23 June, 2025

Achilles tendon injuries: causes, symptoms and treatment

The Achilles tendon, the longest and strongest tendon in the human body, plays a key role in everyday movements like walking, climbing stairs, or standing on tiptoe. However, its constant functional demand also makes it one of the most vulnerable tendons to injury. When Achilles tendon pain appears, it is important to act early to avoid complications such as chronic inflammation, rupture, or loss of function.

Dr. Daniel Poggio, specialist in traumatology and foot and ankle surgery at barnaclínic+, offers in this article a clear and comprehensive guide to Achilles tendon injuries, their treatment and recovery.

Why does the Achilles tendon get injured?

The Achilles tendon connects the calf muscles to the heel and can withstand forces up to 12 times the body weight during running. This is why injuries from overuse, excessive strain or repeated microtrauma are common, especially in active individuals or athletes.

Other contributing factors include aging, poor sports technique, inappropriate footwear or lack of stretching. These can lead to Achilles tendinitis, an inflamed Achilles tendon, or even a partial or complete rupture.

Symptoms of an Achilles tendon injury

Achilles tendon injuries may appear suddenly or progressively. The most common symptoms include:

• Pain in the back of the ankle, usually worse when walking or first thing in the morning.

• Visible swelling of the Achilles tendon, with redness or thickening.

• Morning stiffness or after long periods of rest.

• Weakness or loss of strength when pushing off with the foot.

• A snapping or “whiplash” sensation in the calf, a typical sign of Achilles tendon rupture.

Surprisingly, in some cases it is possible to walk with a ruptured Achilles tendon, although in a very limited way and with an abnormal gait. This situation should never be underestimated and requires urgent medical attention.

“Not all Achilles tendon pain is the same: identifying the cause is key to effective treatment.”

Dr. Daniel Poggio, traumatologist and orthopedic surgeon specialized in foot and ankle injuries

Diagnosis and evaluation

Diagnosis is made through a specialized clinical examination, supported by tests such as musculoskeletal ultrasound or magnetic resonance imaging (MRI), which help assess the degree of thickening, inflammation or tear of the Achilles tendon and define the most appropriate treatment plan.

Treatment of Achilles tendon injuries

The therapeutic approach depends on the severity of the injury, the type of patient and their level of physical activity.

Conservative treatment

In cases of an inflamed Achilles tendon or partial rupture, the treatment is usually non-surgical:

• Relative rest and offloading the area

• Local cold application to reduce Achilles tendon inflammation

• Specialized physiotherapy with eccentric exercises and Achilles tendon stretches

• Heel lift, orthotic insoles or walking boot

• Biological therapies such as PRP (platelet-rich plasma)

• Anti-inflammatory drugs or analgesics as needed

With this approach, Achilles tendon recovery may take between 4 and 12 weeks. Adherence to treatment and personalized physiotherapy are key to preventing relapses.

Achilles tendon surgery: minimally invasive options

When there is a complete rupture of the Achilles tendon, or if conservative treatment is not effective, surgery is considered. As Dr. Poggio explains, we now have safer and less invasive techniques available.

“Minimally invasive Achilles tendon surgery helps reduce complications, speed up recovery and improve functional outcomes.”

Dr. Daniel Poggio

One of the most notable procedures is minimally invasive or endoscopic Achilles tendon surgery. This technique repairs the tendon through very small incisions, using a camera and micro-instruments. As a result:

• It reduces the risk of complications such as infections or adhesions

• It improves functional recovery

• It shortens the time off work or sport

• It minimizes the Achilles tendon surgery scar

This type of procedure is especially recommended for young patients, athletes, or those with high functional demands, and allows for a faster return to daily activities.

The Achilles tendon surgery itself takes between 45 and 90 minutes. After surgery, a structured recovery protocol begins, including progressive immobilization, physiotherapy, and functional rehabilitation.

How long does recovery take after Achilles tendon surgery?

Recovery from an Achilles tendon rupture is progressive and depends on the type of surgery, the pre-existing condition of the tendon, and the patient’s engagement in rehabilitation. In general:

• In the first weeks, a Walker-type boot is used

• Physiotherapy starts early to maintain mobility and avoid stiffness

• From the second month, strength training and gait retraining begin

Under optimal conditions, return to active life takes place between 4 and 6 months after surgery. In elite athletes, this time may be shorter thanks to specific protocols. Even so, it is important to consider potential sequelae from an Achilles tendon rupture, such as mild residual discomfort or partial strength loss, especially if recovery is not properly followed.

“With proper follow-up, most patients with an Achilles tendon injury can walk, run, and live pain-free again.”

Dr. Daniel Poggio

Why treat an Achilles tendon injury at barnaclínic+?

The Traumatology team at barnaclínic+, led by Dr. Daniel Poggio in the area of foot and ankle injuries, offers an advanced, personalized and evidence-based approach. We provide:

• Minimally invasive and endoscopic surgical techniques

• Physiotherapy specialized in sports injuries and tendinopathies

• Recovery protocols tailored to each patient

• Fast diagnosis with high-resolution ultrasound and MRI

If you experience Achilles tendon pain when getting up, persistent discomfort or suspect a rupture, early evaluation is key. At barnaclínic+, we offer the best solutions to help you walk, run or live pain-free again.