How long your recovery from Achilles tendonitis or tendinopathy will take depends on how long you've had your injury for and how robust your tendon is. Other issues such as medical conditions (e.g. diabetes), the menopause, and medication can also play a role. In this article, we look at what typical recovery times are and discuss the most common factors that can speed up or delay recovery. Remember, if you need more help with an Achilles injury, you're welcome to consult one of our team via video call.
The terms tendinitis, tendonitis, tendinosis, and tendinopathy mean the same thing for all practical purposes, and we use these interchangeably in our articles.
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Factors that influence Achilles tendonitis recovery time
Everyone’s case of Achilles tendonitis is unique. The following factors or circumstances can have an impact on your recovery time:
What caused your tendonitis. Overuse tendonitis tends to recover more quickly than tendonitis caused by fluoroquinolone antibiotics, because the antibiotics affect your body’s ability to produce and strengthen collagen fibres (the main building block of tendons).
How long you’ve had your injury for. If it’s your first bout of tendonitis, and it only started recently, it usually reacts more quickly to treatment. This is because the changes inside the tendon when the injury has been allowed to drag on take longer to turn around than when you catch it in the early stages.
Other medical conditions, like diabetes, may slow down the healing process.
The menopause causes a drop in oestrogen levels. Oestrogen plays a role in the production of new collagen fibres, so the menopause slows down your tendon’s recovery.
Certain medications like statins or corticosteroids may affect your body’s ability to repair. Speak to your doctor before changing or stopping medication.
Either resting too much or too little. You will need to reduce your activities to allow your tendon to settle down and heal, but prolonged periods of complete rest can delay healing. Relative rest is a much better option.
Doing the wrong exercises for your specific case in terms of how strong your tendon is and how sensitive it is. Too much exercise or doing it in the wrong position may aggravate your symptoms. Too little exercise may not be sufficient to bring about change.
Progressing your exercises too quickly (causing the pain to flare up) or not progressing it at all (causing your progress to stagnate).
There is evidence that stress and anxiety can increase the intensity of pain and, in some cases, even cause pain to persist long after the injury has healed. If your scans show very little tendon damage or your pain persists despite you being able to perform all the necessary rehab exercises, it may be worth checking if there are other aspects of your life that may be contributing to your pain.
Typical recovery times for Achilles tendonitis caused by overuse
Regardless of any other factors, injured tendons take longer to repair than muscles because:
Tendons are mostly made up of collagen fibres, and the process of producing and strengthening collagen is slower than the process for muscle fibres.
Tendons have a poorer blood supply than muscles.
Best case scenario: 12 weeks recovery time
If your Achilles pain only started recently (within the last few weeks), you should be able to ease back into your sport within 12 weeks of starting the correct treatment plan. When tendonitis is seen to in a timely manner, the tendon doesn’t undergo much structural change, and it can recover in a relatively short period of time.
Most common scenario: 6 to 12 months recovery time
Most people only seek help when their tendons have already been painful for several months. This is because the pain often starts very gradually and, during the early stages, tends to improve with activity. Some people may seek help early but receive poor advice e.g., they’re stuck in a boot for a prolonged period or given lots of Achilles stretches that just end up aggravating their pain.
When Achilles tendonitis drags on for several months, the tendon usually undergoes structural changes that will require quite a few months of dedicated training and careful load management to rectify.
Worst case scenario: more than 12 months
If your pain has been present for close to a year or perhaps even longer, your tendon will likely take more than 12 months to recover.
The road to recovery is full of twists and turns
In an ideal world, our recovery would follow a simple trajectory; as long as you do the right things, your pain and function should improve week-on-week. Unfortunately, this is rarely the case for Achilles tendonitis or tendinopathy rehab.
It’s just not possible to always pitch your rehab at the exact right level for your tendon’s current strength and sensitivity; often, normal daily tasks and responsibilities may throw you a curveball and other times your tendon pain may flare up for no apparent reason.
Flare-ups along the road to recovery are very common and should be expected. When they happen, try not to lose motivation but also don’t just try to ignore them and push through the pain – this usually makes things worse. Instead, learn from flare-ups, temporarily adjust your rehab, and move on.
How we can help
Need more help with your Achilles injury? You’re welcome to consult one of the team at TMA online via video call for an assessment of your injury and a tailored treatment plan.
We're all UK Chartered Physiotherapists with Master’s Degrees related to Sports & Exercise Medicine. But at Treat My Achilles we don't just value qualifications; all of us also have a wealth of experience working with athletes across a broad variety of sports, ranging from recreationally active people to professional athletes. You can meet the team here.
About the Author
Maryke Louw is a chartered physiotherapist with more than 15 years' experience and a Master's Degree in Sports Injury Management. Follow her on LinkedIn and ResearchGate.