Achilles Tendon Surgery and
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Not every Achilles tendon injury or condition requires surgery.
It is generally understood by doctors and surgeons, that surgery will introduce more scar tissue into the Achilles tendon. This added scar tissue will be problematic, requiring physical therapy and conservative treatment options post-surgery. If not dealt with properly, your ankle and Achilles tendon could end up in worse condition than before the surgery! This is why surgery is only performed as a last resort.
Except for specific cases (ie. major tears or a rupture), Achilles Tendon surgery is not even considered until all conservative treatment options have been exhausted. Doctors, orthopedic specialists and physical therapists will advise that you must try at least 6 to 12 months of conservative therapy with no indication of improvement before surgery will even be considered.
Some conservative treatment methods recommended include:
- Rest - This is important for initial healing because without an appropriate amount of rest you are at risk for increased inflammation, pain and re-injury of your Achilles tendon.
- Avoid Activity that caused your achilles injury. - While resting your achilles it's also important to avoid all activities that may have caused your symptoms, including any repetitive ankle movement. This may include reduced activities in your job if that has caused your injury. Continuing on with regular activities can increase the severity of the injury, turning a mild to moderate case of injury into serious damage or leading to injuries in other areas due to overcompensation.
- Apply a Cold Compress or Ice Pack - Immediate cold therapy at the onset of your injury (or during flareups) will allow you to manage pain while getting rid of swelling and inflammation.
- Use DTR Therapy (T•Shellz Wrap®) - After swelling and inflammation has been reduced. Use your own blood flow to maximize your rehabilitation, decrease recovery time, and boost overall long-term healing. Deep Tissue Therapy is especially helpful in dealing with chronic tendon & muscle injuries or on-going pain and stiffness from a strained achilles tendon.
- Physical therapy and rehabilitative exercise under supervision of a physical therapist or doctor. The intent of this is to provide you with increased range of motion, pain relief and strengthening of the soft tissue surrounding the achilles. Caution: aggressive physical therapy can be harmful, such as aggressive stretching or massage, and when dealing with an achilles that has very low range of motion, there is high risk to damage weak and damaged muscles and tendons of the joint.
Other Conservative Treatment Methods can be Risky
In some cases, physicians may recommend drugs or medications like NSAIDs (non-steroidal anti-inflamatory drugs) to manage pain and inflammation. Alternative medications like cortisone injections are NOT advised for any type of Achilles Tendon injury or condition. This is because there is an increased risk of rupture of the tendon following a cortisone injection.
"Medical evidence shows that cortisone shots can damage the surrounding tissue, fray the Achilles tendon, and even trigger a rupture. Most side effects are temporary, but skin weakening (atrophy) and lightening of the skin (depigmentation) can be permanent." (reference: American Academy of Orthopaedic Surgeons)
For acute (new or recent) Achilles tendon tears that have the ability to heal on their own - your doctor may even cast your foot in a toe pointed position (in something called a "hanging enquinus cast") or in a removable brace/splint. A removable splint can be very helpful to prepare you for physical therapy sessions and mobility exercises.
Prolonged use of a cast, removable splint, or long-term rest (restricted movement) without proper exercise or stretching can make your Achilles tendon injury worse. If your Achilles tendon remains completely immobilized and at constant rest, the ends of the Achilles tendon (where it attaches to bone or other muscles) will begin to fill in with scar tissue as part of the healing process. You may also have on-going symptoms of pain, swelling and inflammation, and even poor blood flow circulation.
Lack of proper blood flow and growth of scar tissue will decrease the natural length of the tendon (atrophy) and tighten tissue, reducing the flexibility between your ankle and foot. Your ability to push off with your foot in certain activities such as running, jumping, or going up and down stairs all become compromised. You are also at an increased risk of re-rupture of the tendon, especially if the initial injury was large and required surgery in the first place.
"Complications of cortisone shots can include:
"Risks - Cortisone Shots - Mayo Clinic". 2016. Mayoclinic.Org. Accessed November 17 2016. website
- Joint Infection
- Nerve Damage
- Thinning of skin & soft tissue around injection site
- Temporary Flare of Pain & Inflammation in the Joint
- Tendon Weakening or Rupture
- Thinning of Nearby Bone
- Death of Nearby Bone
- Temporary Increase in Blood Sugar"
If you are not at the surgery stage and your physician has opted to treat your injury with conservative treatment options, then you will find that many of our customers have had great success treating themselves with the powerful conservative treatment products such as the Achilles T•Shellz Wrap®. When used as directed, it is our opinion that the T•Shellz Wrap® will give you the best chances of healing your achilles tendonitis, insertional achilles tendonitis or other soft tissue injury at home without the need for surgery. If surgical intervention is required, talk with your physician about using these same products for post-surgery recovery as you will find them to be highly effective for reducing post-surgery inflammation, enhancing range of motion and minimizing scar tissue growth.
If Achilles Tendon Surgery is Required...
If all conservative treatment methods have been explored and your symptoms (pain as well as limited use for daily activities) persists, then you will be considered a candidate for surgery. You and your doctor may decide to move forward and have you undergo surgery, which will trigger the next chapter of your achilles recovery journey. Your post surgery rehabilitation efforts will have an important impact on how soon you can return to living and enjoying your normal daily life.
The surgery that is selected for your injury will depend on the level of your pain and the amount of damage your doctor suspects there may be to your tendon. Much of this damage will be determined through the use of physical exams, x-rays and MRI results.
With acute (recent) tearing, the separation in your Achilles tendon is likely to be very minimal. If you have an acute tear you may qualify for less invasive surgery (such as a mini-open procedure). Surgeons will always choose a shorter, less invasive procedure if it is possible to do so. Most surgeons know that a less complicated procedure will have less trauma to the tendon and a much quicker rate of recovery after the surgery.
One week after the Achilles tendon has ruptured the ends of the tendon begin to fill in with scar tissue as part of the healing process. This added scar tissue will negatively affect your ability to do normal activities (like running, jumping or going up and down a flight of stairs). If significant scar tissue is present, then a more complicated procedure may be needed to clean out the presence of any scar tissue for optimal healing after the surgery.
An injury that is 4 to 6 weeks old is considered a chronic rupture. When you have a chronic Achilles tendon rupture the tendon tears continue to separate further from their ends increasing the gap in the tendon. A chronic rupture often requires a difficult, drastic surgery - often times with a tendon transfer (graft) to complete the surgery and a lengthy recovery period.
Surgery for the Achilles Tendon will require either the release of tendon tissue from the lateral epicondyle (the end of your humerus bone) which is then reattached, removal of damaged tissue from the tendon (also referred to as debridement), or repair of the torn tissue. Tendon repair can only be considered if the procedure does not over-tighten the tendon itself; this would result in a reduction of mobility/flexibility.
All of these surgical techniques can be completed through Arthroscopic surgery, Open surgery or Percutaneous Tenotomy (or a combination of procedures).
For achilles tendon injuries, arthroscopic surgery or percutaneous tenotomy are the preferred procedures as they are minimally invasive and patients usually recover at a much faster rate.
For most soft tissue injuries, arthroscopic surgery is the preferred procedure as it is minimally invasive and patients usually recover at a much faster rate. This type of surgery will provide the surgeon with first hand insight into the nature of the injury and possibly limit the amount of ankle damage from surgery, helping promote a more effective recovery.
Some cases however, will require open surgery as the scope of arthroscopic surgery is limited in comparison to full exposure of the achilles in open surgery. If you undergo an open surgery for your Achilles, you should anticipate a much longer time for rehabilitation efforts.
As with any surgery there are risks to every procedure depending on a lot of factors, including your age, the severity of your injury and your level of health going into the procedure. It is always best to discuss all possible risks and complications with your doctor, orthopaedic specialist and/or surgeon before the procedure. It's important to be aware of the risks you may face with any procedure intended to fix or relieve pain from your Achilles tendon injury.
Open Achilles Tendon Surgery
This is the traditional Achilles tendon surgery and remains the 'gold standard' of surgery treatments. During this procedure one long incision (10 to 17 cm in length) is made slightly on an angle on the back on your lower leg/heel. An angled incision like this one allows for the patient's comfort during future recovery during physical therapy and when transitioning back into normal footwear.
An open incision this large also provides enough room for the surgeon to prepare a tendon transfer if it's required. When repairing the tendon, non-absorbale sutures may be placed above and below the tear to make sure that the repair is as strong as possible. A small screw/anchor is used to reattach the tendon back to the heel bone if the Achilles tendon has been ruptured completely.
An open procedure with precise suturing improves overall strength of your Achilles tendon during the recovery process, making it less likely to re-rupture in the future.
Debulking or Debridement of the Achilles Tendon
This surgical technique is done during open Achilles tendon surgery. To perform a debulking or debridement the surgeon will cut away any damaged/inflamed tissue and scrape down any calcium deposits (bone spurs) that have grown on your heel. Scar tissue may be removed from the sheath surrounding the tendon, from the tendon itself or from both surfaces.
Debulking or debridement of the Achilles tendon is used as a last resort, if all methods of conservative therapy have been exhausted.
This procedure is typically used for conditions such as Tendocalcaneal bursitis, Achilles Tendinitis, Achilles (mid-point or insertional) Tendonosis and in some cases when the tendon has ruptured as well.
Mini-Open Achilles Tendon Repair
During this procedure the surgeon will make one 3 to 4 cm long incision on the back of your ankle and 2 to 4 smaller vertical incisions around the long incision. These smaller veritical incisions are made with a pair of surgical scissors and are commonly referred to as "stab incisions".
Once the incisions are opened up, the surgeon will place precise sutures with non-absorbable stitches to strengthen the damaged Achilles tendon tissue. This suturing technique reduces the amount of scar tissue on the tendon after surgery and provides better surface healing of the skin. Unlike the traditional method of an open surgery, this procedure has less risks and complications involved. To learn about all risks you may face be sure to speak to your doctor.
Percutaneous Achilles Tendon Surgery
During this procedure the surgeon will make 3 to 4 incisions (approx. 2.5 cm long) on both sides of the Achilles tendon. Small forceps are used to free the tendon sheath (the soft tissue casing around your Achilles tendon) to make room for the surgeon to stitch/suture any tears.
This procedure can be done in 3 different ways depending on the preference and experience of your surgeon.
Instead of making several 2.5 cm incisions for this procedure, some surgeons will use guided imaging with an ultrasound to see the Achilles tendon tissue without having to open up your ankle. For this technique, they will use a surgical needle to repeatedly stab your Achilles tendon. These "stab incisions" will allow the surgeon to "blindly" suture your tendon without seeing the actual tissue. As another option - some surgeons will only make 1 to 3 incisions for smaller surgical implements to repair your tendon while relying on imaging ultrasound to see your damaged tissue. During either procedure the use of ultrasound imaging or endoscopic techniques requires a very skilled surgeon.
"Blind" suturing can be dangerous depending on the experience level of your surgeon. Without seeing your tendon tissue, it is possible that your surgeon won't use enough sutures to repair your tendon. They could also hit one of the nerves in your ankle or align your tendon tissue incorrectly. Each of these issues can result in a re-rupture of your Achilles tendon if left untreated.
Achilles Tendon Transfer
Your surgeon will decide to perform an Achilles tendon transfer procedure if the gap in your tendon is really wide or your tendon has become frayed and weak over time. The donor Achilles tendon tissue will bridge the gap and cover the weaker portions of your tendon to strengthen it and increase your overall rate of recovery.
Stability of your Ankle after the Surgery
It is important to understand that surgery may not give you 100% functionality of your leg, but you should be able to return to most if not all of your pre-injury activities. These surgical procedures are often performed with very successful results. What truly makes a difference is your commitment to a doctor recommended rehabilitation program after surgery as there is always a possibility of re-injuring your tendon even after a surgical procedure. One complication of surgical repair for Achilles tendon tear is that skin can become thin at site of incision, and may have limited blood flow.
Many people don't realize that Achilles tendon surgery can be very traumatic to your body. The type of trauma you experience after surgery can be compared to what you go through when you first injured your Achilles tendon.
During the first 24 to 72 hours after the surgery your ankle will be tender, swollen and very painful. Your leg will be weak and unstable making it impossible for you to put weight on your leg without some kind of help. This is why your doctor or surgeon will have you outfitted for a cast, ankle brace and/or crutches before the procedure. When you are relying on a cast/brace and crutches your Achilles tendon is less likely to be as active as it once was. This is usually why atrophy (loss) of your lower leg muscles (specifically your calf muscle) happens.
In general, more than 80%* of people who undergo surgery for an injured Achilles Tendon are able to return to their active lifestyle. In order to avoid re-injury, it is important to commit to a regular conservative therapy routine. *(reference: webmd.com)
Ask any doctor and they will tell you that the success of your surgery depends on your level of dedication to regular at home care of your Achilles Tendon. Most of our Achilles tendon post-op clients have treated themselves successfully through regular use of a Cold Compress or Ice Pack and an Achilles TShellz Wrap.
Using these therapies will lessen the chance and/or severity of ankle joint degeneration and muscular atrophy during your rehabilitation process. In some cases our customers have prevented the onset of degeneration through regular use of these treatments. They will even combine these therapeutic treatments with the rehabilitation plan recommended by their doctor, surgeon or physical therapist.
Getting Started with Your Post-Operative Rehabilitation
After your surgery is done, you will probably receive a tailored rehabilitation plan directly from your surgeon or physical therapist. This rehabilitation plan will combine rest, exercise, and conservative therapies, to aid in your recovery. All rehabilitation efforts will be explored under the guidance of a doctor or physical therapist, but you will also be expected to continue your exercise, stretching and treatment at home. The success of your rehabilitation will depend on a variety of factors including (but not limited to):
- your age, overall health and activity level
- the state of your injury before surgery (severe injuries like a tendon rupture, open wound, bone damage or fracture will require more intense surgery)
- the type of surgery you have undergone
- how soon you must return to normal activity
No two rehabilitation plans are alike - The less invasive your surgery is,
the quicker your road to recovery will be.
The goal of a rehabilitation plan is to manage pain and swelling while improving function, strength, and range of motion. Ultimately, you will regain strength in your ankle and Achilles tendon to be able to walk normally and return to full activity. You will most likely spend a lot of time with a physical therapist after your surgery, but as your healing progresses, emphasis will be placed on your personal at home treatment. The success of your rehabilitation will depend on your dedication to working with your doctor and physical therapist while also managing your recovery on a daily basis at home.
Regardless of what type of surgery you've had (or even if you don't need surgery) your home therapy routine can be improved by controlling initial and on-going pain/swelling, and increasing blood flow to heal your tendon so that you can achieve long-term, positive results. This can easily be done by incorporating a Cold Compress or Ice Pack and an Achilles TShellz Wrap. Regular treatment with an Achilles TShellz Wrap will provide deep tissue heat, increasing localized bloodflow which will help increase your body's natural healing rate. An enhanced healing rate will help decrease time spent in recovery.
Speak to your doctor, surgeon or phsyical therapist about incorporating TShellz Wrap treatments into your post-operative rehabilitation program to boost your overall recovery process.
Post-OP Phase 1: Protect your Achilles Tendon
Rehabilitation after surgery on your Achilles tendon will first focus on protecting your ankle from further damage as well as initiating simple movement routines. The level of protection needed for your ankle will depend on the type of surgery you have had. You may be given (or advised to purchase) an ankle brace to wear for a week or more after surgery, or until your first follow-up appointment with the surgeon.
After an open Achilles tendon surgery (depending on how much damage was repaired) your ankle will be immobilized in a short or long-leg cast with absolutely no weight bearing on your injured leg for 4-8 weeks. After 4-8 weeks your Achilles tendon will start to heal to the point where weight bearing is acceptable. At this point a new low-heeled, short-leg equinus cast or controlled ankle motion brace will be used.
You may need to wear a short cast and/or a removable brace for up to 4 weeks after a Percutaneous Tendon Surgery or Mini-open Achilles Tendon Repair procedure. After 4-6 weeks have passed, you may be able to return to weight bearing capability with the aid of a splint or walking boot.
Directly after your surgery has been completed, you will undergo Step 1 of the healing process by stopping the bleeding that has started because of the incisions and work done inside of your achilles. Depending on the type of procedure you have just had, your tissue may be sutured together, reconstructed or removed to fix your underlying condition. In any case, as with any injury to your tissue, the tissue in your ankle will be bleeding again. Depending on the type of injury you have, your surgeon may even stimulate bleeding during your surgery to trigger the healing process.
Typically your body will have begun to stop the bleeding as soon as your surgeon has completed your surgery. This means that the veins carrying your blood will close off, and your blood will coagulate (condense to seal the bleeding off) in order to reduce the amount of blood loss in your body. Your body knows to do this automatically because blood is so vital to the healing process. Blood is basically the vehicle for oxygen, nutrients, white blood cells and anti-bodies that travel directly to the injury in your achilles - where these things are needed most.
In order to reduce pain, swelling and inflammation your doctor will prescribe an anti-inflammatory drug to be taken during the first week after your surgery, or for however long it is needed, depending on your pain level. Your surgeon will also recommend the use of a Cold Compress or Ice Pack on a frequent basis - multiple times per day - to control your inflammation and reduce your pain.
If you have undergone an arthroscopic surgery, you may have less blood loss and your doctor or surgeon will check before you leave the hospital to make sure your bleeding at the incisions has stopped. If you have undergone open achilles surgery, your doctor and/or surgeon will check your incisions periodically over the next few days of your hospital-stay to ensure that your body has stopped the bleeding on its own and also make sure that your incisions are starting to heal.
Movements to Watch Out For After Surgery
You will possibly be advised by your physician not to drive or operate a motorized vehicle for at least a week after your surgery. This is because restriction of ankle movement may affect your ability to brake or accelerate your vehicle properly, particularly in an emergency situation which may require rapid, deliberate movements of the foot.
Right after surgery, avoid straining with the lower leg/ankle that was just operated on. This basically includes undergoing any range of motion activity that would move the foot up or down. This shouldn't be too problematic as you will probably be wearing a boot in a locked position (with regard to plantar flexion).
After your incisions, repaired and/or removed tissue has stopped bleeding; your achilles will probably be tender, swollen, red and hot to the touch - these are all symptoms of inflammation. Step 2 of the healing process is inflammation reduction. At this point you will be home if you have had arthroscopic surgery, or you may still be in the hospital if you have had open surgery. In order to reduce pain, swelling and inflammation your doctor will prescribe an anti-inflammatory drug to be taken during the first week or 2 after your surgery. Your surgeon will also recommend a cooling therapy, like R.I.C.E. (Rest, Ice, Compression, Elevation).
Rest at this point is vital to your rehabilitation plan depending on the surgery you have undergone. If you have had arthroscopic surgery with minimal internal wounding from your surgeon, you may be encouraged to start movement early or as soon as possible. Limited movements of the achilles/lower leg will be required in most cases after the surgery. If you have had an invasive open surgery, then you may be encouraged to rest longer at first before starting movement.
Your doctor or surgeon will advance you to the next Phase of rehabilitation when there is no evidence of inflammation or swelling in the achilles, heel and lower leg. If you have had arthroscopic surgery, your doctor may expect that you are able to move your lower leg, ankle, foot and toes around pain free (with the aid of a sling if needed) before moving onto the next Phase of rehabilitation.
Post-OP Phase 2: Gain Back Range of Motion and Stability in the Achilles
After your Achilles tendon starts to heal your tissue will be in a weakened state and will not be as strong as healthy tissue for some time. This is why you need to be on "re-injury watch" and make the most of your physical therapy appointments and home therapies during your rehabilitation. It would be devastating if overdoing it at any point during the first few months of rehabilitation would send you right back into the operating room.
After the initial healing of your achilles surgery (when Step 1 and 2 of the healing process is done), temporary tissue will start to grow around tissue that was damaged during your injury or the surgery. Step 3 is the Growth of Temporary Tissue.
Once your new tissue has begun to grow you will be encouraged to gain back some of your range of motion (ROM) and increase the stability of your achilles, leg and ankle. Your doctor or surgeon may also introduce regular physical therapy appointments. You may still be expected to wear a brace to reduce the amount of stress you are placing on your ankle and achilles tendon during movement (reducing your risk of re-injury).
You will start gradual movement of your achilles in a free (non-forced) way with very low impact exercises, normally with very few repetitions of activity. Your joint may be stiff at first, and you should expect simple and easy movement to be a bit more difficult for you to master and painful. Exercise of any kind is a method of increasing blood-flow in your achilles to increase the amount of oxygen, nutrients, white blood cells and anti-bodies that travel to your injured tissue.
You might start with gentle active foot extensions (ie. toe curls) and flexion exercises with a hard brace/cast on at 0 - 14 days. Once you're out of a hard brace, pain becomes the guiding factor with tolerance of weight-bearing or any exercises/stretches.
At about 6 to 12 weeks (depending on your type of surgery) you still need to allow for healing from the surgery. Although you may be feeling much better and your pain is dropping, your achilles tendon at 4 weeks is only about 20% healed. At 8 weeks it will be about 40% strong and after 12 weeks the tendon is 60% as strong as normal tendon. The point where the pain decreases yet the tendons are still weak is a critical point. This is the stage where you need to be very careful about re-injury.
Your surgeon will recommend regular physical therapy appointments in the first 6 weeks after surgery. The type of surgery and the degree of damage to your achilles tendon will also make a difference in how soon you start physical therapy.
Your physical therapy appointments will be 1-3 times per week, and the progression of movement in your achilles will be the guide. At your appointments you will be encouraged to gain back some of your range of motion and increase the stability of your injured ankle. You will start with the gradual movement in a free (non-forced) way with little weight or resistance, normally with very few repetitions of activity. Your foot will be stiff and painful at first, and simple, easy movements may seem challenging in the beginning. Don't be discouraged, your hard work will payoff in the end!
At Home Stretching/Exercise - Your therapist will encourage you, telling you just how important it is to commit to regular exercise at home as well as in the clinic. You should be doing homes exercises up to 3 times per day. They will give you the exercises and guidance based on your overall soreness level and morning discomfort.
We advise our clients to apply a T•Shellz Wrap® treatment to help increase blood flow before stretching (or exercise). Apply a TShellz Wrap treatment for approximately 15 to 20 minutes (finishing 15 minutes before exercise) to help increase elasticity and flexibility of your tendons, ligaments and muscles. The increased elasticity will help minimize tissue tears and scar tissue growth (increase ROM and decrease reinjury risk.
Controlling post-exercise swelling and inflammation is crucial during this Phase. Any sign of swelling or inflammation after exercise may be an indication of minor re-injury to your achilles or surrounding tissue and muscle. Control your inflammation immediately after exercise with a 15 to 20 minute cold treatment. If you are not careful to treat your swelling or inflammation immediately after exercise you may experience a set-back in your recovery.
Your doctor, surgeon or physical therapist will advance you to the next Phase of rehabilitation when you show measured improvement of range of motion (ROM), strength, stability and flexibility of your foot and ankle. The level of improvement will depend on the severity of your injury and the type of surgery you have had. For example, if you have had a relatively simple arthroscopic repair of tissue, you may be expected to move the ankle around before moving to Phase 3 of your rehabilitation.
If you have questions, call our office at 1-866-237-9608 (toll free continental US).
At Home Stretching/Exercise
Full heel to hip movement is common to many physical therapy recovery routines. it is considered to be a foundation stretch used to rehabilitate from a variety of injuries, including recovery from open Achilles tendon surgery, percutaneous or mini-open repair procedures. Along with other stretches, your physical therapist will most probably prescribe heel to hip movement (sometimes referred to as "heel slides") to introduce gentle stretching of your leg and keep your Achilles tendon active and moving.
Post-OP Phase 3: Gain Back Full Capability of Your Achilles & Ankle Joint
After temporary tissue has grown (Step 3 of the healing process), this temporary tissue will go through different stages of conversion into healthy, normal, flexible tissue. This is Step 4 of the healing process (Complete Tissue Re-Growth). Before converting into healthy tissue, temporary tissue will often become tough, dense, fibrous scar tissue. Scar tissue has an unorganized, inflexible tissue structure, which makes it brittle. Scar tissue will provide your injury with more long term fusing power, but will also stick to surrounding healthy tissue in your lower leg, achilles and heel. The growth of this scar tissue is what stiffens your achilles, restricting movement and flexibility.
This phase of your rehabilitation will focus on an increase in activity level in order to regain full range of motion (ROM) and muscle strength in your foot. Your doctor or physical therapist will increase your activity by introducing the regular use of a towel stretch, calf stretches, step ups and balance exercises.
Use an Achilles T•Shellz Wrap® (Deep Tissue Therapy) BEFORE workouts and a Cold Compress or Ice Pack after work-outs. This protocol will go a long way to maintaining overall tissue stretchability, reduce re-injury risk, and treat any pain, swelling or inflammation due to overexertion of your leg/ankle.
Your doctor or physical therapist will advance you to the next Phase of rehabilitation when you have regained full ROM (range of motion) without pain in your achilles. You may also have to pass clinical exams or tests of your muscle strength, balance, stability and flexibility in order to be cleared for Phase 4.
Post-OP Phase 4: Return to Regular Activities
In many cases, your doctor or surgeon may recommend that you continue muscle strengthening and stretching instructed during your rehabilitation in order to maintain healthy ROM of your achilles. Additional cardiovascular exercise will also be encouraged. If you are an athlete or have a job that requires extensive physical capability, your doctor or physical therapist will likely advise a very gradual return to previous activity. They also may encourage continued rehabilitation and/or maintenance of your lower leg through physical therapy or conservative treatment methods, to prevent re-injury of your achilles.
Scar tissue may plague you for weeks, months and maybe even years after your surgery depending on your level of activity and the amount of conservative therapy you have undergone during your rehabilitation. Scar tissue will be a major problem as scar tissue can easily build up quickly and its hard to get rid of.
Even if you have been cleared to get back to activity, you still must be careful with the activity you take on. You need to keep in mind that your achilles won't be back to 100% for some time (if at all) and so continued stretching with the exercises and stretches outlined give by you physical therapist and treatment with T•Shellz and cold therapy will maintain good health of the achilles and significantly reduce your risk of re-injury.
Your success to recovering from achilles surgery is up to you. Many of our past clients have found the following points to be quite valuable during their recovery period.
- listen well to your physician and if conservative treatments are recommended, ask your physician about incorporating the use of an Achilles T•Shellz Wrap® at home. Stick all prescribed treatments daily to ensure you maximize the opportunity to heal
- Frequent use of a Cold Compress or Ice Pack after your surgery will get the swelling down. Much of the pain you feel will be from the swelling, and you will be surprised how quick the pain drops off once the swelling is down.
- Consistent use of the Achilles TShellz Wrap (a safe, carbon fiber electromagnetic energy emission device) will help reduce reinjury risk and promote blood flow to the area (and thereby accelerate the body's own healing process).
- When applied before stretching, the Achilles TShellz Wrap will help elongate connective tissue in the lower leg, achilles and heel. This soft tissue will remain elongated for some time after treatment. This means that it helps improve your range of motion which is exactly what you want when trying to recover from tendon and muscle damage.
How Long To Heal After Achilles Surgery?
Depending on your job (and whether your occupation has contributed to causing your condition), your injury, the type of surgery you have had, and the level of commitment toward your post-op rehabilitation, you may be able to return back to work from within 6 to 12 weeks after the surgery. Overall healing of your achilles after surgery may take upwards of 6 to 12 months, which means you may not be able to return to sports or walking/running/climbing with heavy loads, until a year has passed after your surgery.
Most people won't be able to return to other regular activities, like driving, until 8 weeks after Achilles tendon surgery. This timeframe is of course different for everyone, and depends on the advice of your surgeon and/or physical therapist. For example, you may be cleared to return to driving when you have shown that you are physically capable of raising and moving your leg on your own during physical therapy.
Athletes may take up to 7 months to heal before they are ready to begin their sport again. Athletes are typically in very good health (good bloodflow - high oxygen/nutrient delivery), so their bodies have natural advantaged to heal soft tissue more quickly than average. Complete recovery from a Achilles tendon surgery for non-athletes could take up to 1 year.
Expectations for Long-term Recovery
Rehabilitation after your Achilles surgery is just the beginning of your recovery process. Even after you've had surgery to fix your Achilles tendon, it is improbable that your tendon will heal 100%. From this point on, you will always need to be careful with your Achilles tendon. Your achilles tendon is almost certainly weaker than it was before the injury, so your risk of re-injury in the future is much higher. Achilles re-injury statistics support this, as in this 2013 study of elite male football players: "27% of all Achilles tendinopathies were reinjuries". source: Gajhede-Knudsen M, E. A. Gajhede-Knudsen M, et al. "Recurrence Of Achilles Tendon Injuries In Elite Male Football Players Is More Common After Early Return To Play: An 11-Year Follow-Up Of The UEFA C... - Pubmed - NCBI ." Ncbi.nlm.nih.gov. N. p., 2018. Web. 8 June 2018.
Manage Your Symptoms On A Daily Basis To Prevent Re-Injury
It's simple to manage long-term healing of your Achilles tendon with conservative treatment methods that can be conveniently used in the comfort of your own home. If you are looking for an all-natural pain management and long-term healing solution that will provide long-lasting relief, speak to your doctor today about incorporating the Achilles TShellz Wrap into your treatment plan.
A Cold Compress or Ice Pack can help you to decrease post-operative pain and swelling while also managing any pain from occasional inflammatory flare-ups (re-injury). Consistent treatment with a Cold Compress or Ice Pack will effectively reduce your inflammation, draw the pain out of your achilles and gently numb the nerve endings in your tissue for rapid, long-lasting pain relief.
During your last few stages of rehabilitation, while you are undergoing physical therapy and focusing on improvements to your range of motion, it is important to maintain healthy blood flow in your Achilles tendon. Strong and healthy tendons and muscles need a solid blood circulatory system and this is exactly what our TShellz Wraps are made for.
Reduced blood flow slows down your recovery process and keeps your Achilles tendon tissue in a weakened state. If your tissue remains in this condition, you will always be at risk of re-injury that will severely set back all of your hard work of rehabilitating your achilles injury.
Use TShellz Wraps regularly to prevent re-injury and keep your muscles, tendons and ligaments elastic and flexible. Healthy blood flow is vital to the healing process after achilles surgery. Your blood flow is what brings oxygen, nutrients, anti-bodies and energy (things needed to heal) into your damaged tissue. Blood Flow promotes tissue re-growth, strengthening the delicate work your surgeon has done.
Regular treatments with DTR Therapy (via use of the T•Shellz Wrap®) will help you increase blood flow for up to 4 hours with just one 20 minute application! An Achilles TShellz Wrap will help you increase blood flow to your repaired tendon. There simply isn't a better product on the market to increase your body's natural healing process and provide long-term health benefits.
Dealing with Scar Tissue After Achilles Surgery
How Scar Tissue Affects Your Rehabilitation
Tendons, ligaments, muscle and other soft tissue in the foot are all meant to be soft and flexible, ready to work and move extreme forces in everyday activities. When I say extreme force, I mean try to imagine the amount of tension that is put on your achilles when running or climbing stairs - even when you are just walking even, let alone running.
Scar tissue grows in damaged tissue when it tries to heal; little tiny band-aids that overlap each other to bind tiny tissue tears together. With this added scar tissue, muscles & tendons & ligaments become rigid, less flexible and unable to handle the forces that it once could. If you're suffering with scar tissue now you may feel the effects with stiffness, tightness, weakness and tiredness in your achilles.
Scar tissue is something that will be present in your tendon before and after your surgery. The growth of scar tissue is ultimately what causes stiffening in your Achilles tendon, restricting movement and flexibility. Scar Tissue is something that cannot be avoided during surgery. Your surgeon will determine if the anticipated outcome from surgery will be successful, despite the buildup of scar tissue that you will develop as a result of the surgery. Overall, the surgeon may be able to remove a lot of the initial buildup of scar tissue around the injury and in doing so, view a positive outcome from the surgery.
Scar tissue can form fast to bring together the edges of a tear, but working fast doesn't mean that the job's done right. When scar tissue forms it doesn't come together as neatly as regular (healthy) tissue would. Scar tissue fibers will lay down over top of your tear in a cluttered, messy and jumbled up way.
On-going issues with scar tissue can result in soft tissue tears and increase chances of strain to nearby tendons or ligaments (as they are now handling higher forces due to overcompensation).
Scar tissue is one of the MAIN reasons why a chronic achilles injury has not healed and your Range of Motion (ROM) is reduced from what it once was.
Scar tissue will form fast to deal with a soft tissue achilles injury, and this scar tissue will attach to EVERYTHING in the area, including the surrounding healthy tissue as well. This can result in a fusing together of the soft tissue in your achilles and lower leg that shouldn't be fused together, and this will cause extreme pain when you move your achilles - it is literally ripping scar tissue. This is why physical therapy is often painful - the therapist stretches the joint, forcing the scar tissue bonds to break so you can regain your range of motion.
Scar tissue is a major problem especially when it comes to an achilles injury - causing your injury to become chronic, and taking months or even YEARS to completely heal!
Unfortunately, scar tissue may plague you for weeks, months and maybe even years after your surgery, depending on your level of activity and the amount of conservative treatments you have done during your rehabilitation.
You can quickly minimize scar tissue growth and reduce risk of re-injury to your achilles and leg muscles/tendons/ligaments by increasing blood flow to that area and increasing the elasticity of soft tissue in the area. Treating yourself with the Achilles TShellz Wrap is the easiest and most effective way to help accelerate your recovery at home by increasing soft tissue elasticity which helps reduce the risk of more scar tissue growth.
When applied before activity or work, the TShellz Wrap will relax and lengthen your soft tissue to help improve your range of motion and prevent atrophy (tissue wasting & shortening) of your injured achilles.
Overall, continued treatment with the Achilles TShellz Wrap will maintain good health in your Achilles Tendon and significantly reduce your risk of reinjury.
Deep Tissue Regeneration Therapy for Fast Tracking Post Surgery Recovery
Improve Circulation & Reduce Re-Injury Risk with the T•Shellz Wrap®
If you want to heal quickly, you need to keep your blood moving and that's where
DTR Therapy, comes in.
What is DTR Therapy? It's a substantial increase in the flow of blood to soft tissue in the achilles and lower leg without the need to exercise your already damaged tissue.
Have you seen what happens when you add water to a flower wilted from drought? In essence, your injured achilles or calf muscle is much like a "wilted" flower; your body wants to heal its injury, but needs lots of nutrients to do it. Blood brings new life to your cells by delivering healing nutrients and oxygen that are vital to your tissue. In addition, the blood carries away toxins and cellular waste cleaning the area and healing it faster. Without a good supply of blood, your injury simply won't heal properly.
With DTR Therapy your injured achilles is constantly being fed with healing, nutritious, oxygen and energy filled blood. This is exactly what your body needs to heal.
In order to get maximum blood flow to your achilles, you need to help your body stimulate blood flow. DTR Therapy is the fast, easy and pain-free way to increase blood flow and speed healing. It's the key to dealing with tears, tendonitis, strains, spasms and other damage in soft tissue properly.
- When treating any soft tissue injury, an effective therapy will increase blood flow to the injury while the joint is immobile.
- This increase in blood flow will accelerate the body's own ability to heal itself.
- The TShellz Wrap is a highly effective blood circulation stimulation device approved by the FDA for use at home.
T•Shellz Wrap® = The Perfect Deep Tissue Regeneration Therapy Delivery Tool
When to use an Achilles TShellz Wrap:
- Once the swelling is gone (usually after applying cold compression to the injury over 24 to 72 hr period).
- BEFORE getting out of bed in the morning. BEFORE going to bed at night.
- BEFORE exercise, workouts or activity of any kind to increase elasticity of tendons, ligaments and muscles and decrease the chance of re-injury.
- AFTER surgery (once the skin wound has healed over) to increase post-surgery healing rate and minimize scar tissue growth (due to reinjury) at the surgery location.
- Anytime BEFORE you feel you might undertake activity that will put significant strain on the injury area.
When to use a Cold Compress or Ice Pack:
- 24 to 72 hours after your initial injury or when you first notice pain and swelling to stop celluar damage, relieve pain, and decrease swelling.
- After exercise, workouts or activity of any kind to prevent re-injury.
- Before and after surgery during rehabilitation to control pre and post-surgery pain and swelling.
- Anytime you feel your lower leg, heel or achilles has been over-extended, over-worked, twisted, strained or sprained causing pain and swelling.
- Anytime you have swelling, sharp throbbing pain or inflammation.
- Any other situation where you need to draw the pain and inflammation out of your lower leg and foot.
Minimize Your Chance of Achilles Surgery with these Effective Conservative Treatment Options
If your doctor thinks you might be able to avoid surgery by using conservative treatments, you can join our many customers who have had great success treating themselves with the powerful treatment products we offer through AidMyAchilles.
Tendinosis, Tendinitis or Tenosynovitis of the achilles, strains, tears and other soft tissue achilles injuries are not uncommon - it can happen to anyone. Right now, there are thousands of doctors and physical therapists dealing with patients that require a solution to heal their injury as fast as possible. Maybe they are just patients that are unwilling to just take pain pills, lay in bed and wait or perhaps they are patients with extensive access to medical care with a great insurance plan. Even fortunate patients such as this have greatly benefited from boosting their PT and medical treatments with home therapies using the products we have recommended.
Regardless of who you are or your reasons, if you want to be proactive about properly addressing your achilles condition and minimizing the negative impact it will have on your lifestyle, talk with your physician about accelerating your therapy at home with Deep Tissue Regeneration Therapy through the use of an Achilles T•Shellz Wrap®. We have many happy customers that have healed their injuries much faster than even they had hoped for and significantly reduced their pain during treatment and through the healing process.
Are You Dealing with Rehabilitation After Achilles Tendon Surgery?
We Have Answers that can Help...
Most cases of Achilles tendonitis/tendonosis will respond well to conservative treatments, however, surgery will be needed in some cases (especially with a full Achilles tendon rupture). Undergoing Achilles tendon surgery, whether you have an open, percutaneous or mini-open procedure, can be a scary and challenging time for most.
The Internet and any medical professionals available to you (your surgeon, orthopaedic specialist and/or physical therapist) will provide a wealth of information and details on the surgery itself, but it can be a challange to fully understand the medical terminology used, how your body reacts to the surgery and what comprehensive rehabilitation plan will get your body healed as soon as possible.
Surgery in itself is not the end of the journey, it is merely the beginning of a new chapter. Your rehabilitation efforts will have an important impact on how soon you can return to living and enjoying your normal daily life.
It truly takes a cohesive rehab plan after surgery - incorporating conservative therapy, rest and physical therapy/exercise - to ensure a complete recovery takes hold. There is no single answer and each individual experience in rehabilitation is different.
We here at AidMyAchilles provide suggestions and options for people to help get them through this life changing event. We assist many people in shaping an individual course of action to help them heal after surgery.
Click HERE to Go To Our Online Store If you have questions, call our office at 1-866-237-9608 (toll free continental US).
The Next Step Is Up To You!
Living with pain is never easy as it affects your entire lifestyle. Living with pain during or after intensive surgery with a lengthy rehabilitation period can be even harder! Nothing is more important than making the proper decision when it comes to treating your ankle pain after surgery.
Doctors and Surgeons are always improving the technologies used in surgery, and results from surgery now are much more positive than they were in the past. However, all surgeries introduce scar tissue, and recovery from achilles surgery is often less successful than you might expect. If you do wind up getting surgery, know that rehabilitation at-home while attending regular physical therapy or doctor appointments is vital for your overall recovery. It is especially vital to the lower leg, achilles and ankle areas, as they consistently handle extreme forces (body weight). Consistent exercise and conservative treatment on a daily basis during your rehabilitation while working with your doctor, surgeon or physical therapist is key - and this is why you should seriously consider maximizing your recovery by using the Achilles T•Shellz Wrap® at home once you are approved for physical therapy.
AidMyAchilles.com stands out in this regard as our goal is to help you keep your achilles healthy for the long-term in a cost effective manner. This might mean healing your achilles without needing surgery. If you couldn't avoid surgery, then our tools can also help you recover from surgery more quickly and completely..
We strongly believe that we can help you, and we have thousands of happy clients to back this claim. You are welcome to try our products for a 60 day period.. If you are committed to following the treatments outlined in the product instructions we are very confident that our TShellz Wraps will aid you immensely. If you do not receive the benefits that countless of our other customers have experienced from our products, call us, mail the product back to us and we will provide you with a full product refund.
Our online shop accepts Visa & Mastercard as well as a Paypal Payment option.
We also encourage your to Call Our Office at 1-866-237-9608 (toll free continental NA) where we can answer any questions you have and/or take your order via phone.
Our customer service lines are open 5 days a week helping people understand their injuries and how to treat them. Simply call toll free 1-866-237-9608 to talk or place an order with one of our knowledgeable Product Advisers. They have the ability to answer questions and even put together a treatment plan for you.
The bottom line is, you are welcome to try our products for a full 2 months. If you do not receive the benefits that others have experienced, simply return your purchase back to us and we will issue a prompt & full refund. There will be no hassle and no hard feelings.
Prevention and Promotion of Lifelong Health
If you want to avoid re-injury, or manage pain and increase circulation for lifelong health benefits, an Achilles TShellz Wrap will provide exceptional results. Why spend time in pain, off from work, and missing out on your active lifestyle when you can be proactive about your injury and the health of your body? Talk to your doctor about incorporating a regular routine of using Deep Tissue Regeneration Therapy into your everyday health regimen.
If you are still uncertain which route to go or if you would like to discuss issues affecting your ankle pain, Achilles tendonitis, tendonosis or other soft tissue injuries, then do not hesitate to contact a AidMyAchilles Advisor immediately by phone North America Toll Free 1-866-237-9608 | Outside North America +1-705-532-1671 or email firstname.lastname@example.org
Product Advisors are available 9:00 am to 5:00 pm Eastern Standard Time Monday to Friday.
North America Toll Free 1-866-237-9608
Outside North America +1-705-532-1671
AidMyAchilles advisors do not work on commission, so be assured you will only receive fair and objective information.
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