Achilles Tendon Rupture

  • Medical Author: Steven S. Bhimji, MD, MSc, PhD
  • Medical Editor: William C. Shiel Jr., MD, FACP, FACR
    William C. Shiel Jr., MD, FACP, FACR

    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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What causes an Achilles tendon rupture?

Repeated stress from a variety of causes is often the cause of Achilles tendon injury. The stress may occur from any of the following:

  • Excessive activity or overuse
  • Flat feet
  • Poorly fitting or inadequate shoes
  • Inadequate warm-up or proper conditioning
  • Jogging or running on hard surfaces
  • Older recreational athlete
  • Previous Achilles tendon injury (tendonitis/rupture)
  • Repeated steroid injections
  • Sudden changes in intensity of exercise
  • Use of fluoroquinolone antibiotics (especially in children)
  • Trauma to the ankle
  • Tense calf muscles prior to exercise
  • Weak calf muscles

What are Achilles tendon rupture symptoms and signs?

Background history

  • Patients with an Achilles tendon rupture will often complain of a sudden snap in the back of the leg. The pain is often intense.
  • With a complete rupture, the individual will only be able to ambulate with a limp. Most people will not be able to climb stairs, run, or stand on their toes.
  • Swelling around the calf may occur.
  • Patients may often have had a sudden increase in exercise or intensity of activity.
  • Some patients may have had recent corticosteroid injections or use of fluoroquinolone antibiotics.
  • Some athletes may have had a prior injury to the tendon.

Physical exam

  • When Achilles tendon injury is suspected, the entire lower lag is examined for swelling, bruising, and tenderness. If there is a full rupture, a gap in the tendon may be noted.
  • Patients will not be able to stand on the toes if there is a complete Achilles tendon rupture.
  • Several tests can be performed to look for Achilles tendon rupture. One of the most widely used tests is called the Thompson test. The patient is asked to lie down on the stomach and the examiner squeezes the calf area. In normal people, this leads to flexion of the foot. With Achilles tendon injury, this movement is not seen.
Medically Reviewed by a Doctor on 2/19/2016
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