Symptoms and causes

Symptoms

Although it's possible to have no signs or symptoms with an Achilles tendon rupture, most people have:

  • The feeling of having been kicked in the calf
  • Pain, possibly severe, and swelling near the heel
  • An inability to bend the foot downward or "push off" the injured leg when walking
  • An inability to stand on the toes on the injured leg
  • A popping or snapping sound when the injury occurs

When to see your doctor

Seek medical advice immediately if you hear a pop in your heel, especially if you can't walk properly afterward.

Causes

Your Achilles tendon helps you point your foot downward, rise on your toes and push off your foot as you walk. You rely on it virtually every time you walk and move your foot.

Rupture usually occurs in the section of the tendon situated within 2 1/2 inches (about 6 centimeters) of the point where it attaches to the heel bone. This section might be prone to rupture because blood flow is poor, which also can impair its ability to heal.

Ruptures often are caused by a sudden increase in the stress on your Achilles tendon. Common examples include:

  • Increasing the intensity of sports participation, especially in sports that involve jumping
  • Falling from a height
  • Stepping into a hole

Risk factors

Factors that may increase your risk of Achilles tendon rupture include:

  • Age. The peak age for Achilles tendon rupture is 30 to 40.
  • Sex. Achilles tendon rupture is up to five times more likely to occur in men than in women.
  • Recreational sports. Achilles tendon injuries occur more often during sports that involve running, jumping, and sudden starts and stops — such as soccer, basketball and tennis.
  • Steroid injections. Doctors sometimes inject steroids into an ankle joint to reduce pain and inflammation. However, this medication can weaken nearby tendons and has been associated with Achilles tendon ruptures.
  • Certain antibiotics. Fluoroquinolone antibiotics, such as ciprofloxacin (Cipro) or levofloxacin (Levaquin), increase the risk of Achilles tendon rupture.
  • Obesity. Excess weight puts more strain on the tendon.
Aug. 02, 2017
References
  1. Maughan KL. Achilles tendinopathy and tendon rupture. https://www.uptodate.com/contents/search. Accessed June 26, 2017.
  2. Achilles tendon rupture. American Academy of Orthopaedic Surgeons. http://orthoinfo.aaos.org/topic.cfm?topic=av0003. Accessed June 26, 2017.
  3. Li Q, et al. Minimally invasive versus open surgery for acute Achilles tendon rupture: A systematic review of overlapping meta-analyses. Journal of Orthopaedic Surgery and Research. 2016;11:65.
  4. Zhang H, et al. Surgical versus conservative intervention for acute Achilles tendon rupture: A PRISMA-compliant systematic review of overlapping meta-analyses. Medicine. 2015;94:1.
  5. Functional rehabilitation. American Academy of Physical Medicine and Rehabilitation. http://www.aapmr.org/about-physiatry/conditions-treatments/musculoskeletal-medicine/functional-rehabilitation. Accessed June 27, 2017.
  6. Barfod KW, et al. Nonoperative dynamic treatment of acute Achilles tendon rupture: The influence of early weight-bearing on clinical outcome. Journal of Bone and Joint Surgery. 2014;96:1497.