A torn Achilles tendon is a notoriously difficult injury to recover from.
Top athletes describe tearing their Achilles tendon like being kicked in the back of the leg. They often say they feel and hear a pop as they fall.
But professional athletes aren’t the only ones who end up with a torn Achilles tendon—weekend warriors do too.
Typically, it’s about 10 months to a year before patients are back to doing what they were doing before tearing their Achilles.
To better understand the process of treating Achilles tendon injuries, we talked to Dr. Timothy Charlton, associate professor of orthopaedic surgery and co-director of the Foot and Ankle program at Cedars-Sinai.
What causes a torn Achilles tendon?
Dr. Charlton: Tearing your Achilles tendon is typically related to sports.
Usually the tear happens when your momentum is going backward and then you decide to move forward. An example is backpedaling for an overhead in tennis and then striding forward to hit the shot.
Is surgery the only option for repairing a torn Achilles tendon?
Dr. Charlton: There are a few options.
A traditional open surgery is the most popular method for top athletes hoping to get back to peak physical ability in the shortest amount of time possible.
The biggest drawback to open surgery is the potential for infection. If the Achilles tendon gets infected, it could mean a long and complex recovery.
Closed treatment (without surgery) has been shown to be effective in healing the Achilles, but there are signs that forgoing surgery can lead to a greater chance of it being re-torn in the future.
Finally, there’s a happy-medium approach, which is minimally invasive surgery. This technique has the benefits of open surgery—such as less risk of being re-torn—while limiting the likelihood of infection.
How long does it take to recover?
Dr. Charlton: Typically, it’s about 10 months to a year before patients are back to doing what they were doing before tearing their Achilles.
Life is about managing expectations: The top athletes have the best trainers and nutritionists to get them back in the game, and even then it can take 9 months or longer for them to recover.
Besides a torn tendon, are there other kinds of Achilles injuries?
Dr. Charlton: You can have an Achilles tendon that is working overtime or too hard and hasn’t torn. This is called tendinopathy. Classic signs are tenderness where the Achilles hits the heel bone, right in the back of the shoe.
The second area where tendinopathy happens is called the watershed area, where the tendon is thick and sore just above where the shoe hits the back of your foot.
How is tendinopathy treated?
Dr. Charlton: Tendinopathy is a lingering problem where it takes at least 3 months for patients to really start improving.
Rest, ice, even wearing cowboy boots can help the tendon rest and decompress.
Also, anti-inflammatories, physical therapies, and stretching at home will all contribute to healing tendinopathy.
How can we best protect our Achilles tendons?
Dr. Charlton: Stretching and being sufficiently strong and flexible are all important.
Also, I suggest staying within the boundaries of your own physical ability when being active. Exercise and sports should be about fun and not about pushing your body to the point of potential catastrophic injury—this is always a good strategy.