An Achilles tendon rupture: causes, treatment and rehabilitation

Overloading the Achilles tendon can lead to a partial or complete rupture. This condition, in turn, triggers an inflammatory process that causes pain and movement problems.

Achilles tendon rupture: causes, treatment and rehabilitation

Latest update: May 20, 2023

An Achilles tendon rupture is an injury to the fiber cord that connects the muscles in the back of the calf to the heel bone. It is common in people who play sports, although it is also associated with obesity and the use of certain medications.

It occurs when the tendon suffers a partial or total tear from a stretch beyond its capacity. Often this situation is the result of a forced jump, sudden accelerations when running, or too much pressure. It can also be caused by a fall or any trauma to the area.

The main symptoms are pain and inability to walk; these can vary in intensity depending on the severity of the injury. Usually can It however treated with physiotherapy and exercise. Do you want to know more about it? Read more about the causes and about the rehabilitation process.

What are the causes of an Achilles tendon rupture?

The Achilles tendon is a band of tissue that runs across the back of the lower leg. It is responsible for attaching the gastrocnemius and soleus muscles to the heel bone. Also known as the “heel cord,” this strap propels the foot off the ground and allows you to walk, run, or jump.

In most cases, the tear occurs at the point of the tendon that is about 6 centimeters from where it attaches to the heel bone. The it is most likely when the leg is straightened and the calf muscle is contracted.

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Risk factors

Stretching muscles
Some types of athletes are more likely to suffer Achilles tendon injuries.

As detailed in a publication (English link) in the Jour nal of Functional Morphology and Kinesiologycomes an Achilles tendon rupture more common during sports. Middle-aged men – especially untrained athletes – are more at risk than younger men.

Other identified risk factors include the following:

  • A sudden increase in pressure exerted on the Achilles heel.
  • Regular practice of sports involving jumping is becoming.
  • Trips, falls or accidents.
  • Treatment with steroid injections.
  • Long-term use of antibiotic medicines.
  • Anatomical abnormalities.
  • Overweight and obesity.
  • Chronic inflammation or rheumatoid arthritis.

Achilles tendon rupture symptoms

Sometimes the Achilles tendon rupture heals itself asymptomatically. However, due to the severity or lack of treatment, it can the following clinical signs cause:

  • The feeling of being hit on the calf.
  • The inability to bending the foot or standing on tiptoe.
  • walking abnormally.
  • The inability to push the injured leg forward when walking.
  • Hearing a snap or crack with the injury.
  • Difficulty climbing stairs.
  • Bruising or swelling in the leg or foot.


To diagnose an Achilles tendon rupture, the doctor starts with a physical examination of the affected area. First, he or she will inspect the calf for signs of tenderness or swelling. At this point you can feel a space if the tendon is completely torn.

In the next step, the practitioner will ask the patient to perform a series of movements and exercises to determine range of motion and muscle strength. If the Achilles tendon is torn, the person will have less ability to push down or lean on the toes.

Additional diagnostic tests may include ultrasound or MRI include. These procedures are painless and are intended to create images of the body tissue in order to learn the exact extent of the injury.

Achilles tendon rupture treatment

To design an appropriate treatment for a ruptured Achilles tendon, the practitioner will take into account important factors such as age, lifestyle and severity of the injury. Sometimes, especially if they are athletes, people opt for surgery to repair the tendon.

But before resorting to this measure as an alternative, there are some care and habits that support the recovery process with a favorable prognosis. Let’s take a closer look at those.

Non-surgical treatment

Non-surgical treatment of an Achilles tendon rupture avoids risks of surgery, such as infection. The downside of it is however that recovery may take longer and that the injury can return. These measures include the following:

  • Use of crutches. This is a measure suggested by the orthopedic physiotherapist to keep the tendon at rest.
  • Placing ice on the affected area. Applying ice packs for 15 to 20 minutes every 4 to 6 hours helps to reduce pain and inflammation.
  • Take over-the-counter pain relievers and anti-inflammatories. These help control pain and swelling.
  • Loves the ankle the first weeksin peace.
  • Do recovery exercises under the guidance of a physiotherapist.

Read more here:
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Surgical procedure

An operation
Complete or severe ruptures may require a surgical solution. The specialist trained for this is the traumatologist.

Surgery to repair the Achilles tendon is a procedure in which the doctor makes an incision in the lower leg. Subsequently, the doctor will to repair a torn tendon by applying multiple sutures.

Now, as described in a study shared by Frontiers i n Surgerysurgical treatment reduces the risk of reinruption, but has a higher complication rate compared to conservative treatment.


The rehabilitation process of an Achilles tendon rupture includes a series of physical therapy exercises that aim have the muscles of the leg and of course the tendon to reinforce . Usually there is a full recovery in a period of 4 to 6 months.

It is very important to adhere to this plan hand in hand with a professional. This is because the exercises must be performed gradually. That is, its intensity changes as the recovery phase progresses.

On the other hand, there is a form of rehabilitation known as ‘functional rehabilitation’. This consists of performing some weight-bearing exercises, targeting the ankle, which usually in the first weeks after the injury be done. In fact, they are practiced while the person is still wearing their immobilization device.

An overview of studies shared by Foot and Ankle Clinics reported that these types of therapies can provide similar results to surgical treatment. Of course it has to be done in the hands of a physiotherapist. The idea is to restore both mobility and physical performance.

Once the recovery process is complete, the risk of another trauma increases. Therefore, it is important to take preventative measures such as the following:

  • Stay in good shape and do warm-ups and stretches before any exercise.
  • Avoid wearing high heels or shoes that are unsuitable for sports.
  • Ask your doctor or you may play tennis, basketball and other sports.
  • Have a healthy diet.
  • Avoid being overweight.

What you need to remember

An Achilles tendon rupture can both pain as a limitation of movement cause. Although it usually affects athletes, anyone can suffer from it, through an accident, improper sports practice or being overweight.

In many cases, it improves after a period of rest and physical therapy. However, sometimes surgery is needed. Therefore, if there is a suspicion that it could be this injury, it is best to go to the doctor so that he can guide you and give you the most appropriate treatment according to your individual case. Perhaps also interesting for you

All cited sources have been thoroughly checked by our team to ensure their quality, reliability, timeliness and validity. The bibliography of this article was considered reliable and scientifically accurate.

  • Aminlari A, Stone J, McKee R, Subramony R, Nadolski A, Tolia V, Hayden SR. Diagnosing Achilles Tendon Rupture with Ultrasound in Patients Treated Surgically: A Systematic Review and Meta-Analysis. J Emerg Med. 2021 Nov;61(5):558-567. doi: 10.1016/j.jemermed.2021.09.008. Epub 2021 Nov 17. PMID: 34801318.
  • Egger AC, Berkowitz MJ. Achilles tendon injuries. Curr Rev Musculoskeletal Med. 2017 Mar;10(1):72-80. doi: 10.1007/s12178-017-9386-7. PMID: 28194638; PMCID: PMC5344857.
  • Glazebrook M, Rubinger D. Functional Rehabilitation for Nonsurgical Treatment of Acute Achilles Tendon Rupture. Foot Ankle Clin. 2019 Sep;24(3):387-398. doi: 10.1016/j.fcl.2019.05.001. Epub 2019 Jun 22. PMID: 31370992.
  • Metzl JA, Ahmad CS, Levine WN. The ruptured Achilles tendon: operative and non-operative treatment options. Curr Rev Musculoskeletal Med. 2008 Jun;1(2):161-4. doi: 10.1007/s12178-008-9025-4. PMID: 19468891; PMCID: PMC2684209.
  • Park SH, Lee HS, Young KW, Seo SG. Treatment of Acute Achilles Tendon Rupture. Clin Orthop Surg. 2020 Mar;12(1):1-8. doi: 10.4055/cios.2020.12.1.1. Epub 2020 Feb 13. PMID: 32117532; PMCID: PMC7031433.
  • Shamrock AG, Varacallo M. Achilles Tendon Rupture. [Updated 2023 Mar 19]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from:
  • She, G., Teng, Q., Li, J., Zheng, X., Chen, L., & Hou, H. (2021). Comparing Surgical and Conservative Treatment on Achilles Tendon Rupture: A Comprehensive Meta-Analysis of RCTs. In Frontiers in Surgery (Vol. 8). Frontiers Media SA.
  • Tarantino D, Palermi S, Sirico F, Corrado B. Achilles Tendon Rupture: Mechanisms of Injury, Principles of Rehabilitation and Return to Play. J Funct Morphol Kinesiol. 2020 Dec 17;5(4):95. doi: 10.3390/jfmk5040095. PMID: 33467310; PMCID: PMC7804867.
  • Zellers JA, Christensen M, Kjær IL, Rathleff MS, Silbernagel KG. Defining Components of Early Functional Rehabilitation for Acute Achilles Tendon Rupture: A Systematic Review. Orthop J Sports Med. 2019 Nov 25;7(11):2325967119884071. doi: 10.1177/2325967119884071. PMID: 31803789; PMCID: PMC6878623.

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