Overview

Achilles (uh-KILL-eez) tendon rupture is an injury that affects the tendon in the back of the lower leg. It mainly happens while playing sports, especially jumping sports, for fun. But it can happen to anyone.

The Achilles tendon is a strong fibrous cord that joins the muscles in the back of the calf to the heel bone. Stretching the Achilles tendon too far can make it tear partway or all the way. The tear is called a rupture.

The Achilles tendon helps with pointing the foot downward, rising on the toes and pushing off on the foot while walking. People use their Achilles tendons every time they walk and move their feet.

If the Achilles tendon ruptures, there may be a pop, then a sharp pain in the back of the ankle and lower leg. This is likely to make walking hard. Many people have surgery to repair the tear. But for many people, treatment without surgery works just as well.

Symptoms

Some people have no symptoms with an Achilles tendon rupture. But most people:

  • Have a feeling of having been kicked in the calf.
  • Have sharp pain and swelling near the heel.
  • Find it hard to bend the foot downward or "push off" the injured foot when walking.
  • Find it hard to stand on the toes on the injured foot.
  • Hear a popping or snapping sound at the time of the injury.

When to see your doctor

Talk with a healthcare professional right away if you hear a pop in your heel, especially if it's hard to walk after that.

Causes

The cause of Achilles tendon rupture is often an injury that puts sudden force on the Achilles tendon. It can happen from:

  • Jumping or sharp cutting and pivoting in a sport.
  • Falling from a height or landing from a jump.
  • Stepping into a hole.

Risk factors

Factors that may raise the risk of Achilles tendon rupture include:

  • Age. The peak age for Achilles tendon rupture is 30 to 40.
  • Sex assigned at birth. People assigned male at birth are up to five times more likely to have Achilles tendon rupture than are people assigned female at birth.
  • Sports played for fun. Achilles tendon injuries happen more often during sports that involve running, jumping, and sudden starts and stops. These include soccer, basketball, volleyball and tennis.
  • Steroid shots. Healthcare professionals sometimes inject steroids into an ankle joint to reduce pain and swelling. But steroid medicines can weaken nearby tendons. They've been linked to Achilles tendon ruptures.
  • Certain antibiotics. Fluoroquinolone antibiotics, such as ciprofloxacin (Cipro) or levofloxacin, raise the risk of Achilles tendon rupture.
  • Obesity. Excess weight puts more strain on the tendon.

Prevention

To reduce your chance of having Achilles tendon issues follow these tips:

  • Stretch and strengthen calf muscles. Stretch your calf muscles until you feel a pull, but not pain. Don't bounce during a stretch. Calf-strengthening exercises also can help the muscle and tendon take on more force and protect against injury.
  • Vary your exercises. Mix high-impact sports, such as running, with low-impact sports, such as walking, biking or swimming. Limit activities that put a lot of stress on your Achilles tendons, such as activities that involve hill running and jumping.
  • Choose safer running surfaces. Don't run on hard or slippery surfaces. Wear athletic shoes that fit well and have good cushioning.
  • Add to your training slowly. Achilles tendon injuries often happen after training harder or all of a sudden. Add to how long, how far, how hard and how often you train by no more than 10% a week.
By Mayo Clinic Staff