Achilles Tendon Injury
Tendinitis, partial tears and complete ruptures
The Achilles is the strongest tendon in the body — but also the most commonly ruptured. Injuries range from chronic tendinitis in runners to sudden complete tears in weekend cricketers.
Symptoms
- Sudden 'kick from behind' feeling with a pop (rupture)
- Pain and stiffness 5–7 cm above the heel (tendinitis)
- Swelling and morning stiffness
- Weakness pushing off the foot
Common Causes
- Sudden explosive movement in unconditioned athletes
- Chronic overuse in runners
- Fluoroquinolone antibiotics
- Steroid injections around the tendon (never do this)
How We Diagnose
- Thompson test at the bedside
- Ultrasound — gold standard for tendon rupture
- MRI for chronic tendinopathy
Recovery Timeline
Non-op rupture: 6 months. Percutaneous repair: 4–6 months with early functional rehab. Return to competitive sport by 9 months.
Conservative first. Surgery when it's the right answer.
Conservative treatment
Eccentric loading protocol
Alfredson's protocol — best evidence for chronic tendinopathy.
Shockwave therapy
For non-insertional tendinopathy.
Surgical treatment
Percutaneous / minimally invasive Achilles repair
For acute ruptures — 2-cm incision, back to sport in 6 months.
Reconstruction with FHL tendon transfer
For neglected or chronic ruptures.
Why. When. Can. How long. Surgery?
Achilles Tendon Injury usually develops from a mix of mechanical overload, previous injury, footwear and biological factors. Identifying the specific driver is the first step to a treatment plan that actually works.
Book a review if pain lasts more than 2–3 weeks, disrupts sleep or work, comes with swelling or deformity, or if you have diabetes or a previous foot injury.
Yes — most cases respond to structured conservative care. Surgery is only offered after an appropriate non-surgical trial has genuinely failed or if structural damage is progressing.
Mild cases settle in 2–6 weeks; moderate cases in 6–12 weeks; surgical cases follow a structured 3–6 month rehabilitation programme.
Not usually. Surgery is reserved for structural damage or true failure of conservative care — decided together after a full review of your history, examination and imaging.
Often yes, with condition-specific physiotherapy, footwear/orthotic optimisation, activity modification and injections where indicated — provided the plan is followed properly for long enough.
Delay allows the underlying mechanics to progress — ligaments loosen, cartilage wears, deformity becomes rigid. Late-stage reconstruction is always bigger than early treatment.
Achilles Tendon Injury — 12 frequently asked questions
Surgery vs no surgery for rupture?+
For active patients, surgical repair has a much lower re-rupture rate. Non-operative treatment is reserved for elderly or low-demand patients.
Can I run through Achilles pain?+
No. Continuing to run risks a full rupture.
Why is achilles tendon injury affecting me now?+
Achilles Tendon Injury is usually the result of accumulated mechanical stress, an untreated older injury, or a change in activity, footwear or body weight. A structured evaluation identifies the exact driver so treatment targets the cause, not just the symptom.
When should I see a foot & ankle specialist for achilles tendon injury?+
If pain lasts more than 2–3 weeks, wakes you at night, causes limping, prevents sport or work, or comes with swelling, deformity or numbness — book a specialist review. Early expert care almost always prevents surgery later.
Can achilles tendon injury be treated without surgery?+
Yes — the majority of patients improve with a structured conservative programme: activity modification, specific physiotherapy, footwear and orthotic optimisation, and targeted injections when indicated. Surgery is reserved for cases where an appropriate non-surgical trial has genuinely failed.
How long does recovery take?+
Recovery depends on severity and treatment pathway. Simple cases settle in 2–6 weeks with conservative care. Surgical reconstruction typically follows a structured 3–6 month protected weight-bearing and rehabilitation programme, with return to sport around 4–6 months.
Will I need surgery?+
Not necessarily. Dr. Chandan Narang follows a strict conservative-first protocol. Surgery is offered only when imaging and clinical findings show that non-surgical care cannot restore function, or if there is structural damage that will worsen if left alone.
Can I avoid surgery if I follow physiotherapy properly?+
Often, yes — provided the physiotherapy is condition-specific (not generic), progressive, and combined with the right footwear, orthotics and activity modification. Many "failed physio" cases in fact never received the right protocol.
What happens if I delay treatment?+
Delay allows the underlying mechanical problem to progress: ligaments loosen further, cartilage wears down, deformity becomes rigid, and tendons tear. Reconstructive surgery for late-stage disease is bigger, longer and more expensive than early treatment.
Is this treatable through an online video consultation?+
Yes. Most achilles tendon injury cases can be reviewed via a structured video consultation with X-rays or MRI uploaded in advance. In-person examination is only required when a specific hands-on test is decisive.
What imaging will I need?+
Weight-bearing X-rays are the standard baseline. MRI is used for suspected soft-tissue tears, cartilage lesions or occult fractures. CT is reserved for complex bony deformity or trauma planning. Ultrasound is used selectively for dynamic tendon assessment.
Do I need to bring old reports and X-rays?+
Yes. Old imaging is invaluable for tracking progression. Please upload every prior report and image via WhatsApp before your consultation so Dr. Chandan Narang can review everything ahead of time.
Get an expert opinion on your achilles tendon injury — from anywhere in India.
Upload your X-ray or MRI in advance. Dr. Chandan Narang will review your case in a structured video consultation.