This page is awaiting validation. It does not replace a consultation or a programme adapted to your situation.
What is a rupture?
The Achilles connects calf muscles to the heel and transfers push-off force. A rupture interrupts part or all of its fibres. It differs from gradual tendinopathy pain, although the tendon may have been painful before the injury.
Rupture often occurs during acceleration, jumping or a change of support, but not only in athletes. Some illnesses and medicines increase risk. Having no previous tendon pain does not fully protect against rupture.
Chapter sources [1]
Understand the picture
The tendon transfers push-off force
Calf
Muscle force travels towards the heel.
Rupture site
Examination checks continuity and function.
Protection
The medical team sets the foot position.
Chapter sources [1]
Which symptoms may suggest it?
Some people describe being struck behind the leg when nobody touched them. A snap, pain, swelling and difficulty pushing through the forefoot may follow. Pain can later settle without the tendon being repaired.
Other muscles may still allow some foot movement and limited walking. Walking alone is therefore not reassuring enough. Do not repeatedly rise onto your toes or perform a calf-squeeze test on yourself.
Chapter sources [1]
What should you do before assessment?
Stop sport and seek prompt medical assessment, ideally the same day. Limit loading and arrange safe transport. Avoid calf stretching or manipulating the foot to release a supposed blockage.
An open injury, cold or numb foot, major deformity or uncontrolled pain needs urgent care. In Luxembourg, 112 is the emergency number. This guide must not delay examination of a possible rupture.
Chapter sources [1]
How is a rupture confirmed?
The clinician examines the injury history, tendon, foot position and response to clinical tests. Other causes of calf or ankle pain are considered. Skin condition and risk factors also matter.
Ultrasound or other imaging may help if the diagnosis is uncertain or more detail is needed. It is not always required when examination clearly shows a rupture. Older or previously missed injuries can need a different approach.
Chapter sources [1]
Surgery or non-surgical treatment?
Both options may be considered. Non-surgical treatment includes protection holding the foot in a suitable position, followed by guided progression. Surgery brings tendon ends together, but still requires protection and rehabilitation afterwards.
The choice depends on the injury, delay, health, activities and risks. Discuss re-rupture, wound problems, infection and the demands of each plan. Age or participation in sport alone does not decide the treatment.
Chapter sources [1]
Why are boot and loading instructions precise?
A boot or cast protects the tendon during early repair. Wedges can control foot position. Permitted loading and wedge changes depend on the protocol: some allow early protected weight-bearing, while others require more restriction.
Ask for written instructions for walking, sleeping, washing and any boot removal. Do not remove a wedge or increase stretching because another patient has already done so. Report a fall or unexpected movement according to your team’s instructions.
Chapter sources [1]
What should you watch during protection?
Contact the team promptly if the boot causes significant pain, a wound, numb toes or colour change. After surgery, spreading redness, discharge, fever or increasing wound pain needs medical advice.
Immobilisation increases clot risk. A newly painful swollen calf needs prompt assessment. With breathlessness, chest pain or faintness, call 112. Follow prescribed clot prevention; this guide cannot determine whether you need it or the dose.
In everyday life
Stages under medical supervision
Assess
Confirm the injury and discuss treatment.
Protect
Follow boot, wedge and loading instructions.
Rebuild
Gradually restore walking, strength and sporting tasks.
What is rehabilitation’s role?
Physiotherapy stays within the medical team’s limits. Initially it may help with crutches, safe journeys and permitted activities. Ankle movement and calf strengthening begin at the specified stage with controlled range.
Walking, strength, balance and push-off are then rebuilt gradually. The tendon can remain vulnerable despite little pain. Pain alone must not decide whether stretching or jumping is allowed. General website exercises do not replace this protocol.
Chapter sources [1]
Managing work, transport and home
Plan stairs, carrying and washing before managing alone with crutches. A light bag and organising essentials on one floor may help depending on your abilities. Avoid loads that prevent correct use of walking aids.
Work return depends on journeys, standing and possible task changes. Driving with a boot or a leg unable to perform an emergency stop is unsafe. Seek advice specific to the injured side, vehicle and protocol.
Chapter sources [1]
How is sport return decided?
Recovery takes several months, and strength may return more slowly than walking. Running, then jumping or direction changes, depends on functional stages and team agreement. No online deadline guarantees your tendon is ready.
Arrange reassessment of strength, push-off and responses to exercise. A new snap or sudden loss of function needs prompt assessment. Regular review supports adjustment without promising the same outcome for everyone.
Chapter sources [1]
Your questions
Could I have a rupture if I can still walk?
Yes. Other muscles may allow limited walking. Loss of push-off after a snap needs prompt examination.
Chapter sources [1]
Is surgery essential to return to sport?
Not in every situation. The decision depends on injury, activities, health and the benefits and risks discussed with the team.
Chapter sources [1]
Can I remove the boot at night?
Only according to your protocol. Ask for written rules for sleep, washing, wedges and walking. These vary with the treatment stage.
Chapter sources [1]
When can I stretch my calf?
At the time and within the range allowed by the team. Early stretching can undermine protection; absence of pain does not make it safe.
Chapter sources [1]
Sources and references
- [1] Achilles Tendon Rupture (Tear) - OrthoInfo - AAOS
- [2] DVT (deep vein thrombosis) - NHS
- [3] Recommendations | Diabetic foot problems: prevention and management | Guidance | NICE
Text updated on
Medical review: awaiting Hasib Selimovic.