Achilles Tendonitis – When Is Surgery Needed?

Achilles tendonitis is a common overuse injury that affects the Achilles tendon. The Achilles tendon is the band of tissue that connects the calf muscles to the heel bone. It typically occurs in runners, athletes, or individuals who suddenly increase their level of physical activity. However, it can also affect people who are simply on their feet for long periods, especially without proper footwear.

There are two main types of the condition: insertional, where the pain is felt at the heel where the tendon attaches, and non-insertional, where damage occurs in the middle portion of the tendon.

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Symptoms Of Achilles Tendonitis

The symptoms usually start off mild and gradually worsen over time. Here’s what to look out for:

• Pain or aching in the back of your heel or just above it, especially after walking, running, or climbing stairs
• Swelling or puffiness in the area around the back of your ankle
• Stiffness in the heel and lower leg in the morning, which may get better as you move around
• Pain when standing on your toes or pushing off your foot while walking or running
• A warm, tender feeling or tightness in the lower back part of your leg

In more serious cases, you might feel a sharp pain or a popping sensation, which could mean a tear or rupture — a medical emergency that requires immediate attention.

Typical Treatments For Achilles Tendonitis

In most cases, non-surgical treatments are highly effective, especially when the condition is caught early. These include:

• Rest and Activity Modification: Reducing activities that strain the tendon gives it time to heal.
• Ice and Elevation: Ice packs and keeping the leg elevated can help reduce inflammation.
• Anti-Inflammatory Medications: NSAIDs such as ibuprofen may relieve pain and swelling.
• Heel Lifts and Supportive Footwear: These reduce strain on the tendon and promote healing.
• Physiotherapy: A structured rehabilitation plan often includes eccentric strengthening exercises, stretching, and ultrasound therapy.
• Orthotics: Custom inserts can improve foot mechanics and reduce tension on the tendon.

For persistent cases, shockwave therapy or PRP (platelet-rich plasma) injections may be recommended to encourage healing.

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When Is Surgery Needed?

Surgery is generally considered a last resort and is only advised when conservative treatments fail after six to twelve months. Surgery may be necessary if:

• There is a partial tear or rupture.
• The pain severely limits activity and does not improve.
• There is a large amount of tendon degeneration.
• A bony spur has developed that irritates the tendon.

Surgical options vary depending on the severity of the injury. The most common procedure involves removing damaged tissue and, in some cases, transferring another tendon to restore strength and function.

Recovery from surgery typically involves several weeks of immobilisation, followed by gradual rehabilitation. Full recovery may take up to 6–12 months, but most patients regain full function and return to sports or daily activities.

Our Preferred Doctors (Orthopaedic Surgeon) For Achilles Tendonitis Treatment

ORTHOPAEDIC SURGEON

Dr Ananda Vella |  Preferred Doctor

OrthoCare – Orthopaedics and Sports Medicine

Get Treatment For Achilles Tendonitis

Achilles tendonitis can be painful and frustrating, but early treatment is often successful without the need for surgery. If symptoms persist despite rest and therapy, it may be time to consult an orthopaedic specialist. Timely intervention can prevent further damage and help you get back on your feet—literally.

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Preferred Doctors: Dr Ananda Vella

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