Achilles Tendon Rupture
OVERVIEW
An Achilles tendon rupture is when the Achilles tendon is torn. This tear usually occurs when sudden, extreme stress is applied to the tendon, causing it to tear. The tear can be either partial or complete, and can be treated surgically or non-surgically, depending on the severity of the tear. Both treatment types need to be paired with physical therapy exercises to return to former activity levels.
ANATOMY
The Achilles tendon, also known as the calcaneal tendon, is a tough, fibrous band of tissue that connects the calf muscle to the heel bone (calcaneus). When the calf muscles flex, the Achilles tendon pulls on the heel, allowing us to walk, run, climb stairs, jump, and stand on the tip of your toes. It is both the strongest and largest tendon in the entire body. While it may be the strongest, it is also vulnerable to injury, due to the high tensions placed on it and its limited blood supply. The tearing of the Achilles tendon is when the tendon tears, resulting in the separation of the tendon fibers. When this occurs, the tendon can no longer perform its normal function.

DESCRIPTION
An Achilles tendon rupture is when the Achilles tendon is torn. The tear may be either partial or complete. In the case of a partial tear, the tendon is partially torn but still joined to the calf muscle. During a complete tear, the connection between the calf muscle and the ankle bone is completely lost. Ruptures are often caused by a sudden increase in stress on the Achilles tendon, such as falling from a height, the intensity of sports, or falling into a hole. While an Achilles tendon rupture can happen to anyone, certain factors increase the likelihood of experiencing the injury:
- Age. The peak age for Achilles tendon rupture is 30 to 40.
- Sex. Men are up to five times more likely to experience an Achilles tendon rupture than women.
- Recreational sports. People who take part in recreational sports, specifically ones that involve running, jumping, and sudden starts and stops, have an increased chance of experiencing an Achilles tendon rupture.
- Steroid injections. Doctors sometimes inject steroids into an ankle joint to reduce pain and inflammation. This medication can weaken nearby tendons and has been associated with Achilles tendon ruptures.
- Certain antibiotics. Fluoroquinolone antibiotics, such as levofloxacin (Levaquin) or ciprofloxacin (Cipro), increase the risk of Achilles tendon ruptures.
- Obesity. Excess weight puts more strain on the tendon.

SYMPTOMS
While it is possible to experience no symptoms with an Achilles tendon rupture, most people experience the following:
- The feeling of having been kicked in the calf.
- Pain (possibly severe).
- Swelling near the heel.
- Inability to bend the foot downward or “push off” the injured leg when walking.
- Inability to stand on the toes of the injured leg.
- Popping or snapping sound during the moment of injury.

DIAGNOSIS
Your Florida Orthopaedic Institute physician will look at your lower leg for tenderness, swelling, and a possible gap in your tendon if it has ruptured completely. Your physician may also squeeze your calf muscle to see if it will automatically flex. If it does not, there is a high chance your Achilles tendon has ruptured. If these tests do not accurately depict whether the tendon has torn partially or completely, then an MRI or ultrasound may be ordered. Both of these tests create images of the tissues of your body and show the tendon.
TREATMENT (OVERVIEW)
Both surgical and nonsurgical treatments are available for the repair of an Achilles tendon rupture. While surgery is often performed to repair the rupture, non-surgical options work well for less severe cases.
NONSURGICAL TREATMENTS
Nonsurgical treatments generally include:
- Resting the tendon by using crutches.
- Icing the area.
- Pain relievers.
- Preventing the ankle from moving for the first few weeks usually with the use of a walking boot with heel wedges or a cast with the foot flexed down.
While nonsurgical options avoid the risks associated with surgery, such as infection, a nonsurgical approach may increase your chances of re-rupture. Additionally, a full recovery may take longer to achieve with nonsurgical treatments.
SURGICAL PROCEDURES/TREATMENTS
The surgical procedure generally involves making an incision in the back of the lower leg and stitching the torn tendon together. Depending on the severity of the rupture, the repair might be reinforced with other tendons, usually ones from other parts of the foot. Patients are generally released from the hospital the day of surgery.
This surgery should not be performed on a patient with an active infection or unhealthy skin at or around the site of the Achilles tendon rupture, or if they are not healthy enough to undergo surgery.
NEXT STEPS
After either a surgical or nonsurgical approach, physical therapy exercises will be required to strengthen the leg muscles and the Achilles tendon. Most people return to their former level of activity within four to six months. It is important to continue strength and stability training afterwards because some problems can persist for up to a year. Currently, rehabilitation after either surgical or nonsurgical treatments is progressing to be done earlier. Studies are ongoing in this area to determine its safety and effectiveness.
Your Florida Orthopaedic Institute physician is sub-specialty trained and up to date on the latest treatment methods and procedures. Schedule an appointment if you think you have injured your Achilles tendon.
Areas of Focus
- Foot, Ankle & Lower Leg
- Achilles Tendinitis - Achilles Insertional Calcific Tendinopathy (ACIT)
- Achilles Tendon Rupture
- Achilles Tendonitis
- Ankle Fracture Surgery
- Ankle Fractures (Broken Ankle)
- Ankle Fusion
- Bunions
- CARTIVA® Implant For Big Toe Joint Arthritis
- Charcot Joint
- Hallux Rigidus - Cheilectomy
- Intraarticular Calcaneal Fracture
- Lisfranc Injuries
- Mallet, Hammer & Claw Toes
- Metatarsalgia
- Morton’s Neuroma
- Neuromas (Foot)
- Plantar Fasciitis
- Podiatrist or Orthopaedic Physician?
- PROstep™ Minimally Invasive Surgery for Bunions
- Sprained Ankle
- Total Ankle Replacement
The following Florida Orthopaedic Institute physicians specialize in Achilles Tendon Rupture:
Specialties
- Achilles Tendinitis - Achilles Insertional Calcific Tendinopathy (ACIT)
- Achilles Tendon Rupture
- Achilles Tendonitis
- ACL Injuries
- ALIF: Anterior Lumbar Interbody Fusion Surgery
- Ankle Fracture Surgery
- Ankle Fractures (Broken Ankle)
- Ankle Fusion
- Arthritis & Adult Reconstruction Surgery
- Arthroscopic Chondroplasty
- Arthroscopic Debridement of the Elbow
- Arthroscopic Rotator Cuff Repair
- Artificial Disc Replacement (ADR)
- Aspiration of the Olecranon Bursa
- Avascular Necrosis (Osteonecrosis)
- Back Surgery Types
- Bankart Repair
- Basal Joint Surgery
- Bicep Tendon Tear
- Bicep Tenodesis
- Bioinductive Implant
- Broken Collarbone
- Bunions
- Bursitis of the Shoulder (Subacromial Bursitis)
- Calcific Tendinitis of the Shoulder
- Carpal Tunnel Syndrome
- CARTIVA® Implant For Big Toe Joint Arthritis
- Charcot Joint
- Chiropractic
- Colles’ Fractures (Broken Wrist)
- Community Outreach
- ConforMIS Knee Replacement
- Cubital Tunnel Syndrome
- De Quervain's Tenosynovitis
- Degenerative Disc Disease
- Diffuse Idiopathic Skeletal Hyperostosis (DISH)
- Discitis
- Dislocated Shoulder
- Dupuytren’s Disease
- Elbow
- Elbow Bursitis
- Elbow Injuries in Throwing Athletes
- Epidural Injections for Spinal Pain
- Finger Dislocation
- Flexor Tendonitis
- Foot, Ankle & Lower Leg
- Fractures Of The Shoulder Blade (Scapula)
- Fractures Of The Tibial Spine
- Functional Nerve Transfers of The Hand
- Ganglion Cysts
- General Orthopedics
- Glenoid Labrum Tear
- Golfer's Elbow
- Growth Plate Injuries Of The Elbow
- Hallux Rigidus - Cheilectomy
- Hand & Finger Replantation
- Hand & Upper Extremity
- Hand & Wrist
- Hand Nerve Decompression
- Hand Skin Grafts
- Hip & Thigh
- Hip Arthroscopy
- Hip Dislocation
- Hip Flexor Strains
- Hip Fractures
- Hip Hemiarthroplasty
- Hip Muscle Strains
- Hyperextension Injury of the Elbow
- Iliotibial Band Syndrome
- Interventional Pain Management
- Interventional Spine
- Intraarticular Calcaneal Fracture
- Knee & Leg
- Kyphosis
- Labral Tears Of The Hip (Acetabular Labrum Tears)
- Lateral Collateral Ligament (LCL) Injuries
- Lisfranc Injuries
- LITTLE LEAGUER'S ELBOW (MEDIAL APOPHYSITIS)
- MACI
- MAKO Knee Replacement Surgery
- MAKO Total Hip Replacement
- Mallet, Hammer & Claw Toes
- Medial Collateral Ligament Injuries
- Meniscus Tears
- Metatarsalgia
- Minimally Invasive Spine Surgery
- Morton’s Neuroma
- Muscle Spasms
- NAVIO Surgical System
- Nerve Pain
- Neuromas (Foot)
- Olecranon Stress Fractures
- Orthopaedic Total Wellness
- Orthopedic Trauma
- Osteoarthritis of the Hip
- Osteoporosis
- Outpatient Spine Surgery
- Partial Knee Replacement
- Patellar Fracture
- Pelvic Ring Fractures
- Peripheral Nerve Surgery (Hand) Revision
- Pinched Nerve
- Plantar Fasciitis
- Podiatrist or Orthopaedic Physician?
- Primary Care Orthopedics Sports Medicine
- PROstep™ Minimally Invasive Surgery for Bunions
- Quadriceps Tendon Tear
- Revascularization of the Hand
- Reverse Total Shoulder Replacement
- Revision Knee Surgery
- Rheumatoid Arthritis (RA) of the Shoulder
- Rheumatoid Arthritis Of The Hand
- Robotics
- ROSA® Knee Robotic Surgical Assistant
- Sciatica
- Scoliosis
- Senior Strong
- Shin Splints
- Shoulder
- Shoulder Arthritis
- Shoulder Arthroscopy
- Shoulder Replacement
- Shoulder Socket Fracture (Glenoid Fracture)
- SLAP Tears & Repairs
- Spinal Fusion
- Spine
- Spondylolisthesis and Spondylolysis
- Sports Hernias (Athletic Pubalgia)
- Sports Medicine
- Sprained Ankle
- Sudden (Acute) Finger, Hand & Wrist Injuries
- Targeted Muscle Reinnervation (TMR)
- Tendon Transfers of The Hand
- Tennis Elbow
- Thigh Fractures
- Thigh Muscle Strains
- Total Ankle Replacement
- Total Hip Arthroplasty
- Total Hip Replacement - Anterior Approach
- Total Knee Replacement
- Triceps Tendonitis
- Trigger Finger
- UCL (Ulnar Collateral Ligament) Injuries
- Ulnar Neuritis
- Valgus Extension Overload
- Verilast
- Vertebroplasty
- WALANT (Wide Awake Local Anesthesia No Tourniquet)
- Whiplash and Whiplash Associated Disorder (WAD)
- Wrist Arthroscopy
- Wrist Fractures
- Wrist Sprains
- Wrist Tendonitis