| Sumario: | BackgroundCase DescriptionOutcomesConclusionPartial tears of the Achilles tendon, particularly those affecting the anterior fibers, are rare and often underdiagnosed. Additionally, management remains controversial, especially in active individuals seeking to avoid surgery.A 32-year-old amateur basketball player sustained an acute partial tear of the anteromedial Achilles tendon near the insertional region, confirmed by high-resolution ultrasound. The lesion was characterized by hypoechoic fiber disruption, tendon thickening, and neovascularization, without complete tear. Nonoperative management was initiated, consisting of activity modification, bilateral heel lifts, and a progressive, pain-guided loading program. Ultrasound-guided percutaneous electrolysis (PE) was introduced as an adjunct intervention to modulate pain and stimulate local tissue remodelling. Six PE sessions were performed over four months, followed by a structured progression exercise program.The patient demonstrated progressive improvement in function and pain. VISA-A (The Victorian Institute of Sport Assessment-Achilles) score increased from 4/100 at baseline to 100/100 at 48 weeks. Dorsiflexion range (lunge test) and heel-rise endurance recovered to near-symmetry with the contralateral limb. Palpation pain decreased from 8/10 to 2/10, and morning pain resolved entirely. Final ultrasound revealed tendon reorganization with a hyperechoic appearance and reduced neovascularization.This case highlights that a rare insertional partial Achilles tear can be effectively managed with a simple, individualized loading program, reinforcing mechanotherapy as the key component of rehabilitation. The adjunctive use of ultrasound-guided percutaneous electrolysis may enhance outcomes, suggesting a potentially efficient alternative to more complex treatment approaches.
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