Non-operative Achilles Tendon Rupture and Tendonitis Treatments

Achilles Tendon Rupture

Immediate evaluation is recommended. Crutches may be needed to help walking. A cast may be necessary for a small, partial tear. The cast will keep the ankle from moving. 

Achilles Tendonitis

Achilles tendonitis can develop into a chronic problem if treatment is not initiated in a timely manner. Over time, inflammation can lead to degenerative changes within the tendon and a higher chance of Achilles tendon rupture. Therefore, it is important to initiate treatment for symptoms of Achilles tendonitis.

The best treatment of Achilles tendonitis is prevention. Stretching the Achilles tendon before exercise, even at the start of the day, will help to maintain ankle flexibility. Problems with foot mechanics can also lead to Achilles tendonitis. This can often be treated with devices inserted into the shoes such as heel cups, arch supports, and custom orthotics.

The treatments of Achilles tendonitis include:

• Rest - Resting the painful Achilles tendon will allow the inflammation to subside and allow for healing. A period of rest after the onset of symptoms is important in controlling Achilles tendonitis.
• Immobilization - In patients who have more significant symptoms, a period of immobilization can help. Either a removable walking boot or a cast can allow the inflamed tendon to cool down quickly.
• Heel Wedge - A heel wedge can be inserted into the shoe to minimize the stress on the Achilles tendon. These can be placed in both athletic and work shoes.
• Ice - Applying ice to the area of inflammation can help stimulate blood flow to the area and relieve the pain associated with inflammation. Apply ice several times a day, including after exercise.
• Anti-Inflammatory Medications - The pain and swelling most commonly associated with Achilles tendonitis can be improved with non-steroidal, anti-inflammatory medications (NSAIDs) which include Celebrex®, Advil®, Motrin®, Naprosyn®. Be sure to consult your physician before starting any medications.
• Physical therapy - Physical therapists can help formulate a stretching and rehabilitation program to improve flexibility of the Achilles tendon.
• Cortisone injections - Cortisone injections should not be used for Achilles tendonitis. Studies have shown an increased incidence of Achilles tendon rupture after cortisone injections.