Achilles tendon rupture: diagnosis & treatment


The Achilles tendon attaches the gastrocnemius, the soleus and plantaris muscles to the calcaneus. It is one of the longest and thickest tendons in the body and is a powerful plantar flexor of the foot and ankle.

The two most common pathologies involving the Achilles tendon are tendinopathy and rupture. Patients with tendinopathy typically describe a gradual onset of pain, while ruptures are associated with an acute event.

Achilles tendon ruptures generally occur because the load applied to it is greater than the tendon's ability to withstand that load. This usually occurs as a result of a sudden, quick movement where there is a forceful stretch of the tendon or a contraction of the muscles.

Movements like jumping, sprinting or pushing off are common injury mechanisms. This occurs most often in sports that require a lot of stopping and starting (acceleration-deceleration sports) such as tennis, basketball, netball and squash. In some cases, older patients with very degenerative tendons, the force needed to rupture the tendon is not very great. In this group a high index of suspicion is needed. Most Achilles tendon ruptures occur 2-6cm above the calcaneal insertion of Achilles. This area represents a zone of relative hypovascularity.

Objectives of this course

  • Understand the typical history associated with Achilles tendon ruptures.
  • Be able to conduct the clinical examination needed to diagnose an Achilles tendon rupture.
  • Have an awareness of the limitations of the radiological studies that can be used to assist diagnosing this injury and be able to order these appropriately (where needed).
  • Have an understanding of the different treatment options and be able to council a patient appropriately about them.
  • Be able to manage an Achilles tendon rupture non-surgically.
  • Understand the indications for referral for an orthopaedic assessment.


Once you have completed this short course and quiz, please click 'submit' where you will be taken to the results page. From here you can print your certificate for 1 Continuing Professional Development (CPD) hour.


This content was created by Dr Helen Joyce Fulcher MBChB, DipPaed, PGCertHSc(Sports Med), in August 2016, and updated in 2020.

The material is presented by the Goodfellow Unit (GFU), an accredited continuing medical education/ continuing professional development (CME/CPD) provider for the Royal New Zealand College of General Practitioners and functions under a tripartite agreement between the Goodfellow Foundation, the College and the University of Auckland. The Unit is located within the Department of General Practice and Primary Health Care, and within the School of Population Health.


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