How long does it usually take before Achilles tendonitis becomes irreversible?

Did you do anything within those two and a half months to treat it? Ice? Massage? Heel lifts?

It will eventually heal but ice, temporary heal lift, and having a massage therapist work on your calves may speed the healing process.

I don't think it's too late for you, let me explain:

I have chronic, irreversible achilles tendonitis, and it took about 6 months of constant misdiagnoses, incorrect treatment, beginning running, pushing it, and reinjuring repeatedly (about 11 times) until it ended my running career. DON'T be like me. Now that your season is over STOP RUNNING FOR AT LEAST 6 MONTHS!! It will truly take that long for it to heal completely. If you don't let it heal completely, IT WILL NEVER HEAL. Also, you can't force it to heal - you can, however, speed the process by icing, doing eccentric heel lifting exercises, and going easy on it. Pushing anything too hard (even a little bit) can reinjure it and render weeks/months of prior treatment useless.

You need to be active to encourage healing, it's never a good idea to be sedentary. I'd recommend biking (easy) to stay in shape, swimming, calisthenics, etc.

Six to eight weeks minimum of no running. If you feel anything similar to achilles pain when you start up, that means more (2) weeks off before you try again.

know someone who had this wrote:

Did you do anything within those two and a half months to treat it? Ice? Massage? Heel lifts?

I didn't do anything for the first month after getting it - it always went away after a minute or two of running, so I didn't think it was anything serious.

The Achilles really started acting up after I did some fast strides (13.x seconds for 100 meters). After that, I tried ice, getting new trainers with higher heels, calf massages, elevating the affected leg while sleeping, and eccentric calf drops. Those things helped me enough to run well (I PR'd too), but my Achilles still alternated between discomfort and pain during the rest of the day when I was moving around but not running.

Anyway, I'm pretty sure that the tight calf muscles or lack of strength in my calves were causing the problem. A week or two before getting injured, my calves were feeling pretty stiff and tight, and I've pretty much ruled out other causes. I don't overpronate, didn't run in brand new or worn out shoes, rarely run on hills, and didn't have sudden or large increases in mileage or intensity.

the achilles exercises (eccentric calf raises) take quite a while to solve the problem and they require maintenance. if you're doing the exercises wrong (not concentrating on the slow lowering of the heel), you won't, as I didn't, get the full benefits of it. but add in the opposite exercise to prevent shin splints (facing down on the steps, raise and lower your foot with the heel on the edge of the step, many times). all that other stuff is extraneous.

I had Achilles problems for 5 years. Eccentric calf exercises finally kicked the problem. Standing ones helped a little, but the seated ones worked the best. And you have to do them every day. I was told that the collagen in tendons takes approximate 100 days to regenerate, and the eccentric calf exercises prevent the tendon from repairing improperly. So it will take a long time to heal, but it will happen. Good luck.

Time to recovery depends on severity- some people can get through it with dropping milage, doing some exercises, taking some NSAIDS, and icing (I fell into that category- but it hurt like hell). Others need a lot of time off, with the eccenttric calf exercises that others have mentioned, and ice.

And just as an fyi- someone just gave our hospital's weekly grand rounds on overuse injuries, and he went over that really the term tendinitis is inaccurate- there is no inflamation (implied with the -itis) when they've biopsied them, or looked at animal models. What there is is an excess of type III collagen, which is a more disordered, weaker form than the normal (for the achilles) type I collagen. Given time, the type III will remodel into type I, as part of the normal repair process. So the preferred term is achilles tendinosis.

dd wrote:

Time to recovery depends on severity- some people can get through it with dropping milage, doing some exercises, taking some NSAIDS, and icing (I fell into that category- but it hurt like hell). Others need a lot of time off, with the eccenttric calf exercises that others have mentioned, and ice.

And just as an fyi- someone just gave our hospital's weekly grand rounds on overuse injuries, and he went over that really the term tendinitis is inaccurate- there is no inflamation (implied with the -itis) when they've biopsied them, or looked at animal models. What there is is an excess of type III collagen, which is a more disordered, weaker form than the normal (for the achilles) type I collagen. Given time, the type III will remodel into type I, as part of the normal repair process. So the preferred term is achilles tendinosis.

If there's no inflammation, why would icing it help?

permanent injury? wrote:

If there's no inflammation, why would icing it help?

It's supposed to stimulate blood flow, especially when you alternate heat and cold. Less blood flow is supposedly one of the reasons why connective tissue is slower to heal than muscle.

Light biking will also help by promoting blood flow without loading the tendons.

Try the no-heeled shoes when you start again. AFTER SIX MONTHS.

REAL SLOW AND LOW VOLUME.

Kilroy wrote:

Try the no-heeled shoes when you start again. AFTER SIX MONTHS.

That is a moronic suggestion. If you have Achilles problems, why do something that will definitely aggravate them?

To OP: there's no magic time limit for healing. Just take time off until it doesn't hurt, and go for a week or two of no hurting before you try to run. The eccentric heel drops are good--do them multiple times, every day. you can roll out your calves with a foam roller if that helps. Mostly, you'll just have to wait for the damage to get repaired, which may indeed take several months since you pushed through it for so long.

Moronic is wearing high heeled shoes 90 hours per week and thinking that won't shorten your tendons.

If you start slow and easy, you'll give your body time to adjust and you can gradually build your way up using a natural stride.

It might not. In fact, very little evidence that icing helps most injuries. But anecdotally it seems to help, and probably doesn't hurt, although that could be wrong. See below:

Am J Sports Med. 2004 Jan-Feb;32(1):251-61.

The use of ice in the treatment of acute soft-tissue injury: a systematic review of randomized controlled trials.

Bleakley C, McDonough S, MacAuley D.

Rehabilitation Science Research Group, University of Ulster at Jordanstown, Antrim, Ireland.

BACKGROUND: There are wide variations in the clinical use of cryotherapy, and guidelines continue to be made on an empirical basis. STUDY DESIGN: Systematic review assessing the evidence base for cryotherapy in the treatment of acute soft-tissue injuries. METHODS: A computerized literature search, citation tracking, and hand searching were carried out up to April 2002. Eligible studies were randomized-controlled trials describing human subjects recovering from acute soft-tissue injuries and employing a cryotherapy treatment in isolation or in combination with other therapies. Two reviewers independently assessed the validity of included trials using the Physiotherapy Evidence Database (PEDro) scale. RESULTS: Twenty-two trials met the inclusion criteria. There was a mean PEDro score of 3.4 out of of 10. There was marginal evidence that ice plus exercise is most effective, after ankle sprain and postsurgery. There was little evidence to suggest that the addition of ice to compression had any significant effect, but this was restricted to treatment of hospital inpatients. Few studies assessed the effectiveness of ice on closed soft-tissue injury, and there was no evidence of an optimal mode or duration of treatment. CONCLUSION: Many more high-quality trials are needed to provide evidence-based guidelines in the treatment of acute soft-tissue injuries.

How low would you recommend biking for? Would swimming be ok too? I have chronic patellar tendonitis.

Why would anyone take advice from a lying medical quack who makes his living from making sure you stay injured.

I disagree. At first, the heel lifts helped to get me running again, but when I started to transition to a more minimalistic shoe slow, I saw that my calves got stronger and the shock from racing in flats or spikes was lessened. The heel lifts also made my arches hurt, so I started to slowly phase them out by rotating different pairs of shoes.

I went to a doctor and went through some structured therapy. It took me 6 months to fully heal my achille's. I biked my ass off to maintain my aerobic fitness. Even so, I had some days after therapy where my achille's would get sore and I had to back off. Even now, if I overdo it for a few days, it gets alittle sore, so it is like the weak link for me. It may not even be 100% even now....

If you rupture it and need surgery then I'd say you have done some permanent damage. Look up some pics on google, it will get your ass on your bike right away.

Kilroy wrote:

Moronic is wearing high heeled shoes 90 hours per week and thinking that won't shorten your tendons.

If you start slow and easy, you'll give your body time to adjust and you can gradually build your way up using a natural stride.

He's spent 20 years wearing regular shoes, and you're suggesting he can undo all of that in six months?

its doable wrote:

If you rupture it and need surgery then I'd say you have done some permanent damage. Look up some pics on google, it will get your ass on your bike right away.

I didn't rupture it, and I definitely don't need surgery. I haven't run a single step since my last cross country meet, but the pain is still there as of today.

The good news is that it's slowly decreasing - it still hurts, but there's a bit less pain than when I first posted on here.

BTW, should I start doing the eccentric calf drops now, or should I wait until the pain is almost gone? Also, will swimming make the Achilles worse or lengthen the recovery time? It's too cold to swim outside, so I'll have to buy a gym membership to get access to an indoor pool if I want to find out for myself.

Why would tendonosis ever become irreversible? Isn't all soft tissue capable of healing?