Quitting smoking may ease tendon pain recovery after Achilles surgery

If tendon pain at the back of your ankle ever ends in surgery, here is something useful: most people in a new study healed without a complication, and the two things linked to trouble are ones you can often influence. Those two things were smoking and a long wait for the operation.

The Achilles tendon connects your calf to your heel. It can tear during sport or a sudden push-off, often in middle age. Surgery is a common fix. The skin over the tendon is thin, so wounds there can be slow to heal. That is where most of the problems showed up.

How the study worked

Researchers looked back at the records of 86 people who had surgery for a fresh Achilles tendon tear at one hospital between 2021 and 2024. They tracked any complication in the 3 months after surgery, plus the extra care people needed. The study was published Oct. 23, 2026, in Medicine. It came from a single hospital with a fairly small group, so the numbers are best seen as a useful guide.

What they found

About 4 in 5 people had no complication. In all, 16 people (18.6%) did. Most of those were wound problems:

• Slow wound healing in 6 people (7.0%)
• A surface infection in 4 people (4.7%)
• A deep infection that needed another procedure in 1 person (1.2%)
• Long-lasting wound problems that needed extended outpatient care in 2 people (2.3%)

People who had a complication needed more care along the way. They stayed longer in the hospital, had more dressing changes and more clinic visits. They were also more likely to be readmitted or to need another operation.

Two factors stood out. People with a history of smoking were about three times as likely to have a complication (the exact figure in the study was 3.21). And each added stretch of time between the injury and the surgery went along with a higher chance of trouble. Higher body weight was also more common among those who had complications.

What does smoking have to do with healing?

Nicotine narrows small blood vessels, and wounds need a steady blood supply to close and fight infection. A thin-skinned area like the back of the ankle has little to spare. That fits with what this study saw. The good news is that smoking is something you can change, and the same goes for how quickly you seek care.

What you can do today

If you smoke and surgery might be in your future, pick one moment in your day to skip a cigarette, such as the first one with your coffee. It is a small first step toward quitting. For help, search for your state’s free quitline, which offers coaching at no cost. If you ever feel a sudden snap at the back of your ankle, get seen promptly rather than waiting it out.