Achilles Tendon Rupture

Soft Tissue Conditions· Also known as: ruptured Achilles, torn Achilles tendon, Achilles tear, snapped AchillesUpdated Oct 2026

Reviewed by Andrew Schox, BSc(Hons) PGradDipPod MPod, October 2026

At a Glance

An Achilles tendon rupture is a tear of the tendon that joins your calf muscles to your heel bone. It is usually a complete tear. It most often happens during sport, especially in middle-aged men who play occasionally. Reported rates range from about 2.1 to 31 in every 100,000 people each year. The usual sign is sudden sharp pain at the back of the ankle, often with a pop or a feeling of being kicked. If this happens, see a doctor the same day. With the right care, whether or not it includes surgery, outcomes are often similar.

What is it?

The Achilles tendon is the largest tendon in your body. It joins your calf muscles to your heel bone and lets you lift your heel off the floor when you walk and run. An Achilles tendon rupture is a tear in this tendon.

A rupture is usually a complete tear. True partial tears are very rare.

Who does it affect?

It happens most often during sport. It is more common in middle-aged men, especially people who play sport only now and then or just for recreation. It can also happen in younger people. The average age reported is 37 to 44 years.

Reported rates range from about 2.1 to 31 in every 100,000 people each year, depending on how and where they were counted. The number of ruptures has risen over recent decades. Most of what is known comes from adults, so this page applies mainly to adults.

Signs and symptoms

A rupture usually starts with sudden, sharp pain at the back of the ankle or in the calf. Many people say it felt as if someone hit or kicked them on the back of the heel, only to turn around and find no one there. You may hear or feel a snap or pop.

Swelling or bruising can follow. It is usually hard to walk, to stand on tiptoe, or to push your foot downwards. The first sharp pain may ease afterwards, but that doesn't mean the tendon is fine.

What causes it?

A rupture usually follows a sudden, high load on the tendon. Examples are a forceful push-off, sprinting, jumping, a fall from a height, or a slip that suddenly forces your foot upwards. It is most common in stop-start sports such as tennis, basketball, netball, football and squash.

The tendon also wears with age, and most people who rupture it have wear in the tendon even if it never hurt before. Some medicines are linked to a higher risk: fluoroquinolone antibiotics, anabolic steroids and corticosteroids (taken as tablets or injected). Rupture usually comes from several factors together rather than one single cause.

How is it diagnosed?

Diagnosis is mostly based on your story and a hands-on examination. Your clinician will ask how it happened, and whether you can rise onto your toes. They may feel for a gap in the tendon, most often 2 to 6 cm above where it joins the heel bone.

They may also squeeze your calf. If the tendon is intact, this makes your foot point downwards. If it is torn, your foot doesn't move. Scans such as ultrasound can help rule out other injuries and add information, but the examination is the main tool.

A rupture is easy to miss. Up to 20 per cent of ruptures are first mistaken for something else, most often an ankle sprain, and up to 25 per cent can be missed at the first visit. Not feeling a gap doesn't rule a rupture out either, because swelling and bleeding in the first days can hide it. If your symptoms fit a rupture, ask for it to be checked properly.

Treatment

For a recent rupture, surgery and non-surgical care often give similar results. The right choice depends on you, so it should be a shared decision with your treating team. Ask about the benefits and risks of both options before you decide.

Looking after it at home

If you feel a sudden pop or sharp pain, stop the activity and see your GP or another doctor today. Don't wait to see if it settles.

If you are put in a boot, follow your team's instructions on foot position and how much weight to put on it. Don't change the wedges or start stretching on your own.

Treatment from your podiatrist

Non-surgical care is called functional rehabilitation. You wear a boot with wedges inside that lifts your heel and keeps your foot pointed down. This lets the ends of the tendon come together. You can walk on it, putting your full weight through it, using crutches.

When this care includes early movement and a set rehabilitation plan with regular check-ups, the chance of the tendon tearing again is no different from surgery. Wearing a brace and putting weight on it early gives results similar to a plaster cast, and is not linked to more re-tears.

Other options

A rupture is called chronic once four weeks have passed since the injury. These tears are managed differently, and a surgeon or specialist team decides the next step. If the gap between the torn ends is more than 6 cm, a tendon graft (tendon tissue used to bridge the gap) may be suggested.

Steroid injections into the tendon are not recommended, because they carry a risk of rupture.

Surgery

Surgery can be done as an open repair or through smaller cuts. Overall, the tendon tore again after surgery in about 2.3 per cent of people, compared with 3.9 per cent after non-surgical care. The difference is small. If early movement isn't part of the rehabilitation, surgery lowers the chance of a re-tear by more.

Surgery brings more complications, mainly infection and problems with the wound: 4.9 per cent compared with 1.6 per cent after non-surgical care. People who had surgery did not do better at 12 months than people treated without it.

Recovery

Which treatment you choose makes less difference than many people expect. At 12 months, physical performance and day-to-day function were similar whichever treatment people had. A re-tear is uncommon.

Blood clots in the leg veins (deep vein thrombosis, or DVT) are a common complication after a rupture. Surgery can also cause wound problems. Know the warning signs listed below.

Go at the pace your physiotherapist or treating team sets before you increase exercise or return to sport. At home, put your whole foot on each step when going upstairs, and take care not to slip in the shower or bath. If you feel a new sudden pain, a pop, or a loss of strength in the tendon during recovery, see your GP or your treating team today.

Preventing it

There is no single proven way to prevent a first rupture, as several factors usually add up. You can lower some risks. If you have had a tendon problem before, tell anyone prescribing fluoroquinolone antibiotics or corticosteroids.

To help avoid a second tear, stick closely to your rehabilitation plan and don't rush back to sport.

When to see a podiatrist

Book an appointment if

You have pain at the back of your ankle or heel that isn't improving over a few days, or your recovery isn't going as expected. Book an appointment with your podiatrist. If you get tendon pain while taking a fluoroquinolone antibiotic or a corticosteroid, talk to the person who prescribed it, and don't stop the medicine on your own.

Seek prompt assessment if

See your GP or another doctor today if you feel a sudden pain in your calf or heel during exercise, hear or feel a snap or pop, or feel as if you were kicked on the back of the leg. The same applies if you can't push your foot downwards, your foot feels weak, the pain is severe, there is swelling, or you can't walk. A rupture can look like a sprain, and the first sharp pain may ease, so get it checked either way. See your GP or another doctor today too if your leg becomes painful or swollen after a foot or ankle injury, as a blood clot is one possible cause. If your GP can't see you today, go to an urgent care clinic or an after-hours GP. Call your local emergency number if you suddenly become short of breath, have chest pain, cough up blood or feel faint after a foot or ankle injury. A health advice phone line, if there is one where you live, can help you decide where to go, but don't let it delay your assessment.

Frequently asked questions

Will I need blood thinners?

Blood thinners are often recommended for about 6 weeks after a rupture, to lower the chance of a blood clot. It isn't clear how well they work, and they carry rare but serious risks, including life-threatening bleeding in fewer than 1 in 100 people. Ask your treating team whether they are recommended for you.

Should I stop my antibiotic or steroid medicine if I'm worried about my tendon?

No, don't stop a prescribed medicine on your own. If you have tendon pain while taking one, talk to the person who prescribed it. If you have a sudden heel or calf injury, mention any recent antibiotic or steroid use, including injections, when you see a clinician.

How reliable is the calf squeeze test?

The calf squeeze test is the most accurate of the hands-on tests for picking up a rupture. No test is perfect, though. If your symptoms fit a rupture, you should still be followed up even if a test looks normal.