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Symptoms and Signs of Achilles Tendon Rupture

Doctor's Notes on Achilles Tendon Rupture

The Achilles tendon is a large ropelike band of fibrous tissue in the back of the ankle that connects the calf muscles to the heel bone. When the calf muscles contract, the Achilles tendon is tightened, pulling the heel, which provides the ability to point the foot and stand on tiptoe. An Achilles tendon rupture refers to a complete tear through the tendon, which usually occurs about 2 inches above the heel bone.

Symptoms of Achilles tendon rupture include sudden and severe pain at the back of the ankle or calf (may be described as "being hit by a rock or shot" or "like someone stepped onto the back of my ankle"), the sound of a loud pop or snap may be heard, and a gap or depression may be felt and seen in the tendon about 2 inches above the heel bone. The initial pain, swelling, and stiffness may be followed by bruising and weakness. The pain of an Achilles tendon rupture may lessen quickly. Standing on tiptoe and pushing off when walking is impossible.

Medical Author: John P. Cunha, DO, FACOEP
Medically Reviewed on 3/11/2019

Achilles Tendon Rupture Symptoms

  • A sudden and severe pain may be felt at the back of the ankle or calf -- often described as "being hit by a rock or shot" or "like someone stepped onto the back of my ankle."
  • The sound of a loud pop or snap may be reported.
  • A gap or depression may be felt and seen in the tendon about 2 inches above the heel bone.
  • Initial pain, swelling, and stiffness may be followed by bruising and weakness.
  • The pain may decrease quickly, and smaller tendons may retain the ability to point the toes. Without the Achilles tendon, though, this would be very difficult.
  • Standing on tiptoe and pushing off when walking will be impossible.
  • A complete tear is more common than a partial tear.

Achilles Tendon Rupture Causes

The Achilles tendon can grow weak and thin with age and lack of use. Then it becomes prone to injury or rupture. Achilles tendon rupture is more common in those with preexisting tendinitis of the Achilles tendon. Certain illnesses (such as arthritis and diabetes) and medications (such as corticosteroids and some antibiotics, including quinolones such as levofloxacin [Levaquin] and ciprofloxacin [Cipro]) can also increase the risk of rupture.

  • Rupture most commonly occurs in the middle-aged male athlete (the weekend warrior who is engaging in a pickup game of basketball, for example). Injury often occurs during recreational sports that require bursts of jumping, pivoting, and running. Most often these are tennis, racquetball, basketball, and badminton.
  • The injury can happen in these situations.
    • You make a forceful push-off with your foot while your knee is straightened by the powerful thigh muscles. One example might be starting a foot race or jumping.
    • You suddenly trip or stumble, and your foot is thrust in front to break a fall, forcefully overstretching the tendon.
    • You fall from a significant height or abruptly step into a hole or off of a curb.

Foot Health Causes of Swollen Feet and Ankles Slideshow

Foot Health Causes of Swollen Feet and Ankles Slideshow

Swollen feet may be painful, uncomfortable, and can make it hard to walk. Swollen feet happen for a variety of reasons. Several medical conditions may cause the symptom. Luckily, once you know the underlying cause of swollen feet, you can take steps to feel better. Read on to learn more about the most common conditions that cause feet to swell up.

REFERENCE:

Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.

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