Achilles Tendon Repair

Achilles Tendon Repair

An Achilles tendon injury can be painful, frustrating, and life-limiting. The tendon is essential for walking, running, and even standing on tiptoe, so when it tears or ruptures, every step becomes difficult. At Princeton Brain, Spine & Orthopedics, our orthopedic specialists offer advanced Achilles tendon repair surgery designed to restore mobility, reduce pain, and help patients return to the activities they love.

What is the Achilles Tendon?

The Achilles tendon is the largest and strongest tendon in the body, connecting the calf muscles to the heel bone. It allows your foot to point downward – a motion called plantar flexion – which powers movements like walking, climbing stairs, sprinting, and jumping.

Despite its strength, the Achilles tendon is vulnerable to injury because it bears tremendous forces and has a limited blood supply. Overuse, sudden trauma, or degeneration over time can lead to conditions such as:

• Achilles tendinitis or tendinosis (inflammation or wear-and-tear damage)
• Partial tears (microtears in the fibers)
• Complete ruptures (the tendon fully separates)

These injuries are common among athletes, active adults, and “weekend warriors,” but they can also occur during everyday activities if the tendon has been weakened.

What is Achilles Tendon Repair?

Achilles tendon repair is a surgical procedure to reconnect and restore a torn or severely damaged tendon. When the tendon ruptures completely, the two ends no longer function together, leaving patients unable to push off the ground effectively. Surgery involves stitching the tendon ends back together or, in more complex cases, reinforcing or replacing the tendon using nearby tissue.
This procedure is typically recommended when:

• A complete rupture prevents walking normally or standing on tiptoe
• Non-surgical treatments (like casting, bracing, or therapy) are unlikely to restore full function
• The patient is active and wishes to return to sports, work, or high-demand activities

Prompt diagnosis and repair are critical; acute ruptures treated within six weeks generally heal more successfully than chronic, untreated injuries.

When is Surgery Recommended?

Not every Achilles injury requires surgery. Minor strains or tendinitis often respond to rest, bracing, and physical therapy. However, surgery may be the best option if you have:

• A full or significant partial tear confirmed by imaging or physical exam
• Persistent tendon pain and weakness despite conservative treatment
• A desire to return to sports or active work that demands strong ankle function
• Good overall health with no major surgical contraindications

For older or less active patients, non-operative care may be considered. But for active individuals, surgical repair often provides a lower risk of re-rupture and a quicker return to function.

What to Expect During Surgery

Achilles tendon repair is typically performed under regional or general anesthesia and takes about one to two hours.
Surgical techniques may include:

• Open repair: A small incision is made at the back of the ankle, and the torn tendon ends are stitched together with strong sutures.
• Minimally invasive or percutaneous repair: Smaller incisions and specialized instruments reduce trauma to surrounding tissue, lowering the risk of wound complications.
• Tendon transfer: In chronic or complex ruptures, another tendon – often the flexor hallucis longus – is used to reinforce or replace the Achilles when direct repair is not possible.

Once the tendon is repaired, the incision is closed and the ankle is immobilized in a boot or cast to protect the repair as healing begins. Most patients go home the same day.

Recovery

Healing is a progressive process, requiring both protection and rehabilitation:

• Weeks 0–6: The ankle is immobilized in a plantar-flexed position with a boot or cast. Depending on the surgeon’s protocol, partial weight bearing with crutches may be allowed. Heel lifts are often used to reduce tension on the tendon.
• Weeks 6–12: Physical therapy begins, focusing on gentle range of motion exercises, flexibility, and gradual strengthening of the calf muscles. Controlled walking is usually introduced during this phase.
• 3–6 months: Patients regain strength and mobility, returning to most normal daily activities. Low-impact sports and exercise may be resumed with clearance from the surgeon.
• 6–12 months: Full recovery, including return to high-impact sports, can take up to a year. Ongoing physical therapy helps restore endurance, balance, and confidence in the repaired tendon.

Recovery is highly individualized. Strictly following post-surgical instructions, attending physical therapy, and avoiding smoking are key factors that improve healing and reduce complications.

Why Choose Princeton Brain, Spine & Orthopedics

Our specialists are highly trained in foot and ankle surgery, using both traditional and minimally invasive approaches based on each patient’s needs. We provide:

• Personalized treatment plans tailored to your health, activity goals, and recovery timeline
• Comprehensive rehabilitation with skilled physical therapists to maximize function
• Advanced imaging and surgical techniques to ensure precise diagnosis and repair
• A patient-centered approach that emphasizes education, communication, and long-term outcomes

Choosing Princeton Brain, Spine & Orthopedics means partnering with a dedicated team committed to helping you heal fully and return to an active lifestyle.

Start Your Recovery Journey Today

Achilles tendon repair is often the most effective way to restore function after a severe tendon injury or rupture. With expert surgical care, comprehensive rehabilitation, and ongoing support, most patients achieve excellent results and return to the activities they enjoy.
If you’re experiencing pain, weakness, or suspect an Achilles tendon injury, contact Princeton Brain, Spine & Orthopedics today to schedule your consultation and take the first step toward recovery.