Understanding Achilles Tendon Injuries: From Weekend Strains to Surgical Repairs

By Gary Feldman, DPM, FACFAS

. https://www.drgaryfeldman.com

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Understanding Achilles Tendon Injuries: From Weekend Strains to Surgical Repairs

The Achilles tendon — the largest and strongest tendon in the human body — plays a critical role in walking, running, and jumping. But despite its strength, it’s also one of the most frequently injured tendons, particularly in active adults and weekend athletes. Understanding how these injuries occur, how they’re treated, and when to seek help can make a significant difference in recovery and long-term mobility.

Achilles tendon injuries typically fall into two categories: tendonitis and tears or ruptures. Tendonitis is an overuse injury caused by repetitive stress, often from sudden increases in activity, improper footwear, or poor biomechanics. It usually begins with pain or stiffness in the back of the heel, especially during or after activity. Left untreated, it can progress and weaken the tendon over time.

A more severe injury — a partial or complete rupture — can occur suddenly, often during a forceful movement like pushing off to run or jump. Patients may feel a sharp pain or hear a popping sound, followed by difficulty walking or bearing weight. A complete rupture typically results in a noticeable gap above the heel and a loss of strength when trying to push off the foot.

Early diagnosis is essential. For mild cases of tendonitis, rest, ice, physical therapy, and changes in activity can reduce inflammation and promote healing. In some cases, immobilization or supportive orthotics may be recommended. If conservative treatment fails, or the tendon is severely damaged, surgery may be necessary to remove scar tissue or repair the tendon.

For Achilles tendon ruptures, treatment depends on the severity of the injury and the patient’s activity level. Nonsurgical treatment with casting or bracing may be effective for some patients, particularly older adults or those with lower activity demands. However, for younger or more active individuals, surgical repair often offers a quicker return to function and a lower risk of re-rupture.

Recovery from Achilles injuries, whether surgical or not, requires time and commitment. Physical therapy is critical to regain strength, flexibility, and balance. Rushing the healing process can lead to re-injury or chronic weakness.

Achilles tendon injuries can be painful and frustrating — but with the right treatment approach, most patients can return to their normal activities and avoid long-term complications. Paying attention to early warning signs and seeking care promptly are key steps toward a full recovery.