What is achilles tendon tear or rupture?

Achilles tendon tear: Overview

You have torn your Achilles tendon. (The Achilles tendon is also called the heel cord.) It connects the calf muscles on the back of the lower leg to the bone at the base of the heel. Sometimes a tendon tear is called a rupture.

Treatment for an Achilles tendon injury depends on how badly the tendon has been torn. A cast or splint can often treat a partial tear. If your tendon has completely torn, you may need surgery. You and your orthopedic doctor will choose a treatment plan, so it is important to go to any follow-up appointments.

Achilles tendon tear

The Achilles tendon connects the calf muscle to the heel bone. A badly torn Achilles tendon causes pain and sudden loss of strength and movement. Sometimes this is called a rupture.

An Achilles tear is most often caused by a sudden, forceful motion that stresses the calf muscle. This can happen during intense sports activity or even during simple running or jumping. Middle-aged adults are more likely to get this kind of injury.

A tendon that is badly or completely torn is most often treated with surgery. Sometimes a tear may be treated with a cast, splint, brace, or other device that keeps the lower leg from moving.

What happens when you have an Achilles tendon tear?

An Achilles tendon can partially or completely tear. A tear usually occurs in the lower part of the tendon. Some doctors believe that this area is most likely to tear because of a limited blood supply.

If you don't treat a badly torn Achilles tendon, your tendon may heal with time. But your leg may not be as strong as if the tear had been treated.

What are the symptoms of an Achilles tendon tear?

Symptoms of an Achilles tendon tear may include:

  • A sudden, sharp pain that feels like a direct hit to the Achilles tendon. There may be a pop when the tear occurs. This may be followed by swelling and bruising.
  • Heel pain. (It may be severe.)
  • Not being able to go on tiptoe with the hurt leg.

If you have only a partial tear of the Achilles tendon, you may have near-normal strength after the injury. Some people with partial tears may not have any symptoms.

How is an Achilles tendon tear treated?

Treatment for an Achilles tendon tear includes:

  • Surgery. This is often used to reattach the ends of a torn Achilles tendon. Surgery works best when you have it soon after your injury. Surgery is followed by rehabilitation (rehab). Recovery may take months.
  • Immobilizing your leg. This prevents movement of the lower leg and ankle. It allows the ends of the Achilles tendon to reattach and heal. It may take as long as 6 months to completely heal the tendon. A cast, splint, brace, walking boot, or other device may be used. This treatment is then followed by rehab.

Treatment takes time, but it usually works. Most people can return to sports and other activities.

If you are healing from an Achilles tendon tear, don't smoke or use other tobacco products. Smoking slows healing. This is because it decreases blood supply and delays tissue repair.

Achilles Tendon Injury

Normal Achilles tendon and torn Achilles tendon

Courtesy of Intermountain Medical Imaging, Boise, Idaho.

Figure 1 shows magnetic resonance imaging (MRI) of a normal heel and Achilles tendon. Figure 2 shows a torn Achilles tendon with fluid collected at the site of the tear.

Caring for an Achilles tendon tear

Home treatment is often used as part of rehabilitation (rehab) after an Achilles tendon tear. Here are some things you can do to help you rest, heal, and strengthen your Achilles tendon. These can also help prevent further injury.

  • Rest your Achilles tendon.

    Avoid all activities that strain the tendon. This includes climbing stairs and running. Try other things, such as swimming, while you give your tendon the days, weeks, or months it needs to heal. Your doctor will tell you what you can and can't do.

  • Reduce pain.
    • Ice your Achilles tendon.
    • Take over-the-counter pain relievers like acetaminophen (such as Tylenol) or nonsteroidal anti-inflammatory drugs (NSAIDs) as directed. Be safe with medicines. Read and follow all instructions on the label.
  • Follow your physical therapy program if one has been prescribed for you.

    Do gentle stretching and strengthening exercises. Focus on calf stretches.

  • Don't smoke or use other tobacco products.

    Smoking slows healing. It decreases blood supply and delays tissue repair.

  • Wear footwear that protects the tendon while it heals.
    • Quality athletic shoes that support your arches and cushion your heels can make a big difference in your comfort and healing. If needed, talk to your physical therapist or podiatrist about heel pads or orthotics.
    • A bandage that keeps your foot in a neutral position (not pointing up or down) can restrict the motion of the tendon.
    • A silicone sleeve or pad can distribute pressure on the Achilles tendon.
  • Wear a night brace.

    Your doctor may suggest this if your Achilles tendon shortens and stiffens while you sleep. The brace keeps your foot in a neutral position.

How is surgery used to treat an Achilles tendon tear?

Surgery is often used to reattach the ends of a torn Achilles tendon.

Surgery works best when you have surgery soon after your injury. Recovery may take months. Most surgeons will wait a few days for swelling to go down. Then they'll do the surgery as soon as they can. It's usually done within 4 to 6 weeks. You'll also need a rehabilitation (rehab) program to help heal and strengthen the tendon.

Surgery for an Achilles tendon tear can be done with a single large cut (incision). This is called open surgery. Or it can be done with several small cuts. This is called percutaneous surgery.

What increases your risk for an Achilles tendon tear?

Things that increase your risk for an Achilles tendon tear include:

Sports and physical activity.

Overuse and repeated movements can weaken the tendon. Playing sports and doing activities at work and at home can raise your risk.

Sports training errors.

These include:

  • Suddenly changing your training program.
  • Changing your ground surfaces or increasing your distance too quickly.
  • Running uphill more often than before.
Age.

Most Achilles tears occur in people older than 30.

Weight.

People who are very heavy have a greater risk.

Being male.

Men are more likely than women to have an Achilles tendon injury.

Footwear.

Wearing shoes that don't support your feet or cushion your heel can increase your risk.

Certain diseases or injuries.
  • A past Achilles tendon injury, osteoarthritis, gout, or rheumatoid arthritis are risk factors.
Some medicines.
  • Corticosteroid injections in the Achilles tendon can weaken it.
  • Fluoroquinolone antibiotics may make a tear more likely.

What causes an Achilles tendon tear?

An Achilles tendon tear is most often caused by a sudden, forceful motion that stresses the calf muscle. This can happen during an intense sports activity or even when you just run or jump. Middle-aged adults are more likely to get this kind of injury.

What is an Achilles tendon tear?

An Achilles tendon tear—sometimes called a rupture—can be partial or complete. Partial tears may cause no symptoms. But complete tears cause pain and sudden loss of strength and movement. Middle-aged adults doing sports activities are more likely to get this kind of injury. Tears also happen in older adults.

Deciding about treatment for an Achilles tendon tear: Overview

If you have a torn Achilles tendon, you may have a choice of treatment. You may have surgery to repair the tendon, or you may let it heal while using a cast or brace (immobilization). Both surgery and immobilization are usually successful. With either treatment, recovery will take months, and both will require rehabilitation (rehab).

You might want to consider surgery if:

  • You are young or physically active.
  • You want to reduce the risk of a future rupture. Another rupture is less likely after surgery than after immobilization.

You may not want to have surgery if:

  • You are older or less active.
  • You want to avoid the risks of surgery, such as infection.

Your doctor can help you weigh the pros and cons of these options so you can decide what's right for you.

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The content above contains general health information provided by Healthwise, Incorporated, and reviewed by its medical experts. This content should not replace the advice of your healthcare provider. Not all treatments or services described are offered as services by us. For recommended treatments, please consult your healthcare provider.