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I tweaked my calf muscle while working out at the gym. I took a day off from exercising, but when I went back, it ruptured completely. Can you help me sort out the best way to treat this? Stay off my foot? Ace wrap? Aspirin or Ibuprofen?

There are many studies comparing various methods of treatment for Achilles tendon rupture. The two main methods are surgical repair and nonoperative treatment with rest, immobilization, and antiinflammatory drugs. There are pros and cons to both management techniques. The main advantage of surgery compared with nonoperative care to repair the torn Achilles tendon is a lower rerupture rate. But the rates of infection, scarring, and nerve injury is much higher for surgical repair. There is some suggestion that the complication rate after surgical repair of a ruptured Achilles tendon will continue to decline over the next few years with improved surgical technique. Surgeons can use minimally invasive (MI) methods. This allows for much smaller incisions and less disruption of the intact soft tissues. After surgery, the patient can wear a special brace called functional bracing. The brace allows the individual to walk, exercise, and train for sports. Recovery is faster and return to work and sports occurs sooner. The risk of rerupture and other complications is low with bracing. Nonoperative care is usually by casting or splinting to immobilize the leg. The foot is held in a position of slight plantar flexion (toes pointing down). This takes the pressure off the healing tendon. There is no risk of nerve injury as there would be with surgery. But recovery is delayed due to weakness of the injured calf muscle. The first step in making the treatment decision is to see your doctor. A medical exam is needed to determine the severity of injury. Your activity level, sports and recreational involvement, and work or occupation may also influence your decision about which way to go with treatment.

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