Question 1

What exactly is an Achilles tendon rupture?

Accepted Answer

It's a complete tear of the Achilles tendon, the thick cord connecting your calf muscles to your heel bone. When it ruptures, the muscle-tendon unit can no longer transmit force to the foot, so you can't push off or stand on tiptoes. Most ruptures occur 4-6cm above the heel bone, in a zone with poor blood supply. About 70-80% of people hear or feel a distinctive 'pop' when it tears.

Question 2

Should I have surgery or try non-surgical treatment?

Accepted Answer

This is a controversial question with no clear 'best' answer for everyone. Both modern surgical repair and functional non-surgical rehabilitation give good outcomes in properly selected patients. Surgery has lower re-rupture rate (2-5% vs 8-12%) and slightly faster return to elite sport, but has risks of infection, wound problems, and nerve damage. Non-surgical treatment with modern accelerated rehab has similar long-term strength and function but requires excellent compliance. Consider surgery if: you're a competitive athlete wanting fastest return, you have large tendon gap (more than 5cm), you're young and very active. Consider non-surgical if: you're recreational athlete willing to accept slightly longer return timeline, you have medical problems increasing surgical risk, large gap can be reduced with foot positioning. Discuss with your surgeon - many factors influence decision.

Question 3

Can the tendon heal without surgery?

Accepted Answer

Yes, absolutely. Multiple high-quality studies show that with modern functional rehabilitation (early weight-bearing in a boot), non-surgical treatment produces similar long-term outcomes to surgery. The old idea that 'you must have surgery' comes from outdated studies that used prolonged cast immobilization without weight-bearing - that approach had poor results. Modern non-surgical treatment (functional rehab) is a legitimate option for most patients. The trade-off is a slightly higher re-rupture rate (8-12% vs 2-5% with surgery).

Question 4

When can I return to sport?

Accepted Answer

Average return to recreational sport is 9 months for surgical repair, 10-12 months for non-surgical treatment. However, timeline is highly individual and depends on meeting objective criteria, not calendar dates. You must pass return-to-sport testing including: 90%+ calf strength symmetry compared to other leg, hop tests (single-leg hop distance within 90% of other leg), normal movement patterns, psychological readiness. Returning too early dramatically increases re-rupture risk. Even at 12 months, some deficit in push-off strength may persist. Elite athletes may return sooner (6-9 months) with intensive rehab, but recreational athletes shouldn't rush.

Question 5

What is the risk of rupturing it again?

Accepted Answer

Overall re-rupture rate: 2-5% with surgical repair, 8-12% with non-surgical treatment, 15-20% with old-fashioned cast immobilization (no longer recommended). Most re-ruptures occur in the first 6 months, often when transitioning from boot to shoes or during early return to activity. Risk factors for re-rupture: poor compliance with boot/rehab, returning to sport too early, smoking, diabetes, steroid use, previous rupture on opposite side. Once you're 12 months post-injury and back to full sport, re-rupture risk drops significantly.

Medical Disclaimer

Achilles Tendon Rupture (Sudden Tear)

📖What is Achilles Tendon Rupture (Sudden Tear)?

🔬What Causes It?

⚠️Risk Factors

You may be at higher risk if:

🛡️Prevention