Achilles Tendon Tear

The Achilles tendon is a cord-like band that connects the muscles of your lower leg (calf) to your heel. The Achilles tendon is the most common site of tendon tearing (rupture).

What are the causes?

This condition may be caused by:

  • Stress from a sudden stretching of the tendon. For example, this may occur when you land from a jump or when your heel drops down into a hole on uneven ground.

  • A hard, direct hit to the tendon.

  • Pushing off your foot forcefully, such as when sprinting, jumping, or changing direction while running.

What increases the risk?

You are more likely to develop this condition if you:

  • Are a runner.

  • Play sports that involve sprinting, running, or jumping.

  • Play contact sports.

  • Have a weak Achilles tendon. Tendons can weaken from aging, repeat injuries, and chronic tendinitis.

  • Are male.

  • Are 30–55 years of age.

  • Take a type of antibiotic medicine called quinolones.

What are the signs or symptoms?

Symptoms of this condition include:

  • Hearing a noise, like a pop or a snap, at the time of injury.

  • Severe, sudden pain in the back of the ankle.

  • Swelling and bruising.

  • Inability to actively point your toes down.

  • Pain when standing or walking.

  • A feeling of reduced strength when you step on the affected foot.

How is this diagnosed?

This condition is usually diagnosed based on a physical exam.

You may also have imaging tests, such as:

  • Ultrasound.

  • X-rays.

  • MRI.

How is this treated?

This condition may be treated with:

  • Rest.

  • Ice applied to the area.

  • Pain medicine.

  • Crutches.

  • A cast, splint, or other device to keep the ankle from moving (immobilized).

  • Heel wedges to reduce the stretch on your tendon as it heals.

  • Surgery. This option may depend on your age and your activity level.

Follow these instructions at home:


  • Take over-the-counter and prescription medicines only as told by your health care provider.

  • Ask your health care provider if the medicine prescribed to you:

    • Requires you to avoid driving or using heavy machinery.

    • Can cause constipation. You may need to take these actions to prevent or treat constipation:

      • Drink enough fluid to keep your urine pale yellow.

      • Take over-the-counter or prescription medicines.

      • Eat foods that are high in fiber, such as beans, whole grains, and fresh fruits and vegetables.

      • Limit foods that are high in fat and processed sugars, such as fried or sweet foods.

If you have a cast:

  • Do not stick anything inside the cast to scratch your skin. Doing that increases your risk of infection.

  • You may put lotion on dry skin around the edges of the cast. Do not put lotion on the skin underneath the cast.

If you have a splint or brace:

  • Wear it as told by your health care provider. Remove it only as told by your health care provider.

  • Loosen it if your toes tingle, become numb, or turn cold and blue.

If you have a cast, splint, or brace:

  • Keep it clean and dry.

  • Check the skin around it every day. Tell your health care provider about any concerns.

  • Ask your health care provider when it is safe to drive if you have it on a leg or foot that you use for driving.


  • Do not take baths, swim, or use a hot tub until your health care provider approves. Ask your health care provider if you may take showers. You may only be allowed to take sponge baths.

  • If the cast, splint, or brace is not waterproof:

    • Do not let it get wet.

    • Cover it with a watertight covering when you take a bath or shower.

Managing pain, stiffness, and swelling

Bag of ice on a towel on the skin.
  • If directed, put ice on the injured area.

    • If you have a removable splint or brace, remove it as told by your health care provider.

    • Put ice in a plastic bag.

    • Place a towel between your skin and the bag or between your cast and the bag.

    • Leave the ice on for 20 minutes, 2–3 times a day.

  • Move your toes often to avoid stiffness and to lessen swelling.

  • Raise (elevate) the injured area above the level of your heart while you are sitting or lying down.


  • Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.

  • Do not use the injured leg to support your body weight until your health care provider says that you can. Use crutches as told by your health care provider.

  • Ask your health care provider which exercises are safe for you.

General instructions

  • Do not put pressure on any part of a cast or splint until it is fully hardened. This may take several hours.

  • Do not use any products that contain nicotine or tobacco, such as cigarettes, e-cigarettes, and chewing tobacco. These can delay healing. If you need help quitting, ask your health care provider.

  • Use heel wedges if told by your health care provider.

  • Keep all follow-up visits as told by your health care provider. This is important.

How is this prevented?

  • Do exercises exactly as told by your therapist or health care provider and adjust them as directed.

  • Warm up and stretch before being active.

  • Cool down and stretch after being active.

  • Rest between periods of activity.

  • Use equipment that fits you.

Contact a health care provider if you have:

  • More pain and swelling.

  • Pain that is not controlled with medicines.

  • New symptoms or symptoms that get worse.

  • Problems moving your toes or foot.

  • Warmth in your foot.

  • A fever.


  • An Achilles tendon tear is an injury that involves a tear in this tendon.

  • This injury typically occurs in runners or athletes who play sports that involve sprinting, running, or jumping.

  • An Achilles tendon tear causes sudden severe pain in your ankle and an inability to point your foot down.

  • Treatment for this injury may include rest, ice, and pain medicines. In some cases, surgery may be needed.

This information is not intended to replace advice given to you by your health care provider. Make sure you discuss any questions you have with your health care provider.

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