Question 1

What causes the Achilles tendon to rupture?

Accepted Answer

The Achilles tendon is the strongest tendon in your body, connecting your calf muscles to your heel bone. It ruptures from sudden forceful loading - typically jumping, sprinting, or sudden push-off. The classic scenario is a 'weekend warrior' - someone 35-45 years old who plays recreational sport (basketball, tennis, squash) once or twice a week. The tendon often has pre-existing degeneration (tendinopathy) making it weak, even if you didn't have pain beforehand. When you suddenly contract your calf muscle forcefully (jumping, accelerating), the weakened tendon can't handle the load and tears completely. Feels like being kicked or shot in the calf. Many people hear or feel an audible 'pop' at the moment it ruptures.

Question 2

Should I have surgery or non-surgical treatment?

Accepted Answer

Modern evidence shows both can work well but have different trade-offs. Surgery: Lower re-rupture rate (2-5% vs 10-15%), slightly stronger push-off long-term, but has wound complications in 5-10% (infection, skin breakdown, scarring) and sural nerve numbness in 10-20%. Non-surgical (functional rehabilitation): Avoids surgery risks, no scar, similar return to activities, but higher re-rupture rate and slightly weaker strength. Best for surgery: young active people wanting to return to jumping sports, those wanting lowest re-rupture risk. Best for non-surgical: older less active people, medical problems making surgery risky, patient preference. Discuss with your surgeon - both are valid options.

Question 3

Will I be able to return to sport?

Accepted Answer

Most people return to sport (80-90%), but timeline is long: 6-9 months for recreational sport, 9-12 months for competitive. Success depends critically on physiotherapy compliance - you must do exercises daily for months. Younger athletes have better outcomes. Studies show about 70-80% return to pre-injury sport level. Push-off power may be 5-15% weaker than other leg permanently, but this doesn't usually limit function. Re-rupture risk is 2-5% with surgery, 10-15% without surgery - most re-ruptures happen when returning to sport too early. Don't rush - wait until calf strength is 80-90% of other side before full sport.

Question 4

What is the Thompson test?

Accepted Answer

The Thompson test (also called Simmonds test) diagnoses Achilles rupture. You lie face down with feet hanging off the bed. Doctor squeezes your calf muscle firmly. Normally, this squeezing makes your foot point down (plantarflex) because the calf muscle connects to foot via the Achilles tendon. If the tendon is completely ruptured, squeezing the calf produces NO foot movement - the connection is broken. This is a positive Thompson test and confirms complete rupture. The test is very reliable - if positive, you definitely have a rupture. False positives are rare.

Question 5

How long will I be on crutches?

Accepted Answer

Depends on treatment and protocol. Modern functional rehabilitation (non-surgical): 1-2 weeks on crutches, then wean off as tolerated in boot - many people walk in boot without crutches by 2-4 weeks. After surgery (traditional protocol): non-weight bearing with crutches for 2-4 weeks, then partial weight bearing with crutches for 2 weeks, then wean off - so 4-6 weeks total. Modern accelerated protocol after surgery: may allow immediate weight bearing in boot, so 1-2 weeks on crutches. By 6-8 weeks, almost everyone is walking in the boot without crutches. Your surgeon will specify the protocol for you.

Medical Disclaimer

Achilles Tendon Rupture (Complete Tear)

📖What is Achilles Tendon Rupture (Complete Tear)?

🔬What Causes It?

⚠️Risk Factors

You may be at higher risk if:

🛡️Prevention