An Achilles tendon rupture is a complete tear of the tendon that joins the calf muscles to the heel bone. It usually happens suddenly during sport, with a snap or the feeling of being kicked in the back of the leg, and afterwards it is difficult to push off the foot. It needs same-day assessment, and it can be treated either in a walking boot or with surgery, followed in both cases by several months of rehabilitation.
Also known as torn Achilles, Achilles tear, ruptured Achilles tendon
Anatomy: where the problem is
Side view of the lower leg. Highlighted in the diagram: Achilles tendon.
Symptoms
- A sudden snap or pop at the back of the ankle or lower calf
- A feeling of being kicked or hit from behind
- Sharp pain that may ease quickly to a dull ache
- Difficulty pushing off, walking normally or rising onto the toes
- A gap or dent that can be felt in the tendon
- Swelling and bruising around the heel and ankle
Causes and risk factors
- Sudden push-off or change of direction, as in racket sports, football and sprinting
- Returning to sport after a long break
- Being aged 30 to 50
- Previous Achilles tendon problems
- Fluoroquinolone antibiotics such as ciprofloxacin
- Steroid tablets or steroid injections near the tendon
What the evidence says helps
- Prompt diagnosis matters, because ruptures are sometimes mistaken for a sprain. Treatment should start within days.1
- Both surgery and non-surgical treatment are established options. A review of 29 studies found that surgery slightly lowered the risk of the tendon rupturing again (about 2 in 100 compared with 4 in 100) but carried a higher risk of other complications, mainly infection.1
- In a trial of over 500 adults, surgery did not give better results than non-surgical treatment at 12 months, although re-rupture was more common without surgery.3
- For people treated without surgery, a large UK trial found that a functional walking boot with early weight-bearing gave results similar to a plaster cast.2
- Whichever route is chosen, a structured rehabilitation programme lasting several months is needed to restore calf strength.12
Things you can try at home
- If you feel a snap at the back of the ankle, stop, do not stretch the calf, and get assessed the same day
- Keep the foot pointed down and avoid walking on it until it has been examined
- Follow the boot and wedge instructions you are given exactly, including at night
- Do not stretch the calf in the early months: the tendon needs to heal at the right length
- Rebuild calf strength gradually under guidance, starting with seated exercises
- Expect a return to running at around four to six months, and to sport later
When to get urgent help
Contact your GP urgently, call NHS 111, or call 999 in an emergency if you have:
- A sudden snap or pop at the back of the ankle with difficulty walking or pushing off: go to A&E or a minor injuries unit the same day
- A swollen, warm, tender calf, especially in one leg only: get same-day medical help, as this can be a blood clot
- Calf pain or swelling with breathlessness or chest pain: call 999
- Increasing pain, redness or discharge around a surgical wound: get same-day medical help
- A new snap or sudden loss of strength during recovery: contact your treating team urgently
How Apollo can help
If you come to us with a suspected rupture, we test the tendon and send you for same-day medical assessment. Once your orthopaedic team has set the plan, we guide rehabilitation through each stage, whether you were treated in a boot or with surgery: protected loading, restoring ankle movement without overstretching, progressive calf strengthening, then walking, running and sport-specific work. We use VALD testing to measure calf strength and the difference between your legs, which helps decide when you are ready for each step.
No GP referral needed. Clinics in Sheringham, Coltishall and Norwich.
Related reading
Frequently asked questions
How do I know if I have ruptured my Achilles tendon?
Typical signs are a sudden snap at the back of the ankle, a feeling of being kicked, and difficulty pushing off or standing on tiptoe on that leg. You may still be able to walk and move the foot, so do not rely on that. Get it examined the same day.
Is surgery or a boot better for a ruptured Achilles?
Both are good options. Surgery slightly lowers the chance of the tendon rupturing again but has a higher risk of wound and other complications. Results at a year are similar. The choice depends on your age, activity, health and preference, and should be discussed with the orthopaedic team.
How long does recovery take?
Most people are in a boot for around eight to ten weeks. Walking normally takes about three months, running four to six months, and a return to sport six to twelve months. Calf strength can take a year or more to recover and may not fully match the other side.
References
- Ochen Y, et al. (2019). Operative treatment versus nonoperative treatment of Achilles tendon ruptures: systematic review and meta-analysis. BMJ. View source
- Costa ML, et al. (2020). Plaster cast versus functional brace for non-surgical treatment of Achilles tendon rupture (UKSTAR): a multicentre randomised controlled trial and economic evaluation. The Lancet 395:441-448. View source
- Myhrvold SB, et al. (2022). Nonoperative or Surgical Treatment of Acute Achilles’ Tendon Rupture. New England Journal of Medicine 386:1409-1420. View source
This page is general information, not a diagnosis or a substitute for medical advice. If you are worried about your symptoms, speak to your GP or a registered healthcare professional. Content prepared from the sources above, November 2026.
