Common Types of Achilles Tendon Injuries
Achilles Tendinitis
Achilles tendinitis refers to inflammation of the tendon, usually caused by overuse. It often develops gradually in people who increase their activity too quickly or train without adequate rest. Pain is typically felt as stiffness and soreness in the back of the heel or lower calf, especially in the morning or after exercise.
There are two main forms:
- Insertional tendinitis, which affects the lower portion of the tendon where it attaches to the heel bone.
- Non-insertional tendinitis, which occurs higher up in the tendon and is more common in younger, active individuals.
Achilles Tendinosis
When Achilles problems become chronic, the condition may progress to tendinosis. Unlike tendinitis, tendinosis is not primarily inflammatory. Instead, the tendon develops microscopic degeneration and thickening due to repeated stress.
Patients often notice persistent pain, swelling and a nodular thickening along the tendon. Because tendinosis represents a breakdown of tendon structure, it can take longer to heal than simple tendinitis.
Achilles Rupture
An Achilles rupture is a complete or partial tear of the tendon, often occurring during sudden explosive movements such as sprinting, jumping, or pushing off forcefully. Many patients describe hearing or feeling a “pop” at the back of the ankle, followed by sharp pain and difficulty walking.
A rupture usually causes significant weakness, making it hard to push off the foot. Some patients cannot stand on their tiptoes. This is a serious injury that requires immediate medical attention.
Achilles Bursitis
Near the tendon’s insertion at the heel, small fluid-filled sacs called bursae provide cushioning. When these bursae become inflamed (bursitis), pain and swelling develop at the back of the heel. Although not a tendon injury itself, bursitis often coexists with Achilles tendinitis, worsening the discomfort.
How Are Achilles Injuries Diagnosed?
An orthopaedic specialist usually performs a physical examination. Tenderness, swelling, thickening and range of motion are assessed. Imaging tests may also be recommended. Ultrasound can reveal tendon thickening, tears or degeneration, while MRI scans provide detailed views in more complex cases. These tools help determine the type and severity of the injury, thereby guiding treatment.
Treatment Options for Achilles Tendon Injuries
Non-Surgical Treatments
For tendinitis and early tendinosis, conservative management is often effective. Rest and activity modification allow the tendon to heal, while ice, elevation and anti-inflammatory medications reduce pain and swelling. Physiotherapy is highly important in rehabilitating the Achilles tendon. Orthotic inserts and supportive footwear can also reduce stress on the tendon during walking and running.
Surgical Treatments
When conservative methods fail or in the case of a rupture, surgery may be needed.
For chronic tendinosis, surgeons may remove degenerated tissue and repair the healthy portion of the tendon. Sometimes, a tendon transfer from another muscle is used to reinforce the Achilles.
For ruptures, the torn ends of the tendon are stitched back together. This can be performed using traditional open surgery or minimally invasive techniques with smaller incisions. Both methods aim to restore tendon strength and function.
Recovery and Rehabilitation
Recovery depends on the type of injury and treatment. Tendinitis may resolve within weeks to a few months with rest and physiotherapy. Tendinosis and surgical repairs usually require longer rehabilitation.
After surgery for a rupture, patients often wear a cast or boot initially, with the ankle positioned to allow healing. Gradual weight-bearing and physiotherapy will then follow. Regaining full strength and returning to sports typically takes six to twelve months.
Proper adherence to rehabilitation goes a long way in restoring mobility, strengthening surrounding muscles and reducing the risk of re-injury.
Can Achilles Injuries Be Prevented?
Prevention will focus on reducing strain on the tendon as well as maintaining flexibility and strength. Proper warm-ups before exercise, gradual increases in training intensity and wearing supportive shoes all help protect the tendon. Stretching the calves and strengthening lower limb muscles also reduce risk.
Listening to early warning signs is also important. Ignoring persistent heel or calf pain often allows a minor problem to escalate into a more serious injury. Taking breaks, modifying activity and seeking medical advice early can prevent long-term complications.
When to See a Doctor for Achilles Injuries
Mild soreness after exercise may not be alarming, but certain symptoms warrant medical evaluation. These include persistent pain lasting more than a week, swelling or thickening along the tendon, pain that worsens with activity, or difficulty pushing off the foot. A sudden “pop” in the heel or calf followed by weakness is a strong indicator of rupture and requires immediate attention.
An orthopaedic specialist can accurately diagnose the problem and recommend a tailored treatment plan. For more information or a detailed assessment, please contact our sports orthopaedic clinic today.
