The Achilles tendon is the largest and strongest tendon in the body. It provides the majority of our “push-off” power when we walk and run. When this tendon is ruptured, an Achilles tendon repair is recommended, which is typically performed on an outpatient basis. We explain more about the standard procedure for correcting an Achilles tendon tear below.
Have you suffered a partially or fully ruptured Achilles tendon?
If so, let Dr. Silverman help. For more information about Achilles tendon reconstruction, keep reading.
What Happens Before Achilles Tendon Surgery?
The surgical center will provide your with individualized advice in the days and weeks leading up to your operation. On the day of your surgery, the anesthesiologist will give you a regional anesthesia known as a Popliteal nerve block. You will be given medication to induce “twilight sleep,” then you’ll be placed on your stomach and given a Novacaine-like medication around the nerve in the back of your leg. This gives complete pain relief that lasts for 12 to 36 hours. Patients report extraordinary satisfaction with this type of anesthesia.
What Happens During Achilles Tendon Surgery?
During surgery you will be heavily sedated. An incision will be made along the back of the lower leg and heel. The tendon will be repaired with multiple sutures in order to draw the ends together and allow them to mend under the correct tension. The wounds will then be closed with staples.
What Happens After Achilles Tendon Surgery?
You will be permitted to leave the surgical center once your anesthesiologist is satisfied that you have recovered. During your recovery time a family member may take your prescription to the nearest pharmacy. Take your narcotic pain control medications before falling asleep or as you feel the “numbing” effect wearing off. Remember post-operative pain is much easier to control with prevention. Call to schedule your first post-operative visit for two weeks after surgery when you feel able.
Achilles Tendon Repair General Recovery Guideline
This timeline is a general guideline. Your post-operative course may vary.
| Elevation | 23 hours / day for 3 days; then keep elevated as needed. Swelling may last over 4 months. |
| Motion | Move your toes when the block resolves. This will decrease pain and swelling and improve healing. Begin ankle motion at 2 weeks. |
| Walking | Begin partial weight bearing at 2 weeks in the cast or fracture brace with 1” heel lift. If you are in the fracture brace, remove half an inch each week. After the tendon heals at 6 weeks, you may ease out of the boot and gradually resume a normal gait. |
| Bathing | Keep cast dry. Use a DryPro. There are no restrictions after the cast is removed. |
| Pain Control | Expect to use strong narcotics for the first 3-5 days. Ease off as soon as you are comfortable using Tylenol or Motrin. |
| Work | Return depends on specific demands. It is safe to return to sedentary work at 10 days post-op. Return to heavy labor will take at least 3 months. Return to sprinting and heavy running will take 4-5 months. |
| Driving | Patients with left foot surgery may drive an automatic transmission. Patients with right foot surgery may drive with their left foot or wait until healing is adequate and they feel safe. |
Routine Clinic Visits
| 2 weeks | Cast and suture removal. Apply cast or fracture brace. |
| 6 weeks | Begin transition from brace and start physical therapy. |
| 3-4 months | Return for recheck. Minimal feelings of discomfort may linger, your overall comfort/strength level improves over a year. |
| ********** | If at any time during your post-operative period you notice any drainage or foul odor from your incision, a temperature of more than 100.4 degrees and/or increased swelling or tenderness, you should contact our office. |
For more helpful tips, check out these rehab exercise videos that will help you recover, or reach out to Dr. Silverman for more information!