Achilles Tendon Rupture – Causes, Symptoms, Treatments, and Diagnosis

Achilles tendon is one of the most commonly injured tendons in your body. Most Achilles tendon injuries are nothing more than tendonitis, a condition where the tendon becomes sore and swollen. In a severe Achilles tendon injury, the tendon may tear or rupture completely, becoming completely disconnected.

An injury to your Achilles tendon may be caused by a number of things including overuse, increasing your amount of daily exercise dramatically, not stretching before exercising and can even be caused by wearing high heels.

Problems with your feet have also been associated with Achilles tendon injuries, especially with people who have flat feet (also known as overpronation). Having flat feet puts more strain on your Achilles tendon and other tendons in the foot as it stretches them with every step you take.


What is an Achilles tendon Rupture?

You’re much more likely to sustain an Achilles tendon injury when you try to accelerate suddenly, such as when you sprint or jump off a diving board. The quick tensing of your muscles can be more pressure than your tendons can take, causing them to rupture and tear. Men, especially over 30, are especially susceptible to tendon injuries. Stretching and warming up before exercise can significantly reduce your risk for a rupture or other condition such as tendonitis.

The main difference between a ruptured Achilles tendon and run of the mill tendonitis is the amount of pain you feel and when you feel it. Tendonitis tends to get worse over time, where a ruptured tendon will be extremely painful immediately. If you hear a snap or popping sound, odds are you have probably torn or ruptured your tendon completely. Other symptoms include tenderness, swelling, stiffness and the inability to flex your foot and point your toes.

The good news is that mild to moderate Achilles tendon injuries will heal themselves, given enough time and rest. You should always avoid putting weight on an injured tendon. It’s recommended to walk with crutches and to avoid re-injury and promote healthy healing. You can ice your leg for 30 minutes every 4 or 5 hours for the first few days to help relieve the pain.

Using an elastic bandage to compress your leg can help to keep down the swelling, which can help reduce the amount of discomfort you feel. You can also take ibuprofen to help with the pain and swelling. You should be aware that ibuprofen does have side effects like ulcers and bleeding, so it should be used as little as possible unless recommended by your doctor.

Most of the time doing these things will allow your Achilles tendon injury to heal over time. In severe cases, surgery may be required as well as a cast that stays on for 6-10 weeks. It’s recommended to exercise your option for surgery as soon as possible if necessary, as it can reduce your chance of re-injuring your tendon.

Recovery can take months, even after your cast is removed. It’s recommended that you pace yourself and allow your body time to heal and recover from a serious injury. You shouldn’t return to your normal level of activity until you can move your leg as easily and freely as your non-injured leg and feel no pain at all when you walk, run or jump.

Symptoms of an Achilles tendon Rupture

An Achilles tendon rupture is a serious medical condition that’s generally associated with athletes. A rupture may be caused by excessive stress to the tendon, such as when a sprinter takes off or a diver jumps off a diving board. The burst of energy exerted by the muscles can sometimes be too much for your tendon to take.

A rupture is defined as a complete tear of your Achilles tendon. If your tendon is completely torn you may require reconstructive surgery to allow it to heal properly. A rupture will cause a sudden sharp pain that feels like you just got hit in the tendon. There may be a popping sound when the rupture occurs. This will generally be followed by a lot of swelling and bruising.

Difficult to Walk or Stand up on your Tiptoes

You may feel extreme heel pain as well, depending on where the rupture occurred. Your Achilles tendon helps you control your foot and ankle so if your tendon is ruptured it will be difficult to walk or stand up on your tiptoes. You can give yourself a physical examination as well to determine if you’ve suffered a full rupture. It’s easy to tell when your tendon is no longer stretched out over the back of your leg.

Pain In Back of Your Heel

If you’ve only suffered a partial rupture or discomfort for tendonitis the symptoms won’t be as severe. You may even feel close to 100% in strength after a partial injury. You will still feel some pain on the back of your heel which could be mild to severe, along with the usual bruising and swelling associated with an Achilles tendon injury.

Stiffness in The Morning

Your Achilles tendon will be sore and stiff in the morning but may feel better as your day progresses and it’s warmed up a bit. You will probably notice some decreased strength or even a feeling of sluggishness in your leg. Surgery usually is not necessary with a partial rupture, which can heal itself over time with enough rest and time.

Causes of an Achilles tendon Rupture

There are a number of reasons why one may suffer from an Achilles tendon rupture. Including overuse, misalignment, incorrect footwear, and accidents. There are also some medications which have been known to cause tendonitis. As well as a full rupture in the worst case. Typically, more than one of these problems will work together to cause an injury. Such as improper footwear worn while exerting yourself more than usual.


It is different for everyone. Injuries to your Achilles tendon from overuse generally arise when you have increased your levels of activity. And/or exercise dramatically in a short period of time. This may include running or walking more than usual. Walking or running faster than usual or climbing steep hills or stairs you are not accustomed to climbing.

The more powerful or explosive the movement is, such as jumping off a diving board or beginning a sprint, the more likely you will be to sustain an Achilles tendon injury including a full rupture. The activity itself is generally not the problem, the real problem is doing too much too quickly or repeating an activity without enough downtime.


This is another source of Achilles tendon ruptures. If you have under or overpronation, such as people with flat feet do, your tendons will be stretched. And exerted a force on with every step you take. Other physical conditions such as unequal leg length and misshapen heels and foot bones can also lead to an Achilles tendon injury more easily.

Improper Footwear

It can also lead to an injury. Shoes that don’t have a lot of arch support. Or shoes that are lose fitting can easily contribute to an Achilles tendon injury. Replacing worn out shoes is important for athletes as they can cause unnecessary injury.

There are also several medications that are linked to Achilles tendon injuries such as Cipro, Baycip, Ciflox, Ciplox, Cyprobay and any other medication containing ciprofloxacin. Medications such as cortisone can also indirectly cause injuries. But making an injured tendon feel normal, allowing a person to rupture their Achilles tendon easily without noticing.

Treatment of an Achilles tendon Rupture

If you have suffered an injury to your Achilles tendon, it’s important to seek immediate medical treatment if possible. Depending on the severity of the injury and whether or not you’ve ruptured your Achilles tendon before, you may choose from a surgical or nonsurgical approach to treating your Achilles tendon rupture.

Each course of action has its own individual risks and benefits. Those who choose surgery to repair their Achilles tendon will face a 30% higher chance of complications arising that are not related to the original injury such as infection and long-term effects from anesthesia. Those who go the nonsurgical route will have a 300% greater chance of reinjuring their Achilles tendon after it has healed completely.

A nonsurgical alternative is generally the best choice for older patients or people who are more or less inactive. They are also a good choice for those suffering from poor skin integrity which can complicate the surgical procedure. Those who suffer from diabetes, problems with healing, and vascular diseases are generally told to go the route of non-surgery.

Wearing a leg cast for 6-10 weeks (or longer) along with an extended rehabilitation period is the most common nonsurgical treatment for an Achilles tendon rupture. After the cast is removed, generally patients will use a heel lift in their shoe for another 3-6 months. This is also the time when rehabilitation begins. Advantages of this course of action include fewer infections, decreased hospital costs, and overall a lower morbidity percentage.

Surgical options include percutaneous surgery as well as open surgical repair. Percutaneous surgery allows surgeons to repair your tendon without making a large incision in your leg. The open surgical repair will generally use larger incisions. To get a better view of the affected areas of your tendon. Percutaneous surgery will generally have a lower risk of infection. But may increase your risk for nerve damage from the surgery.

Diagnosis of an Achilles tendon Rupture

Achilles tendon ruptures are becoming far more common and happen to men up to four times as much as women. The average age of a man suffering from an Achilles tendon rupture is 35 years old. Which means men aged 30+ are at an increased risk for rupturing their Achilles tendon. Over half of all ruptures occur in professional, white collar workers. Most ruptures occur from repetitive, abrupt movements such as those associated with soccer, basketball, jumping and sprinting.

One way to diagnose a ruptured Achilles tendon is by using the Thompson test, also known as a calf squeeze test. You can perform this test by lying back with your feet over a chair with your toes pointing straight up (if possible). When your calf muscle is squeezed, it should pull on your tendon, making your toes point forward ever so slightly. If your foot doesn’t move at all when your calf is squeezed, it means your tendon is ruptured. Older injuries can potentially cause a false negative in this test. As your body may have been able to partially heal your tendon through the organization of hematoma.

Another way to diagnose an Achilles tendon rupture is to use the Matles test. Also known as a knee flexion test. The patient will flex their knee and calf muscles to move their leg up and down a full 90 degrees. If your foot falls into a neutral position it’s likely that you have suffered an Achilles tendon rupture. Unlike the calf squeeze, this test should not result in a false negative. Even in older injuries as your tendon will be lengthened by your body’s reconstruction process.

You can also diagnose an Achilles tendon rupture by physically examining the tendon using your hands. You can attempt to flex the tendon to test the connectedness to your calf muscle and ankle. This test is prone to false negatives with older injuries though.


The Achilles tendon is one of the most significant of the body’s tendons, in that it can be considered to constitute both the largest and most powerful of the tendons which can be found in the human body.

For this reason, an Achilles tendon rupture can be considered to be a significant impediment to a person’s health and quality of life. Adversely affecting to a degree which can vary in its severity the level of personal comfort and freedom of movement of an individual.

A number of treatments and helpful procedures have thus been formulated for the purpose of addressing the problems that arise from the occurrence of an Achilles tendon rupture. A person who feels that he or she may be suffering from the effects of just one such Achilles tendon rupture would, therefore, be well advised to attend to the kinds of forms which such treatment can take. Another useful step in implementing such a strategy can be to understand why the Achilles tendon holds such an important place in the human body and the nature of the essential functions that it offers in terms of movement to the physically active individual.

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