3 Mar, 2023

Achilles Tendon Injuries: Causes, Symptoms, and Treatments for Ruptures and Tears


Achilles tendon injuries are a common occurrence among athletes and active individuals, particularly those who participate in high-impact sports. These injuries can be debilitating and painful, leading to extended periods of downtime and even requiring surgery. In this article, we will explore the causes, symptoms, and treatments of Achilles tendon injuries, including Achilles tendon ruptures, tears, and tendinopathy.

What is the Achilles tendon?

The Achilles tendon connects your calf muscles to your heel bone. It is both the strongest and largest tendon of the body and is positioned behind the back of your ankle. The Achilles tendon is responsible for the movement of the foot and ankle, allowing us to walk, run, and jump. Due to its constant use, the Achilles tendon is susceptible to injury, particularly in individuals who engage in high-impact activities or have previously suffered from Achilles tendon tears or ruptures.

Causes of a ruptured Achilles tendon or injured Achilles tendon

An Achilles tendon injury can occur for a variety of reasons, including:

  • Sudden movements: A sudden movement or change in direction can cause acute Achilles tendon ruptures or tears.

  • Overuse: Overuse of the Achilles tendon can cause tendinopathy or partial tears. Repetitive strain on the tendon can cause Achilles tendinosis, which describes small tears in the fibres and a breakdown of the collagen that provides strength to the tendon.

  • Direct trauma: A direct blow to the Achilles tendon can cause a rupture or torn tendon.

  • Uneven surfaces: Running or playing sports on uneven surfaces can increase the risk of Achilles tendon disorders, ruptures or injuries.

  • Risk factors: Individuals with a history of Achilles tendon tears, flat feet, or tight calf muscles are at a higher risk of developing Achilles tendon injuries.

Symptoms of Achilles tendon ruptures and injuries

The symptoms of Achilles tendon rupture or other injuries can vary depending on the severity of the injury. Some common symptoms include:

  • Sudden or instant pain in the ankle or back of the leg, accompanied by a snap or pop sensation

  • A sharp pain or a dull ache in the affected area

  • Heel pain

  • Pain and difficulty when walking

  • Swelling and stiffness

  • Reduced range of motion

  • Weakness in the affected leg

Types of Achilles tendon injuries

Achilles tendon injuries can range from mild to severe and may require different types of treatments. Some common types of Achilles tendon injuries include:

  • Achilles Tendinopathy: This condition is characterized by pain and stiffness in the Achilles tendon and can be caused by overuse or degeneration of the tendon.

  • Partial Tear: A partial tear occurs when the Achilles tendon is partially torn but not completely ruptured.

  • Acute Achilles Tendon Rupture: An acute Achilles tendon rupture is a complete tear of the tendon that typically occurs during sports or other high-impact activities.

  • Chronic Achilles Tendon Ruptures: Chronic ruptures occur when the tendon is partially torn and left untreated, leading to a complete rupture over time.

Diagnosis of Achilles tendon injuries

To diagnose an Achilles tendon injury, a doctor will typically perform a physical exam and may order imaging tests, such as an MRI or ultrasound. They may also ask about the patient's medical history and symptoms to determine the type and severity of the injury.

Treatment of Achilles tendon injuries

The treatment of Achilles tendon injuries depends on the type and severity of the injury. Some common treatments include:

  • Non-Surgical Treatment: Non-surgical treatments may include rest, ice, compression, elevation (RICE), physical therapy, and the use of a walking boot or brace.

  • Surgical Treatment: In severe cases, surgical treatment may be necessary, particularly for complete ruptures or chronic injuries. This may involve a surgical repair or reconstruction of the tendon.

  • Steroid Injections: Steroid injections may be used to reduce pain and inflammation in the affected area.

What are the different types of Achilles tendon surgical repair?

An Achilles tendon rupture can be treated surgically by orthopaedic surgeons or foot and ankle surgeons.

  • Open surgery: This is the most traditional form of operative treatment for Achilles tendon rupture. It involves making an incision in the back of the ankle to directly access the torn tendon. Orthopaedic surgeons use this technique to suture the torn ends of the tendon back together.

  • Percutaneous surgery: This is a minimally invasive surgical procedure that involves making several small incisions instead of one large incision. Surgeons use special instruments to reattach the torn tendon ends.

  • Mini-open surgery: This is a hybrid of open and percutaneous techniques. Surgeons make a small incision to gain access to the ruptured tendon and use specialized instruments to repair it. This technique combines the advantages of both open and percutaneous ankle surgery.

How long does it take to recover from a torn Achilles tendon, Achilles tendonitis, or another Achilles injury?

The healing process and recovery time for an Achilles tendon injury depend on the severity of the injury and the treatment that is chosen. For minor injuries, nonsurgical treatment can often lead to a full recovery within a few months. However, for more severe injuries, surgical intervention may be necessary, and recovery can take up to a year or longer.

During the healing process, patients are advised to rest and avoid putting weight on the injured leg. Physical therapy is often recommended to help improve muscle strength and range of motion. A walking boot or an elastic bandage may also be used to protect and support the injured area.

After surgery, patients will need to wear a cast or brace for several weeks and may need to use crutches to move around. They will also need to attend physical therapy sessions to regain strength and flexibility in the affected leg.

Preventing Achilles tendon injuries

Preventing Achilles tendon injuries is essential for active patients, especially those who regularly engage in sports or physical activity. Some preventive measures include:

  • Wearing appropriate footwear with proper arch support

  • Avoiding playing sports on uneven surfaces

  • Learning how to stretch the Achilles tendon and warm up properly before physical activity

  • Maintaining a healthy weight and avoiding excessive weight gain

  • Listening to the body and resting when necessary

  • Seeking treatment promptly if an injury occurs, to prevent further damage


An Achilles tendon injury can be a painful and debilitating condition that can significantly impact a patient's quality of life. Treatment options vary depending on the severity of the injury, but early diagnosis and prompt treatment are essential for a successful recovery. With proper treatment and preventative measures, patients can reduce the risk of future injuries and return to their active lifestyles.

Remember, if you experience sudden sharp pain in the back of your leg, seek medical attention promptly to prevent further injury to the Achilles tendon.

Next steps

  • Book your soft tissue MRI scan, or foot and ankle ultrasound scan, if you think you might have an Achilles tendon injury
  • Read more about imaging types, scan uses and health conditions on our news page.

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