Achilles Tendon Rupture
An Achilles tendon rupture is a tear in the tendon at the back of the ankle, often caused by a sudden push-off or injury. It usually leads to sharp pain and difficulty walking, and understanding the symptoms and treatment options can help guide your recovery.
Overview | Symptoms & Causes | Diagnosis | Treatment Options
The Achilles Tendon
The Achilles tendon is a strong cord at the back of your ankle that connects your calf muscles (the gastrocnemius and soleus) to your heel bone. When your calf muscles tighten, they pull through this tendon to move your foot downwards and push you forward when you walk or run.
An Achilles tendon rupture occurs when this tendon suddenly tears, often during activities that involve pushing off, jumping, or sprinting. Ruptures can happen in otherwise healthy tendons, but they are more common if the tendon has been weakened by tendinopathy, age, or certain medications.
Achilles Tendon Rupture
Signs of a rupture usually appear suddenly and can affect how you move and bear weight. Common symptoms include:
- A sudden, sharp pain at the back of the ankle or heel, sometimes described as being hit or kicked.
- A popping or snapping sound at the time of injury.
- Difficulty walking, especially pushing off the toes or rising onto tiptoes.
- Swelling and bruising around the back of the ankle.
- A gap or depression may sometimes be felt in the tendon above the heel.
Most people find it impossible to continue normal physical activity immediately after a rupture.
If you suspect an Achilles tendon rupture, it is important to seek medical attention promptly, ideally on the same day. Immediate assessment and early diagnosis allows for quicker treatment, which can improve recovery and reduce the risk of long-term weakness or limited ankle movement.
Causes and Risk Factors
An Achilles tendon rupture usually occurs when the tendon is subjected to a sudden, high load it cannot handle. Common causes include:
| Sports injuries | Sudden pushing off, jumping, or sprinting, especially in sports like football, basketball, or tennis. |
| Sudden increase in activity | Rapid changes in exercise intensity or volume can overload the tendon. |
| Pre-existing Achilles tendinopathy | A weakened tendon is more likely to tear. |
| Age | Tendons lose elasticity with age, making rupture more likely, particularly in people over 40. |
| Male sex | Men are more commonly affected than women. |
| Certain medications | Long-term use of corticosteroids or some antibiotics (e.g., fluoroquinolones) may weaken tendons. |
Diagnosing an Achilles tendon rupture
If an Achilles tendon rupture is suspected, a healthcare professional will usually diagnose it through a combination of medical history, physical examination, and imaging.
| Physical Examination | The doctor will examine the back of your ankle and tendon, checking for a gap or depression where the tendon may have torn. They will also assess how well you can move your foot and push off with your toes; limited movement or difficulty pointing your foot downwards can indicate a rupture. |
| Ultrasound | Uses sound waves to create real-time images of the Achilles tendon, showing whether it’s fully or partially torn and where the tear is located. It’s quick, painless, and helps guide whether surgery or non-surgical treatment is most appropriate. |
| MRI Scan | Occasionally used if more detailed images are needed, particularly before surgery. |
Treatment Options
The best treatment depends on the severity of the tear, your activity level, and your overall health. Treatment usually falls into conservative management or surgical approaches.
| Conservative | For some tears, especially partial ruptures, the tendon can heal without surgery. Your foot and ankle may be immobilised in a cast or boot, often with your toes pointing downwards to bring the tendon ends together. |
| Surgical | Surgery involves rejoining the torn ends of the tendon. It can reduce the risk of re-rupture and may allow a slightly quicker return to high-level physical activity. After surgery, your foot will be protected in a cast or boot. |
Whether treated surgically or non-surgically, a progressive rehabilitation programme is key. This includes exercises to restore calf strength, ankle movement, and balance, gradually returning you to walking, running, and other activities. Recovery usually takes several months, and adherence to the rehabilitation plan is essential for the best outcome.
How can Lanthorn help?
Ultrasound Calf - £300
Uses real-time imaging to show whether the tendon is fully or partially torn and helps guide the most appropriate treatment.
MRI Scan - £350
Provides highly detailed images of the tendon and surrounding structures, useful when planning surgery.
Specialist referral and follow-up planning
If a rupture is confirmed, we can arrange timely referral to orthopaedic or sports injury specialists for further assessment and management.
