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Achilles tendon rupture

Back to Patient education: foot & ankle

What is an Achilles tendon rupture?

An Achilles tendon rupture is a tear in the strong fibrous cord that connects the muscles in the back of your calf to your heel bone. The tendon can rupture partially or completely.

Your Achilles tendon is the largest tendon in the body and plays a critical role. In fact, you rely on it every time you move your foot. The tendon helps you point your foot down, rise on your toes and push off as you walk.

An Achilles tendon rupture is a serious injury. If you suspect you have torn your Achilles—especially if you hear a pop or snap in your heel and cannot walk properly—seek medical attention immediately! 

How do an Achilles tendon rupture occur?

These injuries usually result from a sudden increase in the amount of stress on the Achilles tendon.

Common causes include:

  • Increasing the level of physical activity too quickly
  • Falling from a height
  • Stepping into a hole
  • Over-stretching or over-using the tendon
  • Wearing very high heels

Ruptures typically occur within a few inches of the point where the tendon attaches to the heel bone.

What are the symptoms of an Achilles tendon rupture?

Although it’s possible to have no symptoms with an Achilles tendon rupture, common signs include:

In mBecause an Achilles tendon rupture can impair your ability to walk, it’s important to seek medical treatment as soon as possible. The earlier you receive treatment, the better the outcome.

How is an Achilles tendon rupture diagnosed?

In addition to a complete physical exam and patient history, your doctor might order an MRI to determine the extent of the injury.

What is the treatment?

Treatment depends on your age, activity level and the severity of your injury. Most minor to moderate Achilles tendon injuries heal on their own. But it’s important to give them plenty of time. Non-surgical treatment includes rest, ice, compression, elevation, and stretching and strengthening exercises. In some cases, patients wear a cast or walking boot with a heel lift, which allows the ends of the torn tendon to heal.

If the Achilles has ruptured completely, surgery is recommended. The surgeon makes an incision in the back of the lower leg, removes any damaged tissue and stitches the torn tendon together. Surgery is often the treatment of choice for competitive athletes or those whose tendons have ruptured again.

Following surgery, patients wear a cast or walking boot to keep the foot pointed down as the tendon heals. The cast is adjusted gradually to a neutral position. Physical therapy is necessary to strengthen leg muscles and the Achilles tendon itself. Most patients return to normal activities within four to six months.