The Center for Podiatric Care and Sports Medicine

Achilles, You’re Killin’ Me! The Danger of a Ruptured Tendon for Athletes and Everyone Else

Posted by on Thursday, August 15th, 2013


A torn or ruptured Achilles tendon is simply no fun at all. This essential cord of strong, fibrous material attaches the heel bone to the calf muscles and is used in just about every movement — from walking and running to jumping and standing on your tip-toes. It also helps bend the foot downwards at the ankle. As the strongest tendon in the body, the Achilles can withstand a force of about 1,000 pounds.

About 7 out of every 100,000 people will suffer from a ruptured Achilles at some point in time, with over 80% of these injuries occurring during a recreational sports activity. Athletes have a 24% chance of tearing their Achilles, but competitive runners have a 40 to 50% chance of Achilles tendon rupture during their lifetimes.


Symptoms of Ruptured Achilles

Many people say that a ruptured Achilles feels like “being shot in the heel” — if you can imagine how enjoyable that feels. You may hear a snap sound or feel a sudden sharp pain when the tendon tears. After a few moments, the pain settles and the back of the lower leg aches. You can walk and bear weight, but you may find it difficult to point the foot downward or push off the ground on the affected side. You will be unable to stand on tiptoe. Bruising and swelling are likely, and persistent pain will be present. Similar symptoms may be caused by an inflamed Achilles tendon (Achilles tendonitis), a torn calf muscle, arthritis of the ankle, or deep vein thrombosis in the calf, so an MRI or ultrasound scan will likely be used to diagnose your condition.

Causes of Ruptured Achilles

Ruptured Achilles tendons may result from:

  • Falling from a height or down a hole
  • Increasing training intensity abruptly — boosting distance, frequency or duration by more than 10% a week
  • Failing to stretch before and after exercise
  • Repetitive training, especially uphill running
  • Deyhydration, which causes cramping and tightness in the calves
  • Taking antibiotics
  • Improper footwear
  • Explosive movements in competitive sports like basketball, soccer or track & field

Ruptured Achilles Tendon Treatment & Recovery

Nonsurgical treatment for ruptured Achilles tendons involves wearing a cast or walking boot for eight weeks. However, a Swedish study found that the likelihood of re-rupturing the tendon is 12% without surgery and 4% with surgery. Surgical treatment is much harder once a re-rupture has occurred. What is most important is that the individual begins physical therapy right away to begin moving the foot and ankle within two weeks. Generally, younger athletes will elect to have the surgical intervention, while older patients who suffered a degenerative type of rupture will go with the nonsurgical option. People who are obese, sedentary or unfit for surgery are also advised to try the cast or boot instead.

The outlook for recovery from Achilles tendon surgery is good. Most people are back to work within two weeks and spend about two months waiting for the Achilles tendon to heal. Unfortunately, the total recovery time lasts much longer. A gradual return to sport can be made starting at three or four months, but it will likely take a solid 12 months to reach full strength again.


If you have any foot problems or pain, contact The Center for Podiatric Care and Sports MedicineDr. Josef J. GeldwertDr. Katherine Lai, Dr. Ryan Minara and Dr. Mariola Rivera have helped thousands of people get back on their feet. Unfortunately, we cannot give diagnoses or treatment advice online. Please make an appointment to see us if you live in the NY metropolitan area or seek out a podiatrist in your area.