The Center for Podiatric Care and Sports Medicine

Healing the Pain: Why Minimally Invasive Achilles Tendon Surgery May Work For You

Posted by on Wednesday, March 4th, 2015


“I went down like a sack of potatoes,” Brian Frias told Medical Xpress, recalling the moment when his Achilles tendon ruptured as he ran from second to third base. “I would totally recommend the surgery,” he added. Frias was speaking about a new minimally-invasive technique that was used on him, requiring only a 1 – 1.5 inch incision, versus the 5 – 6 inch incisions of old. The smaller the incision, the less risk the patient faces in terms of infection risk and healing complications like scarring. At The Center for Podiatric Care and Sports Medicine, We are equipped to handle acute trauma like Achilles ruptures, including through the latest techniques in minimally invasive surgery.

achilles surgery
Sometimes surgical repair is necessary to re-connect the calf muscle to the heel tendons. Image Source:

Achilles Tendon Surgery vs. Casting

The alternative to surgery — if caught in the first 48 hours — involves putting the foot into a cast for six to eight weeks to offload pressure, which is followed by functional rehabilitation. One study found a 95% satisfaction rate with casting treatment 55 months later. The re-rupture rate for that particular study was around 6%. Yet, that study was completed over a decade ago, before minimally invasive surgery was really an option. Nowadays, we find that early weight bearing four to six weeks after surgery actually helps prevent re-ruptures and enables a speedier recovery. The re-rupture rate following surgical repair is less than 5%.

Who Are The Best and Worst Candidates For Achilles Tendon Surgery?

For athletes and active individuals, surgery is usually the “go-to” treatment to enable a full return to activities.  Surgery, even of the minimally-invasive kind, isn’t an option for everyone. There are some factors that can potentially preclude this option, including:

  • If patient is older
  • If patient is a smoker
  • If patient has a co-morbidity like diabetes
  • If patient is sedentary
  • If patient cannot follow post-operative instructions for care.

Having one or all of these factors does not automatically take you out of consideration for surgery, of course. It is just part of the total picture podiatric surgeons consider. The decision to have Achilles tendon surgery or not is a very personal one and depends upon what you’ve been through thus so far and your individual treatment goals. It is best to see a professional podiatrist specializing in sports medicine and soft tissue injuries to decide on an appropriate course of action.

Alternative Treatments For Achilles Rupture Repair in NYC

Experienced NYC foot surgeon Dr. Josef J. Geldwert runs The Center for Podiatric Care and Sports Medicine. He has seen great success with the TENEX procedure (a method of surgical scar tissue removal) for cases of chronic Achilles pain, as well as successes with surgical and non-surgical treatments for athletes. Platelet rich plasma injections, biopuncture, laser pain management therapy, shockwave treatment, and physical therapy are some of the specialties at our sports medicine center. We are sensitive to the needs of highly active patients and professional athletes who need to get back to their sports as quickly and efficiently as possible. Book your consultation with an expert today. Our office accepts most insurance plans and can work with you to find financing options for treatments that may not be covered yet.


If you have any foot problems or pain, contact The Center for Podiatric Care and Sports MedicineDr. Josef J. GeldwertDr. Katherine Lai, Dr. Ryan Minara and Dr. Mariola Rivera have helped thousands of people get back on their feet. Unfortunately, we cannot give diagnoses or treatment advice online. Please make an appointment to see us if you live in the NY metropolitan area or seek out a podiatrist in your area.