Physical activity has many health benefits, but some sports and exercises can also increase the risk of injury. Activities such as jumping, running, and quick direction changes can put a lot of stress on your body, especially on the Achilles tendon. It is the strong tendon at the back of the ankle. Due to which, sports like soccer, badminton, and volleyball can increase the risk of an Achilles Tendon Rupture.
The injury can happen to both men and women. However, it is most common among men aged 30 to 50 who play sports recreationally from time to time. The number of Achilles tendon ruptures has been increasing every year.
Even though the injury is very common, experts still do not completely agree on the best way to recover after a rupture. Most people continue to experience muscle weakness, stretching or weakening of the tendon, and difficulty returning to their previous activity level.
An Achilles tendon rupture can even end the sports careers of professional athletes.
What Happens To Muscle Strength and Muscle Size After an Achilles Tendon Rupture?
Many people do not fully recover after an Achilles tendon rupture due to changes in muscle size and strength. After an injury, the calf muscles, especially the gastrocnemius and soleus muscles, usually become weaker. Some people still experience weakness even many years after an injury or surgery.
Strength in the injured leg can be much lower than in the uninjured leg, especially during the first few months of recovery. Even after many years, some people continue to have noticeable strength differences between both legs. The weakness happens partly because the injured leg needs to stay immobilized for some time, followed by a slow rehabilitation process. When muscles are not used for long periods, they naturally shrink. The process is known as muscle atrophy.
In healthy people, muscle loss from inactivity typically recovers over time once regular movement resumes. However, after an Achilles tendon rupture:
- Calf muscles remain smaller for years
- Muscle strength never fully returns
- Some muscle loss can become long-term or even permanent.
Recovery after an Achilles tendon rupture can be lengthy, and some people may continue to experience reduced muscle strength and muscle size long after the injury has healed.
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Tendon Length After an Achilles Tendon Rupture
Along with muscle weakness and loss, changes in tendon length also affect recovery after an Achilles Tendon Rupture. Achilles tendon becomes longer during the healing process after a rupture. The stretching, known as tendon elongation, can reduce muscle function and affect balance, strength, and movement. Doctors and researchers also use different methods to measure tendon length, including MRI scans, ultrasound, and X-rays with metal markers.
Tendons can begin to separate and lengthen only a few days after surgery, when the leg is immobilized. Over the following months, the tendon can continue to stretch. Some studies show lengthening of 10-20 millimeters. In some cases, the tendon can become much longer than normal. Most of the stretching happens during the first six months after an injury. Tendon elongation can seriously impair calf muscle function because the muscles lose some of their ability to generate force efficiently.
Researchers have also found that the healing tendon stays very active for various months. Blood flow and energy use in the tendon become higher than normal, and the tendon stiffness continues improving for up to a year after surgery.
These findings show that healing after an Achilles tendon rupture is a slow process that continues for 12 months or longer. Even with different rehabilitation programs, it is difficult to prevent tendon elongation.
Functional Recovery After an Achilles Tendon Rupture
Doctors use physical performance tests to assess how well the leg functions after an Achilles Tendon Rupture. The most common test is the heel-rise test. It measures muscle endurance and calf function.
During the test, a person stands on one leg, repeatedly raises and lowers the heel, tries to lift the heel as high as possible, and continues at a steady pace until fatigue. Doctors usually check how many heel raises can be done. How high does the heel lift? And the total amount of work performed.
Even after six months of injury, the injured leg performs much worse than the healthy leg. People have lower heel-rise heights, reduced calf endurance, and reduced calf power. In most cases, these problems continue even after a year or longer.
That shows some loss of function can become long-term. Researchers also found that tendon length plays an important role in recovery. When the Achilles tendon lengthens during healing, heel-rise performance usually worsens.
Longer tendons are associated with weaker calf function, and greater tendon elongation leads to lower heel-rise heights. Also, restoring normal tendon length can be important for better recovery and movement. It shows that both muscle recovery and proper tendon healing are important for regaining strength and function after an Achilles tendon rupture.
How To Prevent Achilles Tendon Injuries?
It is important to take care of your Achilles tendons even if they are strong and durable. The best thing you can do is train them to do what you want. You can reduce the risk of Achilles injuries by warming up and cooling down every time you exercise or play sports, slowly increasing the length and intensity of the workouts, avoiding exercise on uneven surfaces, and wearing well-fitting shoes.
If you tear your Achilles tendon, be ready to wait a long time for it to recover. Our team of foot and ankle specialists will work with you to get you on your feet and back in the game. Book an appointment to talk to our experts about Achilles tendon injury.
