Other treatments are often used for Achilles tendinopathy and rupture. Before using other treatments, you most likely will try rest and medicine to reduce pain and swelling.

Achilles tendinopathy

For Achilles tendinopathy, consult with a physical therapist about the best treatments for your condition. Common physical therapy treatments for Achilles tendinopathy include:

• Stretching and flexibility exercises to help your tendon heal without shortening and becoming chronically painful.
• Ultrasound heat therapy to improve blood circulation, which may aid the healing process.
• Transcutaneous electrical nerve stimulation (TENS), to provide pain relief for some people.
• Massage, to help increase flexibility and blood circulation in the lower leg and to help prevent further injury.
• Wearing a night brace to keep your leg flexed and prevent your Achilles tendon from tightening while you sleep. An Achilles tendon that often tightens at night is not able to heal properly.

If other treatment does not reduce your Achilles tendinopathy pain, your health professional may recommend using a cast, brace, walking boot, splint, or other device for 4 to 6 weeks to prevent your lower leg and foot from moving and to allow the tendon to heal. This is then followed by physical therapy and modification of activities.

Achilles tendon rupture

A cast or similar device can be used to immobilize a ruptured Achilles tendon, allowing it time to heal on its own. A cast or similar device prevents the lower leg and ankle from moving. Treatment with this type of device may take as long as 6 months to completely heal a tendon. This is usually followed by a rehabilitation program that helps you regain strength and flexibility in the tendon and leg. The rehabilitation program may include physical therapy as noted above.

Your decision about whether to have surgery or use a cast-type device may depend in part on your:

• Attitude toward reinjury and complications. Immobilizing your leg is more likely than surgery to result in another rupture but is less likely to result in complications, such as wound infection.⁵
• Level of activity. If you are very active in sports or have a job that requires leg strength and you want your leg to be as strong as it was before your injury, you may consider surgery.
• Age. If you are an older adult who does not participate in activities that may result in another rupture, and who does not want the added risk of surgery, you may prefer immobilizing your leg.
• Medical condition. If you have another medical condition-such as diabetes or heart or lung disease-that raises the risks associated with surgery, immobilizing your leg may be a better treatment for you.
• Time of injury. Surgery is generally recommended if the rupture is more than 2 weeks old.