Achilles tendon rupture is a painful injury in which the Achilles tendon, the strong fibrous band that connects the calf muscles to the heel bone, partially or completely tears. The Achilles tendon plays an important role in walking, running, jumping, and pushing the foot downward. A rupture usually occurs when the tendon is suddenly overstretched or subjected to more force than it can withstand. It is commonly seen during sports that involve running, jumping, sudden acceleration, or changes in direction, although it can also occur during everyday activities. Achilles tendon rupture is more common in adults, particularly those who participate in recreational sports. A complete rupture can significantly affect the ability to walk and stand on the toes of the affected leg and may require prompt medical evaluation and treatment.
An Achilles tendon rupture generally occurs when the tendon is exposed to sudden or excessive force. Common causes include:
Sports activities such as soccer, basketball, tennis, badminton, and running
Sudden acceleration, jumping, or changing direction
Forceful plantarflexion of the ankle, such as pushing off suddenly
Sudden dorsiflexion of the ankle while the calf muscles are contracted
Falling from a height
Stepping unexpectedly into a hole or depression
Sudden strenuous physical activity after a period of inactivity
Repeated stress or degeneration of the Achilles tendon
Certain medications and medical factors may also increase the risk of tendon injury. These include corticosteroid use or injections near the tendon and certain antibiotics, particularly fluoroquinolone antibiotics. Obesity and increasing age may also contribute to tendon degeneration and injury risk.
A healthcare professional usually begins with a medical history and physical examination. The doctor may ask how the injury occurred and whether a popping or snapping sensation was noticed. During the examination, the doctor may check:
Tenderness and swelling around the Achilles tendon
The ability to walk and push the foot downward
The ability to stand on the toes
The continuity of the tendon
Calf muscle strength and ankle movement
A Thompson test, also known as a calf-squeeze test, may be performed. During this test, the calf is gently squeezed while the doctor observes the movement of the foot. Abnormal or absent downward movement of the foot may indicate an Achilles tendon rupture. Imaging tests such as ultrasound or magnetic resonance imaging (MRI) may be recommended when the diagnosis is uncertain or when the extent and location of the tear need to be assessed.
Surgery may be recommended for certain complete ruptures, particularly in younger or highly active individuals or when the tendon ends are significantly separated. During surgery, the torn tendon ends are brought together and repaired. After surgery, rehabilitation is an important part of recovery. The patient may initially need immobilization followed by a structured physical therapy program.
Physical therapy is usually an important part of recovery, whether treatment is surgical or non-surgical. Rehabilitation is generally introduced gradually to avoid placing excessive stress on the healing tendon. A physiotherapist may recommend exercises to improve:
Ankle range of motion
Calf muscle strength
Tendon flexibility
Balance and coordination
Walking pattern
Functional strength needed for daily activities and sports
The timing and intensity of exercises should be determined by the treating healthcare professional.
Recovery from an Achilles tendon rupture can take several months. The timeline varies depending on the severity of the injury, the treatment method, the individual’s health, and adherence to rehabilitation. Returning to running, jumping, or competitive sports too quickly may increase the risk of reinjury. Activities should therefore be resumed gradually and only when adequate strength and function have returned.
Sudden pain, swelling, or a popping sensation in the back of the ankle during physical activity should be evaluated promptly. Difficulty pushing the foot downward or standing on the toes may indicate an Achilles tendon rupture. A suspected rupture should not be ignored because early diagnosis and appropriate treatment can help support recovery and reduce complications.
Disclaimer: This information is intended for general educational purposes and should not replace consultation with a qualified healthcare professional. A suspected Achilles tendon rupture requires appropriate medical assessment and treatment.
