Achilles Tendon Rupture

An Achilles tendon rupture happens when the tendon connecting your calf muscles to your heel bone partially or completely tears, often with a sudden pop and sharp pain near the heel. This injury can make walking, running or even standing on your toes suddenly difficult. With expert evaluation and the right treatment plan, most people recover well and return to the activities they enjoy.

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Anatomy of the ankle

The Achilles tendon is the largest and strongest tendon in the body. It runs along the back of the lower leg, connecting your calf muscles to the calcaneus, or heel bone. Every time you walk, run, jump or push off the ground, this tendon transfers force from your calf muscles down to your foot and ankle.

Because it absorbs so much force during activity, the Achilles tendon is also vulnerable to wear and overuse. Small, repeated injuries can cause inflammation or degeneration over time. When the tendon fibers can no longer withstand the load placed on them, a sudden tear, or rupture, can occur at the point of greatest stress.

Overview

Symptoms

An Achilles tendon rupture often happens suddenly, and many people remember the exact moment it occurred. Common symptoms include:

A popping or snapping sensation in the back of the ankle
A feeling similar to being kicked from behind
Sudden pain and swelling near the heel
Bruising along the lower leg
Difficulty walking or pushing off the affected foot
Inability to stand on tiptoes
Weakness or a noticeable gap above the heel

Pain may ease somewhat after the initial injury, but weakness and difficulty walking usually continue until the tendon is evaluated and treated.

Causes

Achilles tendon ruptures most often affect adults between the ages of 30 and 50, particularly those who take part in recreational sports. Common causes include:

Sudden push-off movements, such as sprinting or jumping
Rapid changes in direction
Falls or awkward landings
Repetitive overuse without adequate rest

In some cases, the tendon has already weakened from small, unnoticed injuries before the rupture occurs.

Risk factors

Certain factors may increase the likelihood of an Achilles tendon rupture, though having one or more of these does not mean you'll experience this injury. Risk factors include:

Previous Achilles tendon pain or chronic inflammation
Tight calf muscles (see calf strain) or limited ankle flexibility
Long-term use of steroid medications or certain antibiotics
Reduced blood supply to the tendon with aging or certain medical conditions

Understanding these factors helps our specialists recommend the safest activity level and treatment approach for you.

Diagnosis

Diagnosing an Achilles tendon rupture starts with a detailed conversation about how the injury happened, followed by a physical examination of your ankle and calf. Your care team will assess ankle strength and range of motion and may perform the Thompson test, a simple exam that helps evaluate whether the tendon is still intact. Ultrasound or MRI imaging is often used to confirm the location and severity of the tear, helping your care team recommend the treatment approach that fits your needs. For more information, visit sports injury evaluation and imaging.

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