Achilles Tendon Rupture

An Achilles tendon rupture is an injury that happens when your Achilles tendon tears.

The Achilles tendon is a strong band of tissue in the back of your leg, near your heel. It holds your calf muscles to your heel bone. It helps you walk, run and jump. Rupture is the medical term for a ligament or tendon tearing into multiple pieces.

Types of Achilles tendon ruptures

Healthcare providers classify Achilles tendon ruptures as one of two types:

• Partial: Your Achilles tendon is torn, but not all the way through. It’s still in one piece, but there’s a tear in some or most of it.
• Complete: Your Achilles tendon is torn all the way through. It’s separated into two pieces.

Symptoms of an Achilles tendon rupture

The most common ruptured Achilles tendon symptoms include:

• Feeling or hearing a pop in your calf
• Feeling like you got hit or kicked in the heel or calf
• Sudden sharp pain in your ankle near your heel (but some people don’t feel pain when the injury happens)
• Pain when walking, especially on stairs or when going uphill
• Tenderness in your heel or calf
• Trouble walking or moving your heel
• Sudden swelling and bruising on the back of your ankle
• Not being able to point your toes down
• A spongy feeling at the back of your ankle

Achilles tendon rupture causes

An Achilles rupture is usually a sports injury. But anything that puts a lot of sudden force on your Achilles tendon can put too much pressure on it and tear it.

Sports where you suddenly stop, change direction or pivot are more likely to lead to Achilles tears. Examples include:

• Basketball
• Tennis, squash or other racket sports
• Football
• Soccer

You don’t have to be an athlete to tear your Achilles tendon. Other causes include:

• Slipping
• Tripping
• Missing a stair
• Twisting your ankle

Risk factors

Anyone can rupture an Achilles tendon. But you may have a higher risk if you:

• Play sports, especially ones involving sudden stops or pivots
• Are female
• Are between the ages of 30 and 40
• Use anabolic steroids

Some health conditions and treatments may increase your Achilles tendon tear risk, including:

• Rheumatoid arthritis and other conditions that cause inflammation
• Lupus
• Diabetes
• Obesity
• Taking antibiotics, like ciprofloxacin or levofloxacin
• Taking corticosteroids

Talk to your healthcare provider about any risk factors or side effects you should watch out for.

Complications of this condition

An Achilles tendon rupture is a traumatic injury that needs to be treated right away. An untreated ruptured Achilles tendon may not heal properly. This can increase your risk of tearing it again. Improper healing can also affect how well you can use and move your ankle and foot.

How doctors diagnose Achilles ruptures

A healthcare provider will diagnose an Achilles tendon rupture with a physical exam and some tests. Your provider will examine your leg and ankle. They may use the Thompson test to see if your heel moves when they squeeze your calf.

You’ll probably need imaging tests, like an X-ray, ultrasound or MRI, to take pictures of your Achilles tendon and the area around it.

Achilles tendon rupture treatment

Surgery is the most common treatment for an Achilles rupture. Especially if you’re an athlete or physically active. A surgeon will repair your Achilles tendon and reattach it correctly. After surgery, you’ll need to wear a cast or splint on your lower leg. This will support your ankle while your tendon heals.

Your healthcare provider may suggest nonsurgical treatment. Only certain types of ruptures can be treated this way. Your provider will place your foot, ankle and calf in a boot with heel lifts or a cast. Your foot and ankle will flex downward so your Achilles tendon can heal with less tension on it.

Your provider will discuss your treatment options with you. They’ll tell you what they think the best treatment is and why.

When should I see my healthcare provider?

See a healthcare provider right away if you think you have a torn Achilles tendon. The faster you get it diagnosed, the better.

Use the RICE method in the meantime. Stay off your injured leg, ice your calf, apply compression to it and, if possible, elevate it above your heart. You should still see a healthcare provider ASAP. But these steps can reduce swelling while you’re waiting to be seen.

Healing time for a torn Achilles tendon

It usually takes four to six months to heal after an Achilles tendon rupture. But it can take up to a year before it’s safe for you to resume playing sports, do intense physical activities or return to your pre-injury activity level.

Don’t resume any sports or training before your healthcare provider says it’s safe. If you put too much stress on your Achilles tendon too soon, you can injure it again.

You’ll need physical therapy to help you regain your strength, flexibility and range of motion. Your provider will tell you what to expect based on your unique circumstances.