The Achilles tendon, known clinically as the calcaneal tendon, is a dense cord of fibrous tissues that connect the calf muscles to the heel bone. The Achilles tendon is the strongest and thickest tendon in the human body, capable of supporting multiple times one’s own body weight. But despite its strength, and considering how frequently our bodies rely on its support, the Achilles tendon is prone to injury. When this tendon tears or ruptures, surgical intervention and repair are required.
The Achilles tendon is named after the Trojan War hero Achilles in ancient Greek mythology. Achilles’ tendon was the only vulnerable part of the hero’s body after his mother dipped him by his heel into the River Styx. The heel bone (calcaneus), and the soleus and gastrocnemius muscles of the calf and lower leg, are all connected via the Achilles tendon. Together, this system lends its support to various physical activities like walking, running, and, in Achilles’ case, fighting epic battles.
The legend of Achilles is relevant even today, as many great athletes and runners still succumb to Achilles tendon injuries. Sports that require extensive running, jumping, and quick reflexes put athletes at risk for tendon rupture. These types of injuries are known as acute injuries. However, simple movements, various antibiotics, and age-related wear can also strain the Achilles tendon.
A study by NIAMS found that an overwhelming 84% of tendon ruptures occur in male populations. Higher levels of estrogen hormones in women are associated with stronger and more elastic tendons. However, the exact role estrogen plays in tendon strength is still unclear. It could be that greater calf and muscle density exert more pressure on male Achilles tendons, thus increasing risk of injury.
An Achilles tendon rupture is incredibly painful and will render a person immobile. But rupture isn’t the only injury this tendon can sustain. A less severe condition known as Achilles tendinitis is a common affliction marked by heel stiffness and inflammation. This is a chronic condition with more than 200,000 cases each year. Self-care, stretching, and anti-inflammatory drugs can abate the symptoms of Achilles tendinitis. In some cases, this condition can lead to tendon rupture, so preventive measures are often necessary.
Achilles tendon surgery and recovery
When the Achilles tendon snaps or tears, a person usually requires surgery to have the torn band reconnected with stitches. A podiatric surgeon may choose to perform either an open surgery or percutaneous (minimally invasive) surgery. Depending on the method of incision your surgeon implements, patients can experience variations in length of recovery and amount of scarring.
Open surgeries require vertical incisions of three or more inches on the back of the lower leg. These surgeries allow the surgeon more flexibility when operating on the tendon, ensuring optimal care and possibly reducing the risk of re-rupture. However, open procedures like this can prolong recovery time and significantly increase scarring.
As an alternative to open surgeries, minimally invasive procedures require several small incisions to be made on the back of the lower leg. The surgeon will then insert tools into the cuts to operate on and reconnect the broken tendon. These procedures tend to reduce recovery time and minimize scarring. Some studies confirm that patients experience the same low re-rupture rate (3-5 percent) as open surgery patients, but more clinical evidence is needed to elucidate this matter.
Recovery time for both procedures is often slow. A patient will need to wear a cast or splint for 6 to 12 weeks to immobilize the ankle and foot, allowing the tendon to heal. Crutches may be needed for the first few weeks to relieve the tendon of the full weight of the body. After roughly 6 months, patients can resume normal functions of the foot and leg. Patients typically experience a loss of strength in plantar flexion motion after an Achilles tendon tear. Despite this limitation, many athletes are still able to resume sports and other forms of strenuous exercise months after full recovery.
How to reduce scarring after surgery
Keloids and hypertrophic scars are two scar types that can form in response to an Achilles tendon repair surgery. These scars are cosmetically unappealing, itchy, and painful, making them a burden when wearing socks or shoes. The optimal solution to prevent or reduce these scar types is by using silicone gel sheeting or silicone ointments.
Silicone gel technology emerged over 30 years ago, and numerous clinical studies support it as an effective scar management solution. Biodermis has led the medical silicone industry for nearly three decades and continues to provide the highest quality post-operative care to patients. Silicone works by inducing hydration and regulating collagen production at the scar site. This helps to soften and flatten scars, restoring their natural pigmentation and blending them in with the surrounding skin tissue.
Biodermis is an innovative market leader with 30 years of expertise in the medical silicone industry.Visit Biodermis.com today to explore a complete range of scar management and post-operative care solutions.
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