An Achilles tendon rupture is when you tear the tissue that connects your calf muscle to your heel bone.
Your Achilles tendon is very strong and flexible. It’s at the back of your ankle and connects your calf muscle to the bone in the heel of your foot (calcaneum). If you rupture your Achilles tendon, you can either partially or completely tear the tendon.
Most people who injure their Achilles tendon are between 30 and 50 and don’t exercise regularly. It’s more common in men but can affect anyone.
It happens most often in the left leg. This may be because most people are right-handed which means that they ‘push off’ more frequently with the left foot when running. .
If you rupture your Achilles tendon, you may hear a snapping or popping sound when it happens. You will feel a sudden and sharp pain in your heel or calf (lower leg). It might feel like you have been kicked or hit in the back of your leg. You may also:
If you have any of these symptoms and believe you have ruptured your Achilles tendon, go straight to accident and emergency at your local hospital.
If you partially rupture your Achilles tendon, the tear may only be small. Symptoms of pain and stiffness may come on quite suddenly like a complete rupture, but may settle over a few days.
There are a number of factors that can increase the risk of an Achilles tendon rupture, which include the following.
Your doctor will ask you about your symptoms and examine you. He or she may also ask you about your medical history. Your doctor may ask you to do a series of movements or exercises to see how well you can move your lower leg. He or she may also examine your leg, heel and ankle and may squeeze your calf muscle to check the movement of your foot.
You may need to have further tests to confirm if your tendon is torn, which may include the following.
Your doctor may advise you to rest your leg and keep the tendon immobile in a plaster cast while it heals. Or you may need to have an operation to treat an Achilles tendon rupture. The treatment you have will depend on your individual circumstances, such as your age, general health and how active you are. It will also depend on whether you have partially or completely torn your tendon. If you have a partial tear, it might get better without any treatment. Ask your doctor for advice on the best treatment for you.
If you need pain relief, you can take over-the-counter painkillers such as paracetamol or ibuprofen. Always read the patient information that comes with your medicine and if you have any questions, ask your pharmacist for advice.
You may need to wear a plaster cast, brace or boot on your lower leg for six to eight weeks to help the tendon heal. During this time, your doctor will change the cast a number of times to make sure your tendon heals in the right way.
If your tendon is partially ruptured, your doctor will probably advise you to have this treatment instead of surgery. It’s also suitable for people who aren't very physically active. However, there is a greater risk that your tendon will rupture again, compared with surgery. Your doctor will advise you which treatment is best for you.
Your doctor may recommend surgery if you’re young and active, or an athlete. However, this will depend on where your tendon is ruptured. If the rupture is at, or above, the point at which your tendon merges with your calf muscle, for example, surgery may not be possible.
There are three main types of surgery to repair a ruptured Achilles tendon.
In all types of surgery, your surgeon will stitch the tendon together so it can heal. Each type of surgery has different risks. Open surgery is less likely to injure one of the nerves in your leg for example, but has a higher risk of infection. Ask your surgeon to explain the risks in more detail.
After your operation, you will need to wear a series of casts or an adjustable brace on your leg to help your Achilles tendon heal. This will usually be for between four and eight weeks.
There is a chance that your tendon will rupture again after the operation.
After your treatment
After you have your cast or brace removed, you will need to gradually increase your activity to strengthen your Achilles tendon. Your doctor, or a physiotherapist (a health professional who specialises in maintaining and improving movement and mobility), will give you exercises to do. These are designed to increase the range of movement and strength in your lower leg. You will start with gentle exercises and build these up over time.
Your physiotherapist will also advise you on how to return to exercise. You should be able to return to activity six months to a year after your injury. However, this may take longer and will also depend on the activity.
You can help to reduce your risk of an injury to your Achilles tendon by doing the following.
Reviewed by Rachael Mayfield-Blake, Bupa Health Information Team, March 2014.
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For sources and links to further information, see Resources.
This information was published by Bupa's Health Information Team and is based on reputable sources of medical evidence. It has been reviewed by appropriate medical or clinical professionals. Photos are only for illustrative purposes and do not reflect every presentation of a condition. The content is intended only for general information and does not replace the need for personal advice from a qualified health professional. For more details on how we produce our content and its sources, visit the about our health information page.
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