When Does an Injured Tendon Benefit From Surgical Repair?

You cherish being active or, at the very least, you like the freedom of moving around without limitations, but a tendon injury has different plans. These days, you’re sidelined and hobbled by a problematic tendon that’s showing no signs of improving, and you want to know if surgery is the right answer.

While the decision to undergo surgery is one that only you can make, the team here at William Schell, MD, wants to review a few scenarios where we recommend tendon surgery. As a board-certified orthopedic surgeon, Dr. Schell understands better than most which tendon injuries benefit from surgical repair and when to leave well enough alone.

Understanding tendons 

Let’s first review the role that tendons play in your body. Put simply, tendons are tough connective tissues that attach bones to muscles to enable movement. For example, the strongest tendon in your body — your Achilles tendon — connects your heel bone to your calf muscles. In this role, your Achilles tendon helps you walk, run, jump, and climb, so it’s a fairly important component of your mobility.

Common tendon injuries

The human body contains about 4,000 tendons, but despite this large number, most tendon injuries occur in one of these five areas:

1. Achilles tendon — connects your heel to your calf muscles
2. Rotator cuff — connects your upper arm muscles to your shoulder 
3. Patellar tendon — attaches your quadricep muscles to your kneecap
4. Biceps — attaches your arm muscles to your elbow
5. Peroneal tendons — connect muscles in your lower leg to bones in your foot

Of course, you can injure other tendons in your body, but these are the most common. For example, two million Americans seek help for rotator cuff tears each year. 

When surgery is a good solution for tendon problems

There are many ways your tendons can become damaged, but it often boils down to one of two issues:

1. Repetitive stresses and wear and tear that leads to damage over time
2. Acute injury that tears the tendon

These two can cross over, such as when you have preexisting inflammation in your tendon due to tiny tears, which renders the tissue more vulnerable to tearing. As well, certain conditions like rheumatoid arthritis can weaken tendons and lead to damage.

As a rule of thumb, we routinely recommend surgery for complete tendon tears, which means the tissue has detached entirely from the bone or it’s been severed completely. This type of complete rupture doesn't often heal well on its own, and surgery is the best way to repair the tissue and restore function.

We also recommend tendon surgery for partial tears if you're still in pain after trying conservative treatments and/or you’ve lost function or mobility because of the damage.

The best way to determine whether surgery is the right path forward for your tendon injury is to see Dr. Schell for a complete evaluation. If he finds that your tendon isn’t healing well or has little chance of coming back together, he will likely suggest surgical repair. On the other hand, if he sees that tendon might heal without surgery, he may recommend a wait-and-see approach, to start.

To figure out where your tendon injury falls, we suggest that you contact our New York City office, which is located on Columbus Circle on the Upper West Side, to schedule a consultation.