Therapy of the Achilles tendon tear

What therapy is used for an Achilles tendon rupture

As mentioned earlier, a Achilles tendon tear conservative or surgical (see Operation Achilles tendon tear) are treated. While surgical therapy is always considered for competitive athletes, the form of therapy can be conservative for less athletic or older patients. It should be mentioned, however, that in Central Europe, surgical treatment of the Achilles tendon is usually more likely to take place while in anglo-american Raum is more inclined to conservative therapy.

The treatment of a patient with a ruptured Achilles tendon is usually individual and can only be given after diagnosis to be hit. First aid (First aid) in the form of:

  • cancellation the (sporting) activity.
  • cooling (Ice cream, cool pack, ...)
  • Compression bandage
  • Elevate of the leg
  • transport to the doctor


Conservative therapy of the Achilles tendon tear

As part of the diagnosis, the Ultrasonic and X-ray image determine the extent of the Achilles tendon tear. The ultrasound examination is carried out in the equinus position. If the doctor determines that the ends of the tear touch each other when the foot is lowered, the tendon ends can heal together. From an operative therapy of the Achilles tendon tear can then be disregarded.

One of the reasons for this is the elasticity of the tendon. If it appears necessary, it can be stretched up to approximately twice its size. Helpful for the conservative therapy are also special shoes with a raised heel area and an immobile, firm tongue. The Foot raised to an equinus position, which allows the tendon ends to make contact. In most cases, normal exercise can be carried out relatively quickly after a phase of partial exertion. Constant checks with the attending physician should be carried out in order to observe the healing process and optimize it if necessary. Ideally, conservative treatment of the Achilles tendon rupture can take place after about six to eight weeks be deemed complete.

Appointment with an expert in Achilles tendonitis?

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Who am I?
My name is dr. Nicolas Gumpert. I am a specialist in orthopedics and the founder of .
Various television programs and print media report regularly about my work. On HR television you can see me every 6 weeks live on "Hallo Hessen".
But now enough is indicated ;-)

Athletes (joggers, soccer players, etc.) are particularly often affected by the Achilles tendonitis disease. In many cases, the cause of the Achilles tendonitis cannot be identified at first. Therefore, the treatment requires a lot of experience. I focus on Achilles tendonitis.

The aim of every treatment is treatment without surgery with a complete recovery of performance.

Which therapy achieves the best results in the long term can only be determined after looking at all of the information (Examination, X-ray, ultrasound, MRI, etc.) be assessed.

You can find me in:

  • Lumedis - your orthopedic surgeon
    Kaiserstrasse 14
    60311 Frankfurt am Main

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Further information about myself can be found at Dr. Nicolas Gumpert

Duration of therapy

Of course, the exact duration of therapy is from Healing progress dependent on the injury. It is also crucial whether and which surgical procedure was used. In most cases, however, sufferers should end up with about at least 12 weeks calculate.

Course of therapy

In the course of therapy for an Achilles tendon tear, there are two opposing forms:

1. Immobilization

The injured foot is fixed in a cast, shoe or splint for 4-9 weeks. Loads and movements are not allowed

2. Early functional follow-up treatment

The foot can be moved shortly after the operation. Under physiotherapeutic control, the person concerned learns to gradually increase the load. Different aids, such as plaster of paris and orthoses, are also used here.

Until today studies could no relevant differences in the achieved therapeutic success determine. Nevertheless, there is a tendency towards early functional follow-up treatment in Germany! Such a typical course of therapy can e.g. look like this:

In the first few days after the operation, one speaks of one Inflammatory phase. Here lies the observation the beginning healing processes in the foreground. At this time, it does not make sense to directly strain the Achilles tendon. Instead, patients should have other joints, such as move the knee joint. In addition, the healthy leg can be used to maintain muscle strength. During the inflammation phase, the affected foot should be elevated.

Now the so-called follows Proliferation phasein which the patient wears achilles tendon relief shoe day and night (Orthosis) wearing. Under specific physiotherapeutic guidance, exercises promote both mobility and coordination. At this point in time, no strength exercises should be carried out as the tensile strength of the Achilles tendon has not yet been restored. Basically, the therapy at this point in time is only possible pain-free area allowed is.

In the so-called Remodeling phase, from the 8th week onwards, the affected person carefully begins to build up the strength of the shrunken calf muscles. In addition, mobility is further increased, but always in the awareness that the tendon has still not achieved its complete stability.

At the earliest in the 12th week, but often much later, jumps may be performed. Often patients start with hopping on the spot, and increase the exercises to deep jumps of e.g. a pedestal. Based on the jumping ability, the treating orthopedic surgeon and physiotherapist can also determine when sports can be started again.

Therapy after an operation

After the operation of an Achilles tendon tear, the foot is first put through a plaster splint in so-called "Equinus position“Fixed for several days. This position describes the maximum flexion of the foot at the ankleso that the toes are pointing down and the heel is pointing up. There is currently a great discussion among experts about how long the operated foot should be protected. Some experts are of the opinion that 2 days is sufficient, while other experts recommend a significantly longer period. Mostly it joins the Plaster fixation wearing one Orthosis on. This special, orthopedic shoe relieves the Achilles tendon. Eventually the foot will gradually go through Heel wedges used to the normal position.


Ultimately, the course of an Achilles tendon rupture cannot be precisely predicted. The duration of therapy can vary greatly and those affected sometimes have to show a lot of patience and motivation. Nowadays, however, excellent results can be achieved with intensive physiotherapy and medical care!