at the back of the ankle. Many people describe hearing or feeling a snap, followed by weakness or difficulty walking. There may even be a visible gap in the tendon on the back of the leg.

Historically, nonoperative management of Achilles ruptures in a cast was the gold standard. It still may be a viable option for healing if treatment is started within a few days of injury. As more research has emerged, Achilles repair can reduce a re-rupture of the tendon from 8% to about 1%. This has led to more of a conversation with the patients regarding their current activity level, goals and preferences. Either surgical repair or nonoperative treatment might be the best option, depending on the individual.

Achilles repair surgery focuses on reconnecting the torn ends of the tendon and restoring its strength. Previously, the most common method was open repair. Newer techniques have emerged in the realm of minimally invasive techniques and anchoring the tendon into the heel bone. This has proven to have lower wound complications than the traditional open approach. If the tendon is badly damaged, surgeons may use tissue from nearby tendons or synthetic materials to help strengthen the repair.

After surgery, patients can expect to be in a cast or walking boot for about four to eight weeks with physical therapy. Physical therapy plays a crucial role in rebuilding strength, improving flexibility and restoring balance. Most people can return to daily activities within three to six months. Returning to sports or high-impact activities often takes six to twelve months. Following the rehabilitation plan prescribed by your provider, helps prevent complications like re-rupture or stiffness and ensures the best possible outcome.

Not every Achilles injury requires surgery. Mild tendonitis or small tears can often be treated without an operation. Rest, avoiding activities that cause pain, physical therapy, and anti-inflammatory medications may help the tendon heal. Sometimes, providers may recommend special heel lifts or braces to reduce strain on the tendon.

Achilles repair surgery is an important option for people with severe tendon injuries that affect mobility and quality of life. Understanding the causes, treatment options, and recovery process helps patients make informed decisions on the best option for them. With proper treatment and rehabilitation, many individuals successfully regain full function and return to their favorite activities after an Achilles repair.

Dr. Paul Weatherby performs surgeries and procedures at McLeod Regional Medical Center in practice with McLeod Orthopaedics. Dr. Weatherby provides care for the full scope of foot and ankle orthopedic needs, including Ankle Ligament Reconstruction, Ankle Scope (Arthroscopy), Ankle Replacement and Fusion Surgery, Fracture Repair, Hammertoe Correction, Minimally Invasive Bunion Correction, Morton’s Neuroma Excision, and more. For more information, please call 843-777-7900.