Finding yourself facing an unsettling injury like an Achilles tear can be daunting. Understanding the Achilles tear recovery time becomes essential for anyone looking to step back into their routine, and eventually, return to sport with confidence. Treatments can range from surgical to non-operative, depending on the degree of the tear and determining the prior level of function a specific person is trying to reach. Someone who is trying to get back to living a normal life who only needs to worry about climbing stairs and getting in and out of a car is going to have a very different rehab approach from someone trying to return to playing soccer or other sport. This article will address what to expect from a rehabilitation approach, discuss what to expect in terms of recovery time, and different types of treatment options.
**This is not medical advice. Please consult your medical provider for more information.
Understanding Achilles Injuries
Not all Achilles injuries are the same. They can range from mild tendinitis to a complete rupture. The type of injury you’ve sustained directly influences your recovery time and the treatment options, including whether you’ll need surgery for Achilles rupture or can rely on nonsurgical treatment.
The use of a CAM boot to protect the injured Achilles paired with physical therapy are important aspects in the healing process. For those with less severe injuries, incorporating orthotics and anti-inflammatory drugs might suffice to alleviate pain and aide recovery. In more severe cases, your doctor might suggest platelet-rich plasma (PRP) injections or surgery to speed up the healing process.
Remember, the path from injury to recovery varies greatly depending on the individual and the type of Achilles injury. Therapy protocols for rehabilitation are tailored to meet your specific needs. They are aimed at ensuring the quickest and most effective and safe recovery possible. The length of your Achilles tear recovery time and rehab will all depend on the degree of your tear, whether your have a surgical or non-operative approach, and the level of activity you will be returning to.
The Significance of Immediate Care
The initial steps you take after your injury significantly influence your journey towards recovery. Depending on the significance of the injury, making sure to stay off of the foot is important. Following the RICE regimen (rest, ice, compression, and elevation) is a good place to start. Immediate medical attention is needed to determine the degree of the injury.
The RICE regimen should not get confused with the MEAT regimen, which has been discussed in this article here. While the RICE protocol is more outdated, an Achilles tear is not an injury you should be moving and exercising with in the early stages. The RICE protocol is safer in this instance.
Whether operative or non-operative, immobilization in a CAM boot is usually required. This ensures that the tendon remains undisturbed during its critical initial healing phase. Pain medication may be prescribed to alleviate discomfort if needed.
Achieving a balance between rest and gentle, prescribed movements is essential. Your foundation will be set while under the guidance of a medical professional. This is where physical therapy comes into play. Physical therapy will provide a smooth transition into more intensive treatment when appropriate.
For the early stages, immediate medical care mitigates pain and shortens the Achilles tear recovery time. This is done by appropriately grading exercise while also protecting the tendon from further damage. This will ultimately bring you closer to your goal of returning to athletic competition, if this is your goal.
The Role of the RICE Regimen
Right after injury, it’s crucial to rest the Achilles tendon and avoid any activities that might aggravate the tear. The application of ice helps reduce swelling and inflammation. While the initial inflammatory process helps bring blood flow and nutrients to kick off the healing process, managing the swelling later down the line is important for slowing down the healing process. Compression offers additional support and keeps swelling at bay. Elevating the leg above the level of the heart further aids in minimizing swelling.
The Role of Immobilization
Immobilization is a crucial step in the initial recovery phase. With a completely torn Achilles tendon that was surgically repaired, the first 12 weeks will be spent in a CAM boot. The Achilles tendon is the largest tendon in the body. It absorbs a lot of stress and impact with the weight of our bodies standing. It takes on more of this stress and impact as we walk. The freshly repaired Achilles tendon needs time to heal.
During this period, any stress can disrupt the healing process. You want the Achilles tendon to heal in a more taut state. Later on in recovery, stretching will be introduced. But if you place any stress on the Achilles tendon and it does not heal in this taut state, it could cause issues later.
With a partially torn Achilles tendon that is non-operative, immobilization up to 12 weeks may still be necessary. MRIs can be used to keep track of the healing process. The body naturally can repair a partial tear over a period of time, though caution is needed with this approach as to not disturb the healing process beyond what it can handle. Your doctor will help determine and guide you along this process.
Weightbearing Status
While you are in the CAM boot, you may or may not be able to put weight on your leg. Your doctor will determine your weightbearing status based on where you are at in your recovery journey. If you are able to put weight on your foot in the boot, you will start off with heel lifts. Heel lifts place your foot in a more plantarflexed position, taking off additional stress to the Achilles tendon. Over time, you will slowly remove your heel lifts until you are able to stand flat in the boot.
The immobilization phase supports the body’s natural healing mechanisms. It lays the foundation for the next steps in your recovery journey, including starting physical therapy. Think of it as pressing pause on your usual high-energy activities to give your body the break it needs to repair and heal. By adhering to this guidance, you’re setting yourself up for a stronger, more effective recovery.
Physical Therapy and Rehab
4-12 Weeks
Although you will be in the CAM boot for roughly 12 weeks, physical therapy can safely give you graded exercises to help maximize the healing process. Remember the RICE protocol we discussed earlier and how avoiding movement was necessary in the early stages? Well, after the acute stage is over, gentle movement is necessary to help ensure proper blood flow to continue with healing, proper movement of the ankle and other joints of the foot, as well as strengthening muscles to prepare for transition out of the boot.
Professional guidance is important through the first 6-12 weeks because it is crucial to get the foot and ankle moving despite being immobilized in the CAM boot. It is a catch 22; the Achilles tendon needs to be protected, but immobilizing the foot and ankle for that long can create problems elsewhere. This can include hip or back pain from walking differently. While the CAM boot is meant to help protect the Achilles tendon, it inadvertently prevents other muscles and tendons from getting the work that they need to stay strong. Physical therapists will be able to guide you safely on what can be done to strengthen areas that need the work while also protecting the Achilles and ensuring that healing is not delayed.
3-6 Months
After your first 12 weeks, transitioning out the CAM boot is next on the priority list. Now, easier said than done. Once you’ve been walking in a thick boot for 12 weeks, walking in a regular shoe can be tricky (and you would have never thought)! Heel lifts should be used once again when transitioning into a regular shoe. Wearing supportive sneakers will be important (I recommend Hoka, Brooks, and Asics). You will typically start with three heel lifts and each consecutive week, remove one lift. Again, this slowly and gradually places more tension on the Achilles tendon as your entire body weight is placed on your leg.
Physical therapy will also help normalize your walking pattern. Sometimes we can pick up bad habits when walking in a CAM boot. It is important to restore a normal walking pattern when you are able to be back in a shoe. Over time, gentle stretching of the Achilles will restore normal ankle dorsiflexion. This will make it easier for you to walk.
As your range of motion gets closer and closer to normal, gentle strengthening of the calf can begin. The ultimate goal is to be able to perform single leg heel raises on the injured side. This is something that normally takes quite some time to get back. Every person is different and your recovery tie will be unique to you.
6+ Months
Return to normal daily activities can typically be completed within a 6 month time frame. However, if you are trying to return to athletic competition or recreational activities, then your Achilles tear recovery time will take longer. That is because high impact activities place a lot of stress on the foot, ankle, and calf. Return to any sport or high impact recreational activities like running, hiking, or snowboarding require a lot more specific rehab. You have to ensure the Achilles can withstand the high impact and constant stress these activities will place on it.
As your calf starts to show adequate strength, endurance training will help ensure you can withstand the length of time your Achilles will have activity demands on it. You have to be able to last 3-5 mile runs, 8-10 miles hikes, or play the entirety of a football game. If you are a sprinter, making sure the initial push off at the start does not cause a problem is extremely important.
Plyometrics, change of direction, and other sport specific activities will be addressed up until it is safe for you to return to sport. This is individualized, but it can take up to 9 months before it is safe to return to sport. Early return can greatly increase your risk of reinjury.
Advanced Treatment Options
Advanced treatment options have significantly altered the landscape of sports injury recovery. At the forefront of these developments, platelet-rich plasma injections are becoming more popular
Platelet-rich plasma injection (or PRP) is a treatment designed to harness your body’s natural healing capabilities. It is a biologic healing method that concentrates the healing factors in your own blood directly at the injury site. PRP may help accelerate return to low-impact activities. It is important to discuss this option with your doctor to determine if you are a candidate.
Surgical vs. Non-Operative Approach
The body has a remarkable ability to heal itself. However, this does come with limitations. A fully torn Achilles tendon needs to be surgically repaired. If you have a partial tear, the option for a non-operative approach may be available. Your doctor can help determine what the best course of action would be for you. This will be dependent on factors like what type of activity level you want to return to and the degree of the tear that you have.
Long-term Rehabilitation Goals
It is important to note that recovering from an Achilles tear is a marathon and not a sprint. Tendons are designed to resist high forces. They transfer forces from muscle to bone and facilitate movement around joints. Therefore, you must gradually train and strengthen them to resist the high forces they once did.
Once a tear occurs, despite a full recovery, the tendon will never be as strong as it once was pre-injury. This is why it is of the utmost importance that you strengthen not only the tendon and calf muscle, but ensure that everything around it is also strong. This helps provide support above and below the Achilles tendon to help prevent future injuries.
Recovering from an Achilles tear, whether you have surgery or not, will be a long recovery process. However, you can return to your normal daily life. Make sure you follow the guidance of your healthcare professionals and put in the work and effort for your rehab. You’ll be back to doing everything you once were before. If you are curious to learn even more about your Achilles rupture, check out this resource!
Other Related Articles on the Calf, Foot, and Ankle
- What to Know About Calf Strains: Prevention, Treatment, and Recovery
- Managing Pain in the Back of the Ankle
- Ankle Pain When Walking? Why it Hurts and How to Fix It
- Pain When Walking First Thing in the Morning? Try These 7 Exercises for Plantar Fasciitis
- Weak Ankles Running? Stabilization and Strengthening for Pain Free Running
TL;DR
Understanding an Achilles tear recovery time becomes essential for anyone looking to step back into their routine. Treatments can range from surgical to non-operative. This depends on the degree of the tear and the prior level of function someone is trying to reach. This article reviews what to expect from a rehabilitation approach. It also discusses what to expect in terms of recovery time and different types of treatment options.
