Achilles tendon repair is an operation to stitch together a ruptured Achilles tendon — the large tendon connecting the calf muscle to the heel bone. Rupture typically occurs during sport or sudden forceful movements.
An incision is made along the back of the lower leg over the tendon. The torn tendon ends are identified, brought together, and stitched with strong sutures. The wound is closed and a plaster cast or boot is applied with the foot in a downward (equinus) position. The operation takes approximately 45–60 minutes. Minimally invasive techniques using smaller incisions are also available.
Surgical repair is often recommended for younger, active patients and those who wish to return to sport, as it is associated with a lower re-rupture rate than non-operative treatment. The decision depends on your age, activity level, and the position of the tendon ends on ultrasound.
Functional bracing in a walking boot with progressive heel raises (functional rehabilitation) is a well-established non-operative alternative. Recent evidence suggests that with a structured rehabilitation protocol, outcomes can be comparable to surgery for many patients, with a slightly higher re-rupture rate.
Standard pre-assessment. Plan for limited mobility for six to twelve weeks. You will not be able to drive for several weeks. Arrange help at home.
The aim is to restore calf strength and function and allow return to full activity. Surgical repair typically achieves a re-rupture rate of approximately 2–5%, lower than non-operative treatment. Most patients return to sport, though full recovery of calf strength can take six to twelve months.
The incision site may be sensitive and may thicken initially.
Ankle stiffness is expected initially and improves with physiotherapy.
Some residual reduction in calf strength compared to the uninjured side is common.
The skin over the Achilles tendon has relatively poor blood supply. Wound breakdown can occur, particularly in smokers.
The repaired tendon may rupture again, especially if loaded too early. Approximately 2–5%.
The sural nerve runs close to the tendon. Injury causes numbness on the outer side of the foot.
Wound infection requiring antibiotics.
DVT risk during the period of immobilisation.
General, spinal, or regional anaesthesia. A local anaesthetic block around the ankle provides post-operative pain relief.
A cast or boot is worn for approximately six to eight weeks. Weight-bearing progresses from non-weight-bearing to partial and then full weight-bearing, guided by your surgeon. Physiotherapy begins after the cast is removed and focuses on calf strengthening and ankle mobility. Return to gentle sport at four to six months; high-level sport at six to twelve months. Full calf strength recovery may take up to a year.
Review at two weeks for wound check and change of cast/boot. Further reviews at six weeks and three months. Physiotherapy is essential.
Not necessarily. Non-operative treatment with structured rehabilitation is a valid alternative for many patients. Your surgeon will discuss which approach is best for your situation.
Typically at four to six months, depending on recovery. Return to competitive sport may take longer.
Most patients regain good functional strength. A small reduction in peak calf power compared to the uninjured side is common.