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Monday, September 1, 2014
Operative vs non-operative Achilles treatment
I am 60 and have a complete tear in the mid section of my achilles tendon. I do short triathlons but most actively swim and bike. My injury occurred playing squash. What are the pros and cons of surgical vs. non operative approaches to this injury?
You didn't mention how long ago your injury occurred, but I am assuming it was recently. Both non-operative and surgical treatment of Achilles' tendon tears achieve good results.
From an operative perspective, the orthopedic surgeon typically would rather do the surgery closer to the time of injury to allow the surgeon an improved ability to pull the two ends back together.
The pros of non-operative treatment is the avoidance of anesthesia and surgery in people who may not be good candidates.
However, the length of time in immobilization is significantly increased with non-operative treatment. The starting position for treatment is with your toe pointed down to put the muscle in a shortened position to allow better healing. Then, the position is gradually progressed back to a more neutral position over the course of 8 to 12 weeks. Surgery does limit the time spent in immobilization.
Good luck getting back to activity.
Janine Oman, MS, PT/ATC
Assistant Athletic Director
Instructor at the School of Health and Rehabilitation Sciences
College of Medicine
The Ohio State University