What is it?
The tendon tears, usually a few centimeters above the heel. Walking may still be possible, which is why ruptures are sometimes mistaken for sprains.
What causes it?
- Sudden acceleration or jumping, commonly in basketball, tennis, and racquet sports
- Pre-existing tendon degeneration
- Certain antibiotics and steroid use
What does it feel like?
- A pop or snap with sudden pain
- Weakness pushing off or standing on tiptoe
- A gap in the tendon
- Swelling and bruising at the back of the ankle
How is it diagnosed?
A specific exam (the Thompson test) usually confirms the rupture. Ultrasound helps assess the gap between the tendon ends; MRI is used in some cases.
When should you see a podiatrist?
- Immediately — a suspected Achilles rupture should be evaluated within days
Nonsurgical treatment
- Functional rehabilitation
- Immobilization in a boot with the foot pointed down, followed by a structured, gradual rehabilitation program. For many patients this produces results comparable to surgery.
When is surgery considered?
Surgery may be recommended for athletes, for ruptures with a large gap, for delayed diagnosis, or for re-ruptures. The decision is individual and depends on your activity goals and health.
The tendon ends are repaired, sometimes through small incisions. Ruptures diagnosed late may need reconstruction with a tendon transfer or graft.
Related procedures
What is recovery like?
Whether treated with or without surgery, recovery involves several weeks in a boot and months of progressive rehabilitation. Return to sport commonly takes six to twelve months.
Frequently asked questions
Do all Achilles ruptures need surgery?
No. Many are treated successfully without surgery using an accelerated rehabilitation protocol. Your surgeon will discuss which approach suits you.
Can I walk on a ruptured Achilles?
Some people can, which is why ruptures are sometimes missed. Walking does not mean the tendon is intact.