Surgery has been the treatment of choice for the competitive athlete or those with a high level of physical activity, for those with a delay in treatment or diagnosis, and for those whose tendons have ruptured again. Nonsurgical treatment Involves extended casting, special braces, orthotics, and physical therapy. Avoids the normal complications and expenses of surgery. Some studies show the outcome is similar to surgery in regard to strength and function. There is risk of an over-lengthened tendon with inadequate tension.
Extended immobilization can lead to more muscle weakness.
Has a higher incidence of re-rupture than surgical repair. Nonsurgical treatment is often used for nonathletes, or for those with a general low level of physical activity who would not benefit from surgery. The elderly and those with complicating medical conditions should also consider conservative nonsurgical treatment. The majority of people return to normal activity levels with either surgical or nonsurgical treatment. Most studies indicate a better outcome with surgery.