Q+A: Will Achilles scar tissue removal work?

Q Following a partial tear in my Achilles tendon, the scar tissue thickened, resulting in stiffness, aches and swelling. I am due to have an operation to remove this scar tissue, which means that my leg will be immobilised for two weeks. I’m told that, with physiotherapy, I should be running again in six months. But will I be able to regain my full fitness, and what are the chances of the injury returning?

A Yes, it will be possible to return to the level you were at prior to the operation. With the right surgeon and the right rehabilitation, the results can be very good. In fact, some patients have actually found that they can run better, as the rehabilitation can make them stronger than they were prior to the operation.

If there’s degeneration of the tendon, though, the problem can recur. You can reduce the chances of this by embarking on a long-term rehabilitation programme, designed to maintain the surgeon’s and the physios’ efforts during your post-operative rehabilitation.

The question of whether you should have the surgery in the first place, though, remains. If you’ve tried everything else and the injury still doesn’t allow you to run, then the operation should be seriously considered. However, you should have been through the following process before you opt for surgery: lots of heavy soft-tissue massage; stretching your calf muscles; specific gym exercises, such as calf presses; plyometric exercises for the ankle muscles; and balance and coordination exercises.

There are no guarantees that your Achilles will be better after the operation, and it’s even possible it could get worse. Thankfully, though, this is the exception rather than the rule.

Martin Haines, chartered physiotherapist and sports-injury specialist