Achilles Rupture: Surgical vs Non-Surgical Management

Non-surgical management has become increasingly common, with evidence showing comparable strength and re-rupture rates when early functional rehabilitation is used. Surgery may be recommended for certain tear patterns, high-demand athletes or specific clinical situations.
Regardless of treatment pathway, early controlled loading is essential. Prolonged immobilisation leads to stiffness, calf weakness and delayed recovery. Modern rehabilitation encourages early movement within safe limits to promote tendon healing and strength.

Rehabilitation must progress gradually. The Achilles tendon adapts slowly, and sudden increases in load increase the risk of re-injury. Calf strength, particularly endurance strength, is often the limiting factor in recovery.
Return to running and sport is guided by strength testing, movement quality and symptom response rather than time alone.
With appropriate rehabilitation, most individuals return to walking, work and sport successfully. Long-term outcomes are best when rehabilitation is structured, progressive and closely monitored.