Achilles Tendon Rupture | Achilles Tear
Information reviewed by: Dr. Foo Gen Lin | Last updated: Oct 29, 2025
Achilles tendon rupture is often caused by sudden force or overuse, leading to a partial or complete tear. It causes sharp pain, swelling, and mobility loss. Dr Foo provides timely diagnosis and treatment to support recovery and restore function.
MBBS (University of London) | MMed (Ortho) | FRCSEd (Ortho) | FAMS (Ortho)
What Is an Achilles Tendon Rupture?
An Achilles tendon rupture, also called an Achilles tear, is a complete or partial
tear of the Achilles tendon, the fibrous tissue that connects the calf muscles to the
heel bone. It can cause sharp pain, swelling, and difficulty walking,
making everyday movements challenging.
Without prompt medical attention, the injury may
worsen, leading to prolonged discomfort, impaired mobility, and an increased risk of
long-term complications such as tendon weakness or re-rupture.
What Causes Achilles Tendon Ruptures?
An Achilles tendon rupture can occur due to excessive stress on the tendon, often during high-impact activities. Common causes include:
- Sudden Forceful Movements – Sprinting, jumping, or pushing off forcefully can strain the tendon beyond its capacity, leading to a rupture.
- Degenerative Changes – The tendon naturally weakens with age as collagen fibres degrade and blood supply decreases, reducing its strength and elasticity, making it more susceptible to tearing.
- Improper Warm-up – Insufficient stretching or preparation before intense activity can reduce tendon flexibility and increase injury risk.
- Use of Certain Medications – Some antibiotics, including fluoroquinolones like levofloxacin, and corticosteroids have been associated with increased tendon fragility and a higher risk of rupture, especially with prolonged or high-dose use.
- Pre-existing Tendon Damage – Chronic conditions such as Achilles tendinitis or a previous rupture can weaken the tendon over time, increasing the risk of re-injury.
Achilles Tendon Rupture Symptoms & Signs
The most common symptoms of an Achilles tendon rupture include:
- Sudden, sharp pain in the back of the lower leg, often described as feeling like a direct blow or kick.
- Difficulty walking or pushing off the affected foot due to impaired tendon function.
- Swelling and bruising around the ankle or calf, developing shortly after the rupture.
- A popping sensation or sound at the moment of injury, which may be audible or felt.
- A noticeable gap or indentation in the tendon area, particularly in cases of a complete rupture.
Complications of Achilles Tendon Rupture
An Achilles tendon rupture can lead to functional issues if excessive elongation or scar tissue forms, causing stiffness, weakness, instability, or reduced flexibility. Potential complications include:
- Difficulty Walking and Reduced Mobility – A poorly healed or overstretched Achilles tendon may not fully regain its function, affecting walking mechanics and making activities like climbing stairs more challenging.
- Chronic Weakness and Instability – Loss of muscle strength and an elongated tendon can lead to reduced stability, making movement less controlled and increasing the risk of falls.
- Increased Risk of Re-Rupture – A weakened Achilles tendon, especially if overstretched, is more prone to tearing again, particularly during high-impact activities.
- Compensatory Strain on Other Muscles and Joints – When the Achilles tendon is weak, other muscles and joints must work harder, increasing stress on the knees, hips, and lower back, which may lead to pain and discomfort.
Early diagnosis and treatment are essential to prevent these complications and restore function to your leg. If you suspect an Achilles tendon rupture or are experiencing persistent pain and difficulty walking, consult an ankle specialist in Singapore for a thorough evaluation and personalised treatment plan. How Is an Achilles Tendon Rupture Diagnosed?
Diagnosing an Achilles tendon rupture involves a combination of clinical examination and
imaging tests to assess the severity of the injury.
Common diagnostic methods include:
1. Physical Examination
A doctor will perform a visual and manual assessment to check for swelling, bruising, tenderness, and a noticeable gap in the Achilles tendon. They will also evaluate your ability to move the foot and push off the ground.
2. Thompson Test
A specialised clinical test whereby you will lie face down while the doctor gently squeezes the calf muscle. Normally, this action causes the foot to flex downward. If the foot fails to move, it suggests a complete Achilles tendon rupture, indicating a loss of tendon function.
3. Imaging Tests
Imaging tests help confirm the diagnosis and determine the extent of the rupture:
- Ultrasound – Provides real-time imaging by using sound waves to create live visuals of the tendon, helping assess whether the rupture is partial or complete.
- Magnetic Resonance Imaging (MRI) – Uses magnetic fields to produce high-resolution images of soft tissues, making it especially useful for complex cases or pre-surgical evaluation.
Achilles Tendon Rupture Treatment
Treatment for an Achilles tendon rupture depends on the severity of the injury, the patient’s
activity level, and overall health.
Non-surgical treatments are often recommended for partial
ruptures or individuals with lower physical demands, while surgical intervention may be necessary
for complete ruptures or active individuals seeking a faster recovery.
| Treatment | Purpose |
|---|---|
| Non-Surgical Management | |
| Activity Modification | Reducing high-impact activities to minimise strain on the healing tendon and lower the risk of re-injury. |
| Swelling and Pain Management | Applying ice packs and elevating the leg reduces swelling and inflammation, especially in the first 48 hours. Non-steroidal anti-inflammatory drugs (NSAIDs) help relieve pain and control inflammation, but prolonged use should be monitored for side effects. |
| Immobilisation with a Boot or Cast | A boot or cast keeps the foot in a downward (plantarflexed) position, reducing tension on the Achilles tendon by limiting movement and preventing excessive stretching. This stabilisation helps the torn fibres heal naturally while minimising the risk of further strain or improper healing. |
| Physiotherapy | A structured rehabilitation programme that may incorporate weightbearing, ankle mobility exercises, and calf muscle strengthening to restore function and support tendon healing. |
| Surgical Intervention | |
| Minimally Invasive Achilles Tendon Repair | This technique minimises disruption to surrounding tissues, reduces recovery time, lowers the risk of wound complications, and promotes faster rehabilitation compared to traditional open surgery. |
| Open Surgical Repair | Used for severe or complex ruptures, this approach involves a larger incision to provide direct visual access to the tendon for precise reattachment with sutures or reinforcement. While ensuring strong initial repair, it may slightly extend recovery and increase wound-related risks compared to minimally invasive methods. |
How to Prevent Achilles Tears?
While Achilles tendon ruptures cannot always be prevented, certain strategies can help reduce the risk:
- Regular Stretching and Strengthening Exercises – Maintaining tendon flexibility and strengthening the calf muscles improves resilience and reduces strain.
- Wearing Proper Footwear – Supportive shoes help distribute stress evenly across the foot and ankle, reducing excessive pressure on the Achilles tendon.
- Gradual Increase in Activity Intensity – Avoiding sudden spikes in training intensity allows the tendon to adapt progressively, minimising the risk of overloading.
- Adequate Rest and Recovery – Allowing sufficient recovery time between intense workouts or sports activities prevents cumulative stress and overuse injuries.
Every patient deserves a treatment plan tailored to their needs. We start with non-surgical approaches before considering more invasive interventions.
Dr Foo Gen Lin
Where Can I Find an Ankle Specialist in Singapore?
Apex Novena
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101 Irrawaddy Rd, #18-12 Royal Square Medical Centre, Singapore 329565
Nearest MRT: NS20 Novena
Apex East Coast
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112 E Coast Rd, #03-03/04 i12 Katong, Singapore 428802
Nearest MRT: TE26 Marine Parade
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Frequently Asked Questions (FAQs)
Achilles tendon rupture recovery without surgery typically takes 4 to 6 months, though full functional recovery may take longer. This timeframe includes immobilisation in a boot or cast followed by progressive physiotherapy to restore strength, mobility, and tendon integrity. Healing may be slower than with surgery, and there is a slightly higher risk of re-rupture. Recovery timelines can vary, so it is advisable to check with your specialist or surgeon for personalised guidance.
Whether to undergo Achilles tendon surgery depends on the severity of the rupture, your activity level, and overall health. Surgery is often considered for complete ruptures in active individuals seeking faster recovery and reduced re-rupture risk, while non-surgical management may be suitable for partial tears or less physically demanding lifestyles. Both options can achieve good outcomes with proper rehabilitation. It is advisable to consult a specialist to evaluate which approach aligns best with your needs and circumstances.
Walking with a partially torn Achilles tendon is possible but often painful and limited, while walking after a complete rupture is typically very difficult or not possible without support. A partial tear may retain some function, whereas a complete rupture severely impairs the ability to push off the foot. Continuing to walk without treatment can worsen the injury.
An Achilles tendon tear usually happens when the tendon is suddenly overloaded during forceful actions like jumping, sprinting, or pushing off strongly with the foot. It often occurs when the ankle is forced upward sharply or during an explosive movement. Factors such as tendon degeneration, poor conditioning, or insufficient warm-up can further increase the risk of tearing.
Tearing the Achilles tendon typically causes sudden, sharp pain in the back of the lower leg, often described as a snap or being kicked. Many individuals report a popping sound at the time of injury, followed by swelling, bruising, and difficulty walking or pushing off the foot. The pain may subside quickly, but functional loss persists.
An Achilles tear is a serious injury that can significantly impair mobility and function if not properly treated. Complete ruptures often require prolonged rehabilitation or surgery, especially in active individuals, while partial tears may heal with conservative treatment. Delayed or inadequate management can lead to chronic weakness, re-rupture, or compensatory issues. If you suspect a torn Achilles or are experiencing symptoms, it is advisable to consult a specialist for proper diagnosis.
It is sometimes possible to walk with a torn Achilles tendon, particularly if the tear is partial, but the function is often compromised. A complete rupture typically impairs the ability to push off the foot, making walking difficult without assistance. Walking on a torn tendon can worsen the damage or delay healing.
A partially torn Achilles tendon may heal without surgery through immobilisation and rehabilitation, but complete ruptures rarely heal fully on their own. Without proper alignment of tendon ends, healing may result in elongation, weakness, and reduced function. Non-surgical and surgical treatments aim to restore tendon integrity and prevent complications. If you suspect an Achilles tear or are experiencing symptoms, it is advisable to consult a specialist for assessment and treatment guidance.
Early warning signs of an Achilles rupture may include persistent tendon pain, stiffness, or tenderness, particularly during or after activity. These symptoms can indicate underlying tendinopathy, which increases the risk of rupture if left unaddressed. A sudden increase in training intensity, poor conditioning, or inadequate recovery can further aggravate the tendon and heighten the risk.
If an Achilles tendon tear goes untreated, it may result in chronic weakness, loss of ankle function, and a higher risk of re-rupture. Over time, the tendon may heal improperly, often with excessive elongation or scar tissue, reducing strength and mobility. Untreated ruptures can also cause compensatory strain on nearby joints. If you suspect an Achilles tear or are experiencing symptoms, it is advisable to consult a specialist for proper assessment.
You may still be able to bend your foot with a torn Achilles tendon, especially with partial tears, but strength and control are often significantly reduced. In cases of complete rupture, the ability to actively point the foot downward is usually lost because the calf muscles can no longer effectively transmit force to the heel.
Stretching a sore Achilles tendon should be approached with caution, especially if pain is acute or persistent. Gentle stretching may help with mild tightness, but aggressive or improper stretches can aggravate underlying inflammation or contribute to tendon damage. It is advisable to consult a doctor or physiotherapist to determine if stretching is appropriate and to receive guidance on safe mobility exercises.
To sleep with a torn Achilles tendon, it is recommended to slightly elevate the leg and keep the ankle supported in a neutral or plantarflexed position, where the foot points gently downward, using a brace or boot if advised. This helps reduce swelling and protects the tendon during healing. Avoid placing direct pressure on the heel. It is best to consult a specialist or physiotherapist for guidance on the most suitable sleep position for your injury.
Achilles tendonitis usually causes gradual pain and stiffness during activity, whereas a tear often results in sudden sharp pain, swelling, and impaired function. A popping sensation or inability to push off the foot strongly suggests a rupture. Although symptoms can overlap, a thorough clinical examination and imaging such as ultrasound or MRI are needed to confirm a definitive diagnosis.
It is possible to walk with a ruptured Achilles tendon, especially in cases of partial tears, though mobility is usually limited. Some individuals may retain the ability to move the foot, but walking typically becomes difficult or abnormal due to weakness in push-off and loss of tendon function.
Recovery from a ruptured Achilles tendon typically takes between 4 to 12 months, depending on the severity of the injury and treatment approach. Non-surgical and surgical methods both require structured rehabilitation, though surgical patients may regain strength slightly earlier. Full return to high-impact activities is gradual and varies by individual. It is advisable to consult a doctor to determine a realistic recovery timeline based on your condition and activity goals.
Many individuals can return to running after an Achilles tendon rupture, although recovery depends on the success of treatment and commitment to rehabilitation. While some regain full performance, others may experience lingering weakness or reduced push-off strength. A gradual return is based on achieving functional milestones. It is best to consult a specialist or physiotherapist who will work with you to create a plan that supports a progressive return to running.
A ruptured Achilles tendon is often marked by sudden, sharp pain in the back of the lower leg, followed by difficulty walking and pushing off the foot. Some people report hearing a pop or feeling as though they were kicked in the calf. A noticeable gap above the heel may also be present. It is advisable to consult a doctor promptly for a physical examination and imaging, such as ultrasound or MRI, to confirm the diagnosis.
Tendon repair is generally considered a moderate orthopaedic procedure, but it can carry risks typical of surgery such as infection or wound healing complications. Open repair and minimally invasive approaches are both used, depending on the injury. While not classified as major surgery in all cases, it requires anaesthesia and structured postoperative rehabilitation.