Recovering from an Achilles injury is no walk in the park. The Achilles is the largest tendon in your body. It helps you walk, run, jump, and move your foot in every direction. So if you injure or tear it, you won’t be able to do much of anything for a while.
How long it takes for you to heal will depend on how bad your injury is. Tendinitis involves pain and discomfort but no damage to the tendon, so that might be just a few weeks of rest and ice packs. A complete rupture is a totally different story that could take up to a year to heal.
Some people have surgery for Achilles ruptures, and some don’t. In general, those who have surgery have a greater chance of complete healing and a lower risk of injuring it again. No matter which option you choose, here’s what you can expect during recovery.
The Nonsurgical Option
If you haven’t torn your Achilles, you probably won’t need surgery. If the damage is minor, you might be able to rest, apply ice, wear a boot for a while, and have a few physical therapy appointments.
If your tendon is ruptured, your doctor will consider your age, activity level, and how bad the damage is when deciding about surgery. The younger and more active you are, the more likely that surgery will be the answer.
One nonsurgical option is functional bracing where your leg is put in a walking boot. The boot had a wedge in it to force the foot down and stabilize your lower leg. This method of treatment takes about 6 to 12 weeks.
You’ll likely need to wear heel lifts afterward. You’ll also need physical therapy.
This involves exercises, stretches, and other techniques to get you back on your feet. The time you’ll need to spend in physical therapy (PT) depends on how bad your injury is. It may be a few weeks or several months. You may meet with your physical therapist once or twice per week, plus learn exercises to do at home.
The goals of PT are:
- Pain relief. Your physical therapist may use ice, recommend a leg brace, give you ultrasound therapy, or use other ways to ease your pain.
- Proper movement. For different reasons, your ankle, foot, or knee joints may not move the way they should. This can strain your Achilles tendon. To correct these problems, a physical therapist may show you exercises or use hands-on techniques to ease the tension.
- Muscle strength and balance. Weak muscles or a muscle imbalance can take a toll on your Achilles tendon. In physical therapy, expect strength-building exercises tailored for you. These exercises will most likely include activities for core, hips, and knees.
Physical therapy shouldn’t hurt, though some of the exercises may be uncomfortable.
Recovery After Surgery
Achilles surgery takes only about 30 minutes to an hour, and you’ll go home the same day. The surgeons will put you in a cast that extends from below the knee to your toes. It’ll keep your foot in a pointed position.
Below is a timeline for what happens after that. Of course, this isn’t exactly what recovery will look like for everyone. Your progress will depend on your age, health, how bad your injury is -- and how well you stay with your rehab.
- Day of surgery: When you leave the hospital, you’ll get crutches and instructions not to put weight on the injured leg.
- In 2 weeks: Your doctor will take off your cast to remove the stitches and check how the wound is healing. Depending on how it looks, you could go back into the cast, but more likely you’ll get a walking boot. It’ll have a heel lift to keep your foot and ankle in the right position. You’ll also start rehab. The goal is to let the wound heal while you do some upper-body work. All your weight will still be on the crutches.
- By 4 weeks: The boot will be moved gradually to a neutral position (with heel lifts), and in rehab you’ll learn to walk on it correctly. Your physical therapist will move your ankle a bit and start to show you exercises that’ll help strengthen your calves. You’ll also do more work on your core and hips.
- Between 6 and 8 weeks: You’ll have fewer rehab appointments and should be able to stand on the injured leg for 10 seconds at a stretch. The boot could come off during this time, too. You can do more activities now, but still no high-impact exercise. Your therapist might recommend swimming or biking.
- At 4 to 6 months: You should be back to full activity, but you won’t be totally recovered until about a year after surgery. Even then, your strength might never get back to 100%.
Whether you have surgery or not, you’ll probably be wearing special devices in your shoes at some point during your recovery process. Your doctor and physical therapist won’t want you to use a boot for too long. They’ll get you out of it as soon as it’s safe.
The main job of orthotics is to keep your heel raised so the tendon doesn’t have to work so hard. Many people with Achilles issues are bothered when shoes rub on their ankles. To prevent this, there are other products that cover the back of your ankle or move it away from the shoe.