An Achilles tendon rupture is when you tear the tissue that connects your calf muscle to your heel bone.

Your Achilles tendon is very strong and flexible. It’s at the back of your ankle and connects your calf muscle to the bone in the heel of your foot (calcaneum). If you rupture your Achilles tendon, you can either partially or completely tear the tendon.

Most people who injure their Achilles tendon are between 30 and 50 and don’t exercise regularly. It’s more common in men but can affect anyone.

It happens most often in the left leg. This may be because most people are right-handed which means that they ‘push off’ more frequently with the left foot when running.

Symptoms of Achilles tendon rupture

If you have any of these symptoms and believe you have ruptured your Achilles tendon, go straight to accident and emergency at your local hospital.

If you partially rupture your Achilles tendon, the tear may only be small. Symptoms of pain and stiffness may come on quite suddenly like a complete rupture, but may settle over a few days.

Treatment of Achilles tendon rupture

Your doctor may advise you to rest your leg and keep the tendon immobile in a plaster cast while it heals. Or you may need to have an operation to treat an Achilles tendon rupture. The treatment you have will depend on your individual circumstances, such as your age, general health and how active you are. It will also depend on whether you have partially or completely torn your tendon. If you have a partial tear, it might get better without any treatment. Ask your doctor for advice on the best treatment for you.

If you need pain relief, you can take over-the-counter painkillers such as paracetamol or ibuprofen. Always read the patient information that comes with your medicine and if you have any questions, ask your pharmacist for advice.

Non-surgical treatment

You may need to wear a plaster cast, brace or boot on your lower leg for six to eight weeks to help the tendon heal. During this time, your doctor will change the cast a number of times to make sure your tendon heals in the right way.

If your tendon is partially ruptured, your doctor will probably advise you to have this treatment instead of surgery. It’s also suitable for people who aren’t very physically active. However, there is a greater risk that your tendon will rupture again, compared with surgery. Your doctor will advise you which treatment is best for you.

Surgery

Your doctor may recommend surgery if you’re young and active, or an athlete. However, this will depend on where your tendon is ruptured. If the rupture is at, or above, the point at which your tendon merges with your calf muscle, for example, surgery may not be possible.

There are three main types of surgery to repair a ruptured Achilles tendon:

• Open surgery. Your surgeon will make one long cut in your leg to reach the tendon and repair it.
• Limited open surgery. Your surgeon will still make a single cut but it will be shorter.
• Percutaneous surgery. Your surgeon will make a number of small cuts to reach the tendon and repair it.

In all types of surgery, your surgeon will stitch the tendon together so it can heal. Each type of surgery has different risks. Open surgery is less likely to injure one of the nerves in your leg for example, but has a higher risk of infection. Ask your surgeon to explain the risks in more detail.

After your operation, you will need to wear a series of casts or an adjustable brace on your leg to help your Achilles tendon heal. This will usually be for between four and eight weeks.

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