Management for complete Achilles tendon tear
Initial management (including first aid) involves the POLICE regimen; see Subacute management for soft-tissue limb conditions for details. Crutches are usually required during nonweightbearing. Analgesia may be required for discomfort; if the patient has significant pain, paracetamol or nonsteroidal anti-inflammatory drugs (NSAIDs) may be considered; see Analgesia for soft-tissue limb conditions.
Complete Achilles tendon tear may be managed surgically or nonsurgically, based on individual patient factors and shared decision making. Surgical management is associated with a lower rate of re-tear but a higher risk of complications (eg infection). Studies comparing the rates of re-tear after surgical or nonsurgical treatments (eg accelerated functional rehabilitation with early range-of-motion exercises), found no significant differenceSeow, 2021.
The components of accelerated functional rehabilitation are not completely defined but, in most cases, early functional rehabilitation should start within the first 3 weeks of injury or surgeryPark, 2020. Weightbearing and range-of-motion exercises are commonly used interventions. Additional rehabilitative strategies include strengthening programs and general conditioning.
Management for partial tear of the Achilles tendon is as for tendinopathy; see Management principles for tendinopathy.