Achilles Tendon Injuries: Diagnosis, Micro-Injury Strategy, and Treatment Process

Chronic Tendinitis

Interruption of healing in the acute phase paves the way for chronicity. Biomechanical, metabolic (obesity), postural errors, and the use of corticosteroids/estrogen are risk factors. The average age is higher compared to acute cases.

• A mass that shifts with ankle movement can be palpated on the tendon.
• Degenerative (permanent wear) changes begin in the tendon.
• Surgical Treatment: The problematic degenerated part is removed, and tendon transfer is applied if necessary.

Chronic Ruptures (Delayed Diagnosis)

These are ruptures older than three months that were missed or left untreated. They do not present with symptoms as severe or "noisy" as acute ruptures. The most prominent sign is the onset of muscle wasting (atrophy) in the leg.

Treatment Protocol: In non-surgical methods, physical therapy and special orthoses that prevent ankle dorsiflexion are used. Primary repair (end-to-end suturing) can be attempted up to the 3rd month after the injury. In much older cases, tendon advancement or tendon transfer techniques must be applied depending on the gap of the rupture.