Torn Achilles Recovery Time

Though it is the most inflexible tendon in the human body, the Achilles tendon is widely regarded as one of man’s most significant vulnerabilities. This tendon provides an insurmountable amount of function to our bodies – from stabilizing the lower legs to providing forward thrust for our movements; the human body would be much less functional without the Achilles tendon.

Due to its particular use, position on the human body, and outside stressors, the Achilles tendon is especially susceptible to tear, rupture, and degeneration. These types of injuries may occur slowly over time or may be due to solid and sudden forces.

In either case, surgical intervention may be recommended to repair any outstanding damage to the Achilles tendon. With surgery comes some inherent risks, however.

Anatomy of the Achilles Tendon

The Achilles tendon is a band of tough, fibrous tissue that connects the muscles in the calf to the heel bone of the foot (known as the calcaneus). The Achilles tendon may also be called the calcaneal tendon or heel cord.

The Achilles tendon begins at the calf muscles of the posterior superficial compartment. Muscles within this compartment include:

• Plantaris: A tulip-shaped muscle located behind the knee. At its end, a long, slender tendon stretches from the mid-calf and becomes a portion of the Achilles tendon.
• Gastrocnemius: One of two significant muscles that make up the calf. It is separated into two portions – the outer (facing away from the body’s center) and inner (facing towards the inside of the body) heads. Its function within the Achilles tendon is to stabilize the lower leg and bend the knee and foot.
• Soleus: Runs from the underside of the knee to the heel. It is involved in standing and walking. The soleus is Heavily reliant on the gastrocnemius and Achilles tendon to provide function.

These muscles converge at about 6 inches above the heel and join into the Achilles tendon, which stretches to the back of the heel. The Achilles tendon can pull on the heel by flexing the calf mentioned above muscles, allowing us to stand on our toes when running, walking, and jumping.

The Achilles tendon is the largest and what some may consider the strongest tendon in the human body. According to one study, the Achilles tendon can “receive a load stress 3.9 times body weight during walking and 7.7 times body weight when running.”

Despite its strength, the Achilles tendon is one of the most vulnerable parts of the human body. Weak blood supply and high tension make the Achilles tendon susceptible to degeneration and rupture.

Diagnosing an Achilles Tendon Tear

An absolute Achilles tendon tear will be immediately apparent to the person who just sustained such an injury. Along with instability, a person with a completely ruptured Achilles tendon will lose the complete function of the heel.

Though they may find they can still wiggle their toes and perhaps have minor foot movement, a complete Achilles tendon tear will not allow any movements beyond that.

What is much more challenging to diagnose is the presence of microtears in the Achilles tendon. Over time, these microtears will deepen and worsen and may lead to some of the same symptoms as an absolute tear. This is why seeking a trained medical diagnosis is essential after sustaining any injury to the lower leg, heel, and ankle.

Physical Exam and Medical History

Before any intervention occurs, doctors will perform routine medical exams to guide a more in-depth diagnosis. A patient’s medical history will unveil any past trauma that may be impacting the functionality of the Achilles tendon. It can help doctors more accurately pinpoint the current cause of distress.

A physical exam is soon to follow. Your health team will examine your ankle by testing its range of motion. They will apply pressure to extend the ankle past its outer limits and may palpate the area to induce a pain response. They may ask the patient to stand and place all their weight on a single foot.

Any number of physical means can be used to assess the condition of the Achilles tendon, but if these tests are conclusive, they will only lead to one route – medical imaging.

Imaging Tests

Imaging tests are ordered to confirm the suspicion of an Achilles tendon tear. These tests allow doctors to see the inside structures within the ankle and to observe any oddities or damage that may be causing the patient’s dysfunction. Standard imaging tests include:

• X-ray: While these tests do not show the Achilles tendon, they will be used to identify issues with the foot and lower leg bones to determine if another problem, such as osteoarthritis, is linked to the patient’s pain or dysfunction.
• MRI: By using magnetic fields and image-capturing devices, doctors can examine the health of the soft tissues within the ankle with an MRI. While these tests are helpful, they may be unreliable as specific structures within the ankle may resemble an Achilles tear. MRIs and other tests listed here will help ensure the Achilles is the issue.
• Ultrasound: These tests map the ankle’s soft and complex structures using sound waves. They can help doctors determine if soft tissues are adequately located or if some may get caught in the ankle joint during movement.

With other possibilities eliminated and if conservative treatments fail, surgical intervention is ultimately the last option for treating an Achilles tendon tear. While surgical intervention for an Achilles tendon tear is common, many patients come into surgery unprepared for what to expect.

Any patient planning to treat their Achilles tendon tear through surgical means should research every detail heavily before undergoing such an invasive treatment.

Achilles Tendon Tear Surgery Recovery Timeline

Surgery for isolated tears, especially those away from vital organs, is typically minimally invasive. This is also true of Achilles tendon tears, though recovery times may be particularly long depending on the severity of the tear. Additionally, while specific symptoms may be reduced due to conditional side effects, success is highly objective.

Despite these concerns, many patients still opt for surgery as it may be the only treatment option left for their particular issue. Though many factors are out of the hands of the patient, there are certain things they can do to ensure the highest degree of success for their surgery.

Below are some critical points in the surgical process and details of what to expect. Be sure to talk to your doctor about any surgery-related concerns and questions.

• Preparing for Achilles Tendon Tear Surgery: Successful surgeries begin with adequate preparation. These preliminary steps help ensure patient safety and may be critical in determining the procedure’s outcome.
  • Ensure you understand the type of surgery you are going for – partial repair, degenerative reconstruction, or complete removal/replacement surgery. Each variety of surgery will require different preparatory steps, procedures, and recovery periods.
  • Schedule bloodwork to reduce outside risks such as aversion to anesthetics or uncovering unknown blood or autoimmune disorders.
  • Arrange for a ride to and from the hospital. Patients undergoing Achilles tendon tear surgery will be prescribed medications that may prevent them from driving. It is best to have options when going to and from the hospital.
  • Prepare a small luggage parcel for about two or three days’ worth of trip. Toiletries, entertainment, and clothes may be necessary for the hospital stay.
  • Follow your doctor’s orders to a tee. Suppose they give a timeline to refrain from eating or drinking. In that case, it is essential to follow these guidelines as anesthetics may interfere with the body’s natural digestive processes, leading to complications during surgery.
  • Maintaining an adequate sleep schedule boosts the body’s resilience to post-surgical pain and amplifies its healing processes.
  • Once all preparatory steps are complete, check into the hospital on time to ensure doctors have enough time to complete their pre-surgical procedures.
• The Procedure: Achilles tendon tear surgery is typically performed with minimally invasive tools such as an arthroscope. Surgery may take a couple of hours, after which doctors will monitor the patient’s vital signs to ensure the body responds to surgery well.
  • Patients are typically placed under anesthesia until they fall asleep before surgery.
  • Doctors will begin the surgery with small incisions in the ankle, followed by the insertion of a tiny device known as an arthroscope. The arthroscope creates a small tunnel that burrows through the knee, pushing away surrounding tissues.
  • The doctors can place several small tools within the arthroscope to directly see what they’re working on and operate on the tissues.
  • Depending on the condition of the Achilles Tendon, the doctor will remove small portions of it or the entire thing if its condition is immedicable.
  • The doctor will either sew the ruptured Achilles tendon back together, remove degenerated portions of it, and sew it back together, or remove it and replace it entirely. Understanding your medical diagnosis is critical in determining how long surgery will take; the worse the condition of the Achilles tendon, the longer the surgery will take.
  • Once the surgery is finished, doctors will remove the arthroscope and close the incisions.
• First Few Hours After Surgery: Anesthesia will be applied routinely throughout the first few hours after the surgery. Doctors will monitor vital signs to ensure the surgery is successful. Achilles tendon tear surgery is typically very low-risk, and complications are rare.
• 1-2 Days After Surgery: Recovery from Achilles tear surgery is short. While regular functionality isn’t immediate, patients will be tested for movement within 1-2 days after surgery.
  • A physical therapist will be assigned to you and begin a routine of light exercises to help stabilize the ankle.
  • Assisted standing and walking may be asked of you during the sessions immediately following surgery.
  • Sometimes, patients may be asked to perform these light-weight-bearing tasks on the same day of their surgery.
  • You will be released from hospital care and told to monitor your recovery at home. High fever, excessive bleeding, and escalating pain should be reported to your healthcare team immediately.
• One Week After Surgery: Patient activity levels will gradually be increased.
  • Once the patient is home, they will be asked to follow the routines their physical therapist taught them and apply any medication the doctors prescribed.
  • Creams, ointments, and medication should be taken as routinely as the doctors have prescribed, and activity levels should be moderate.
  • Simple physical therapy such as massage and hot/cold treatments can be applied if medication and rest do not help alleviate post-surgical pain. Consult a doctor if the pain becomes excruciating or if you suffer an ankle injury immediately following replacement surgery.
  • After ten days, the stitches placed to close the wound will be removed, and a follow-up exam will occur.
• One Month After Surgery: Light activities can resume, and physical therapy may intensify.
  • At this point, the surgical wounds should be healed, and normal activity levels should resume, albeit with minimal pain and discomfort.
  • Extended use may cause flare-ups of pain, but these bouts of pain should wane over time as the wounds fully recover.
• One Year After Surgery: The surgical pains should be gone, and normal activity levels should return. While pain and discomfort may be inevitable, they should not be so excruciating that they prevent functionality.
  • Patients should expect a reduced range of motion and decreased weight-bearing capabilities on the leg that was operated on.
  • Environmental stresses – high elevation, humidity, excess cold/heat – sometimes trigger pain. This is normal and should only be examined if the pain does not subside once environmental factors have been eliminated.

Before applying surgical intervention to any issue, it may be best to consult specialized medical professionals, for even if conservative treatments have been used, there may be other alternatives a patient will not know to consider.

One treatment that may help repair light Achilles tendon damage or reduce recovery periods post-surgery is regenerative therapy.

Regenerative Therapy and Achilles Tendon Tears

Regenerative therapy is a rapidly advancing sector of alternative treatments for soft-tissue-related injuries. By harvesting adult tissues directly from a patient, processing them, and then transplanting those processed tissues back into the patient, regenerative therapies help to amplify the body’s healing processes and repair damaged soft tissues in our bodies.

Regenerative therapies come in two major branches – platelet-rich plasma therapy and autologous stem cell procedure – each with benefits.

Platelet-Rich Plasma Therapy for Achilles Tendon Tears

PRP injections use a concentrated mixture of one of the body’s natural healing factors (platelets) to amplify its internal healing mechanisms. These tissues are already abundant within the body and are used to repair many of its internal structures.

By harvesting these tissues directly from the patient, isolating them, mixing them with growth factors, and reinjecting them, patients can expect shorter recovery periods and better results post-surgery.

Stem Cell Therapy for Achilles Tendon Tears

Autologous stem cell transplants can help provide an environment around injured tissues, which helps increase the body’s healing response/cascade. The source of the stem cells should be taken directly from the patient’s healthy tissues.

Mesenchymal stem cell-rich fat (adipose) and bone marrow can be processed in preparation for transplantation to improve the healing process into a pseudo-stem-cell state. These new methods have been developing over the past couple of decades. Tissues can be isolated and mixed with growth factors, which help instruct these cells in the repair process.

By transplanting your stem cells into the site of an injury, the cells can send out chemical signals that attract the new healing cells necessary to repair the damaged tissues and “differentiate” into new tenocytes (tendon cells) to help heal the damaged Achilles tendon.

Additionally, combining both therapies relieves symptoms, boosts healing processes, and decreases overall Achilles tendon tear recovery time.