Achilles Tendon Injuries: Insights from an Orthopedic Surgeon

Achilles tendon injuries are among the most common and debilitating issues faced by active individuals, from professional athletes to recreational players. Recently, Tiger Woods was sidelined from the 2025 Masters Tournament due to a ruptured Achilles tendon sustained while training at home. He underwent surgery last month.

This incident reignited conversations about the nature, causes, and treatment of Achilles injuries. Justin M. Weatherall, M.D., orthopedic surgeon with Baptist Health Orthopedic Care, provides expert insights into these injuries.

What Is an Achilles Tendon Injury?

Justin M. Weatherall, M.D., orthopedic surgeon with Baptist Health Orthopedic Care.

The Achilles tendon is the largest tendon in the body, connecting the calf muscles to the heel bone. It plays a crucial role in walking, running, and jumping.

“Your traditional Achilles tendon rupture is going to happen in the mid-substance of the tendon, which is about two to six centimeters above where it attaches to your heel bone,” explains Dr. Weatherall. This location is particularly vulnerable due to its limited blood supply, making it more susceptible to injury.

In most cases, the rupture results from a sudden, forceful movement. “It's usually a forced contracture where your foot is forced up when it hits the ground,” Dr. Weatherall said. Such trauma often occurs during sports that involve abrupt starts and stops. “So, that's why we see it a lot in sports like basketball, soccer, or even pickleball, which has seen an increasing incidence rate recently.”

Who Is Most at Risk?

Although professional athletes frequently make headlines with these injuries, they are not the only ones at risk. Dr. Weatherall notes, “This injury typically happens in your weekend warrior population, average age about 45 to 50, and about 80 percent of these cases are men.” The term "weekend warrior" refers to individuals who engage in intense physical activity sporadically, often without adequate preparation or conditioning.

Certain medical factors can also increase the risk of Achilles tendon issues. “We just encourage stretching,” Dr. Weatherall advises, emphasizing preventive measures. “There are a few things that do predispose you (to injury) like steroids, certain antibiotics. They might change structure to the tendon and temporarily put you at high risk of Achilles tendonitis.”

Treatment Options: Surgery vs. Conservative Management

In the United States, surgical intervention remains the primary approach to treating Achilles tendon ruptures. “Surgery is still the best treatment in the U.S.,” Dr. Weatherall states. However, he also acknowledges emerging alternatives. “There are a lot of new studies that have come out -- mainly done in some of the European countries and in Canada -- showing that non-surgical treatment might be successful for this injury.”

While non-surgical approaches may be appropriate for some individuals, particularly those with less severe ruptures or lower physical demands, surgery offers more predictable outcomes for complete recovery, especially among athletes and highly active individuals.

Recovery: A Long and Challenging Road

Regardless of the treatment method, recovery from an Achilles tendon rupture is extensive and often frustrating. “The recovery after surgery is very long. What I like to tell patients in the office is that surgery is the easy part,” Dr. Weatherall remarks. “It's a quick, usually takes about 30 minutes. However, you're looking at one- to two-year recovery.”

This lengthy timeline reflects the slow healing process of tendon tissue, as well as the rigorous rehabilitation required to restore strength and flexibility. Dr. Weatherall draws a comparison to professional athletes: “Basketball fans may have followed Kevin Durant. They saw it took him about two years to come back.” Mr. Durant sustained a ruptured right Achilles tendon during Game 5 of the 2019 NBA Finals, while playing for the Golden State Warriors.

The early weeks following surgery are particularly difficult. “The worst part is usually the first six weeks when they're immobilized or very limited. If it's the right leg, they may not be able to drive. Once they get beyond that, they start to get a little bit more of their life back,” he explains.

Prevention: Warm-Up, Stretch, and Ease In

Gradual conditioning, regular stretching, and awareness of risk factors can significantly reduce the likelihood of injury. Those taking certain medications, like steroids or specific antibiotics, should consult their healthcare providers about the potential effects on tendon health.

As Dr. Weatherall emphasizes, understanding the mechanics of the injury, exploring appropriate treatment options, and committing to preventive strategies are essential steps for anyone looking to protect their Achilles tendon health.

Given the severity and duration of recovery, prevention is critical—especially for those in higher-risk groups. One of the most important strategies is to avoid jumping into intense physical activity without proper preparation. “Just make sure that you're not going from zero to 60 -- getting right into the activity without stretching and easing into it,” Dr. Weatherall warns.