Houston Methodist. Leading Medicine

Foot FAQ

Question:

Believe it or not, I have gone through rehab three times now for a weak (or easily injured) Achilles tendon. My wife says just have surgery and be done with it. I'm not convinced surgery is the answer. What do you think?

Answer:

Surgery remains a last resort when all attempts at nonoperative care have failed. Almost one-third of all patients with chronic tendinopathies end up having surgery. This is true despite the fact that there is no evidence to support this approach or show which surgical procedure works best. Surgical options include removing scar tissue and adhesions, repairing tendon tears, removing areas of obvious tendon degeneration, and tenotomy (cutting the tendon). If a large portion of the tendon is removed, it may be necessary to transfer a tendon from some other area of the body to the affected site. Surgical options vary according to which tendon is the problem. Rehab may still be the answer if you have not tried eccentric exercise. No one knows for sure why this technique works (and it doesn't seem to help all tendon problems), but the Achilles tendon responds well in many cases. A physical therapist can instruct you in the proper technique, but here's the basic exercise. Stand on a stair (facing the stair as if going up stairs) with just the toes in contact with the stair. Start in a position up on raised toes on the involved leg (shortened or contracted calf muscle), then slowly lower the heel down past the edge of the stair. The knee is kept straight throughout the first set of exercises. The exercise is repeated keeping the knee bent throughout the raising and lowering motion. It is suggested that you do three sets of 15 repetitions, twice a day. Repeat daily for 12 weeks. It takes some time and dedication, but the results can be well worth it. Jonathan D. Rees, MSc,MRCP (UK), FFSEM (UK), et al. Management of Tendinopathy. In The American Journal of Sports Medicine. September 2009. Vol. 37. No. 9. Pp. 1855-1867.

*Disclaimer:* The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.
All content provided by eORTHOPOD® is a registered trademark of Medical Multimedia Group, L.L.C.. Content is the sole property of Medical Multimedia Group, LLC and used herein by permission.

Our Specialties

Where Does It Hurt?

Our Locations

  Follow Us

Follow us on Facebook Follow us on YouTube
Follow us on Twitter