# Achilles tendon rupture

> An Achilles tendon rupture is a tear of the tendon that links your calf muscles to your heel, usually during sport, with a sudden pop or sharp pain. See your GP or a podiatrist the same day if you suspect one. For recent ruptures, surgery and non-surgical care with early rehabilitation can give similar results.

Guide in [Ankle and Achilles](https://footanklelowerlimb.com.au/learn/topics/ankle-and-achilles), from Foot Ankle Lower Limb: https://footanklelowerlimb.com.au/learn/achilles-tendon-rupture
Reviewed by Andrew Schox, BSc(Hons) PGradDipPod MPod (Podiatrist) on 27 October 2026.
Next review by 27 October 2027.

- **It's a tear of the Achilles tendon,** the strong cord that links your calf muscles to your heel, and it's usually a complete tear.
- **It often happens suddenly,** with a pop or a feeling of being kicked, most often during sport.
- **Get it seen the same day by your GP or a podiatrist,** because it's easily mistaken for an ankle sprain.
- **Treatment with or without surgery can give similar results** when non-surgical care includes a boot and early rehabilitation.

## What is an Achilles tendon rupture, and how common is it?

An Achilles tendon rupture is a tear of the tendon that connects your calf muscles to your heel and lets you lift your heel when you walk and run [1]. It's usually a complete tear; true partial tears are very rare [2].

It most often happens during sport, more often in middle-aged men who play only occasionally, though younger people can rupture it too [2]. It's most common in active young to middle-aged adults, with an average age of 37 to 44 [3]. It has become more common over recent decades [2].

## What causes it, and who gets it?

It usually follows a sudden, high load on the tendon: a forceful push-off in sports such as football, tennis, badminton or squash, or a fall or slip that suddenly forces the foot upward [4]. Stop-start sports like netball and basketball are common settings [1]. Wear and tear in the tendon with age can make a tear more likely [5].

Some medicines are linked with a higher risk: fluoroquinolone antibiotics, anabolic steroids and corticosteroids, including injections near the tendon [6]. Higher daily doses of corticosteroid tablets are also linked with it [7]. Rupture seems to come from several factors together rather than one [8].

If you've had a tendon problem before, tell any prescriber before you take these medicines. Please don't stop a prescribed medicine on your own: if you get tendon pain while taking one, talk to the prescriber.

## What does it feel like, and how is it diagnosed?

A rupture typically brings sudden, sharp pain at the back of the ankle or calf, often with a snap or pop, or a feeling that someone has hit the back of your heel [1]. Swelling or bruising may follow, and walking or standing on tiptoe is usually difficult [1]. The pain can ease afterwards, so easing pain doesn't mean it's fine [9].

Diagnosis is mainly by examination. The clinician will ask how it happened and whether you can rise onto your toes, feel along the tendon for a gap, and squeeze your calf. If the tendon is intact the foot normally points down; if it's ruptured there's no movement [1]. This calf-squeeze test was the most accurate of the clinical tests [10]. A gap isn't always felt, so no gap doesn't rule out a rupture [11]. Scans are mainly used to rule out other injuries [12].

It's easily missed: up to 20% of ruptures are first mistaken for an ankle sprain [13].

## What helps first, and is surgery needed?

A suspected rupture needs assessment by a clinician from the start; it isn't something to manage at home alone. For a recent rupture in adults, non-surgical care and surgery can give similar results when the non-surgical care uses functional rehabilitation [3]. This means wearing a boot with wedges that keeps the foot pointed down, and walking on it with crutches [14]. Surgery carries more complications, mainly infection [3], and in adults it wasn't linked with better results at 12 months [15]. The choice is best made together with your treating team, based on your situation [3].

Ask about both options and the risks of each. If you're put in a boot, follow the team's instructions on foot position and weight bearing, and don't change the wedges or start stretching on your own. You can also ask whether blood thinners are recommended for you.

## What if that isn't enough?

If your tendon hasn't recovered as expected, ask your treating clinician for an orthopaedic (bone and joint surgery) opinion. A rupture is called chronic once it's more than four weeks old, and a surgeon may suggest a tendon graft when the gap between the torn ends is greater than 6 cm [16]. The similar results for surgery and non-surgical care above are for recent ruptures, not chronic ones [3].

## How long does recovery take, and can it happen again?

Your treating team can give you a recovery timeline for your situation. Whichever treatment you choose, results tend to be closer than you might expect [15]: re-rupture is uncommon and the differences between treatments are small [3]. Early weight bearing in a brace hasn't been linked with more re-ruptures [2]. A tendon can still tear again [17], so follow your physiotherapist's or treating team's advice before you progress exercise or go back to sport.

> [!tip] Try this
> Put your whole foot on each step when you go upstairs, and take care not to slip in the shower or bath.

## When to see a podiatrist

A sudden pop, a kick-like blow to the back of the leg, or sharp pain in the calf or heel could be a rupture. Please don't wait for it to walk off: an apparent sprain, or a tendon that feels intact, doesn't rule one out [11].

See your GP or a podiatrist the same day if:

- you feel a snap or pop, a kick-like blow to the back of the leg, or sudden pain in your calf or heel, especially during exercise [9][18];
- you feel weakness, can't move your foot down, or have severe pain or swelling [17];
- you can't walk or put weight on the foot [9];
- your calf is hot, swollen and painful, or you feel faint, because blood clots (deep vein thrombosis) are a common complication after a rupture [17][14];
- during recovery, you notice a new sudden pain, a pop or loss of strength in the tendon.

For urgent advice when it isn't an emergency, call healthdirect on 1800 022 222 (24 hours a day), or go to a Medicare Urgent Care Clinic.

Call 000 and ask for an ambulance if you have chest pain, sudden severe breathlessness or cough up blood, or if you collapse [14].

Mention any recent antibiotic or steroid use when you're assessed.

## Common questions

### How do I know if I've torn or only strained my Achilles?

It can be hard to tell yourself. A tear often brings a sudden pop or kick-like blow, sharp pain, weakness and trouble rising onto your toes or walking. But a rupture can feel like a sprain at first, so it's best to have it examined the same day rather than waiting to see if it settles.

### Can I rupture the same Achilles again, or the other one?

A tendon can tear again, though re-rupture is uncommon. The best way to lower the chance is to follow your physiotherapist's or treating team's guidance before you progress exercise or return to sport. Whether the other Achilles is at higher risk isn't clear yet.

## Further reading

- [Achilles tendon rupture on Clindice](https://clindice.com/achilles-tendon-rupture)
- [Achilles Tendon Rupture - Management and Rehabilitation - Worcestershire Acute Hospitals NHS Trust](https://www.worcsacute.nhs.uk/leaflets/achilles-tendon-rupture-management-and-rehabilitation/), NHS
- [Display Patient Information Leaflets](https://www.plymouthhospitals.nhs.uk/display-pil/pil-achilles-tendon-rupture-rehabilitation-8516), NHS
- [Achilles tendon rupture: management and rehabilitation](https://www.cuh.nhs.uk/patient-information/achilles-tendon-rupture-management-and-rehabilitation/), NHS
- [Achilles Tendon Rupture - Information for Patients | Hull University Teaching Hospitals NHS Trust](https://www.hey.nhs.uk/patient-leaflet/achilles-tendon-rupture-information-for-patients/), NHS

## Sources

1. Achilles Tendon Rupture · NHS. https://www.stgeorges.nhs.uk/wp-content/uploads/2023/12/AAE_ATR_LP.pdf
2. Achilles Tendon Rupture: Mechanisms of Injury, Principles of Rehabilitation and Return to Play · Tarantino D, Palermi S, Sirico F et al. · Journal of Functional Morphology and Kinesiology · 2020. https://doi.org/10.3390/jfmk5040095
3. Operative treatment versus nonoperative treatment of Achilles tendon ruptures: systematic review and meta-analysis · Ochen Y, Beks RB, van Heijl M et al. · BMJ (Clinical Research Ed.) · 2019. https://doi.org/10.1136/bmj.k5120
4. Achilles Tendon Rupture - Management and Rehabilitation · Worcestershire Acute Hospitals NHS Trust · 2024. https://www.worcsacute.nhs.uk/leaflets/achilles-tendon-rupture-management-and-rehabilitation/
5. Achilles tendon rupture: a review of etiology, population, anatomy, risk factors, and injury prevention · Hess GW · Foot & Ankle Specialist · 2010. https://doi.org/10.1177/1938640009355191
6. Epidemiology of Achilles Tendon Ruptures in the United States: Athletic and Nonathletic Injuries From 2012 to 2016 · Lemme NJ, Li NY, DeFroda SF et al. · Orthopaedic Journal of Sports Medicine · 2018. https://doi.org/10.1177/2325967118808238
7. Oral and inhaled glucocorticoid use and risk of Achilles or biceps tendon rupture: a population-based case-control study · Spoendlin J, Meier C, Jick SS et al. · Annals of Medicine · 2015. https://doi.org/10.3109/07853890.2015.1074272
8. Risk factors for Achilles tendon rupture: an updated systematic review · Xergia SA, Tsarbou C, Liveris NI et al. · The Physician and Sportsmedicine · 2023. https://doi.org/10.1080/00913847.2022.2085505
9. G-care: The primary care clinical information system · NHS. https://g-care.glos.nhs.uk/clinical-topic/achilles-tendinopathy
10. The utility of clinical measures for the diagnosis of achilles tendon injuries: a systematic review with meta-analysis · Reiman M, Burgi C, Strube E et al. · Journal of Athletic Training · 2014. https://doi.org/10.4085/1062-6050-49.3.36
11. Achilles tendon rupture | Right Decisions · NHS. https://www.rightdecisions.scot.nhs.uk/refhelp-nhs-ayrshire-and-arran/orthopaedicsmsk/foot-and-ankle/achilles-tendon-rupture/
12. Imaging modalities in the diagnosis and monitoring of Achilles tendon ruptures: A systematic review · Dams OC, Reininga IHF, Gielen JL et al. · Injury · 2017. https://doi.org/10.1016/j.injury.2017.09.013
13. Diagnosing Achilles Tendon Rupture with Ultrasound in Patients Treated Surgically: A Systematic Review and Meta-Analysis · Aminlari A, Stone J, McKee R et al. · The Journal of Emergency Medicine · 2021. https://doi.org/10.1016/j.jemermed.2021.09.008
14. Information for patients and carers · NHS. https://www.lancsteachinghospitals.nhs.uk/media/.leaflets/64ad6026d55fd3.05861850.pdf
15. Nonoperative or Surgical Treatment of Acute Achilles' Tendon Rupture · Myhrvold SB, Brouwer EF, Andresen TKM et al. · The New England Journal of Medicine · 2022. https://doi.org/10.1056/nejmoa2108447
16. Free tendon grafts for surgical management of chronic tears of the main body of the Achilles tendon: a systematic review · Maffulli N, Bartoli A, Sammaria G et al. · Knee Surgery, Sports Traumatology, Arthroscopy · 2023. https://doi.org/10.1007/s00167-023-07446-4
17. Achilles tendon injuries · Healthdirect Australia · 2025. https://www.healthdirect.gov.au/achilles-tendon
18. Heel pain · Healthdirect Australia · 2024. https://www.healthdirect.gov.au/heel-pain

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This page is general information, not a diagnosis or a treatment plan for you. For advice about your own feet or legs, see a podiatrist or your doctor. In an emergency, call 000.