You just made an awkward pivot/jump followed by the feeling of someone kicking you at the back of your heel. If you didn’t know immediately, you probably just tore your achilles. Like many, you are probably thinking about going into surgery. Before you make this decision, I want to let you know that there is another option. That is correct, achilles tendon tears can heal without surgery. I have experienced an achilles tear myself playing volleyball and decided to opt out of surgery. These are the key points I considered when making my decision.
– No Surgical complications
— Although slim (<1%), there are risks for complications.
– No significant difference in function at 12 month follow up
– No need for casting!
– Lower chance of re-rupture rate
— Nilsson-Helander., 2010 recruited 72 participants for nonsurgical treatment and 71 participants for surgical treatment. There were 6 people in the nonsurgical group who experienced a rerupture and 2 people in the surgical group who experienced a rerupture.
– A cool cast for 2 weeks
Whether you decide to opt for surgery or not, there is one thing you must take into consideration. You will be in a boot for a prolonged period of time. Your boot is going to give you a couple inches of height and you need to even out your other leg to keep the rest of your body aligned. If not addressed, you can develop secondary issues like knee pain, hip pain, back pain etc. If you’re not interested in developing issues elsewhere, I recommend getting a lift on your good side. The lift should be high enough so that when you are standing, your hips are leveled. You can get creative with this. I used the “Even up” and I glued 3 GAP flip flops underneath reinforced with velcro to my shoe.
An achilles tear can be scary, but it doesn’t have to be. You do not have to be limited. For example, I managed to walk around several miles and did some hikes in California a few weeks after my injury inside the boot. If you are looking for some guidance in making the best decision for your situation, come schedule an evaluation with one of our therapists at POST PT.
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Nilsson-Helander et al. Acute Achilles Tendon Rupture: A Randomized Controlled Study Comparing Surgical and Nonsurgical Treatments Using Validated Outcome Measures. AJSM. Volume 38 Number 11 2010: 2186-2193.
Mattila VM et al. Declining incidence of surgery for Achilles tendon rupture follows publication of major RCT’s: evidence-influenced change evident using the Finnish registry study. Br J Sports Med. 2015; 49: 1084-1086