“How do you know if your Achilles tendon is torn or ruptured?”

I hate to say it but torn and ruptured are the same thing when it comes to an achilles tendon tear (rupture). I know because I have ruptured (torn) both of mine! The achilles tendon tears/ruptures down near the heel bone (calcaneus) and typically needs surgery whereas a calf strain (muscle attached to the achilles tendon) is higher up and heals without surgery.

A physical exam is helpful but you may need an ultrasound or MRI.

Trying walking in your tiptoes. If you have difficulty you may have a rupture or a partial rupture or significant inflammation of the tendon. To be absolutely sure, you should be examined by a sports medicine doctor or orthopedic doctor or podiatrist. Usually a careful examination can give me the answer but if I am not certain I obtain an MRI study.

Most of the time when you tear your Achilles tendon, you can feel a gap in the tendon in the back of your ankle, however I can tell you how someone can help you perform an orthopaedic test to check for torn Achilles. You won't be able to do it yourself. You have to have someone do it for you.

Lay on your stomach. Bend both legs at the knee so that your feet/ankles are pointing up to the ceiling/sky. Relax muscles in your legs. Your examiner uses one hand to squeeze the muscles of your lower leg. Those are the muscles right BELOW the knee, where your lower leg has the biggest girth. When this is done your foot should move pointing your toes up toward the ceiling/sky if your Achilles is intact. If your foot does not move when calf is squeezed, you have a torn Achilles. Always do this test on both feet to compare the result. If Achilles is torn on one foot/ankle, one foot will move and the other will not.

You feel something like a tennis ball hitting you on the back of your leg. You are unable to push your foot down to come up on your toes. There may be a defect or gap you can feel where the tendon should be located. Go see an orthopedic surgeon, because if it is torn, most of the time it needs to be surgically repaired for optimum functioning.
Hope it helps!!

Dr. Bose

Physical exam vs. MRI.

William Muñoz III, M.D.

In the majority of cases, an Achilles year is the result of a traumatic injury. Often, it occurs during sports and mostly non-contact. The patient will feel and hear a pop in the back of the ankle with immediate pain and swelling. Usually, there is significant weakness and difficulty walking, but often patients can walk with a limp. The best way to determine the diagnosis is to see an orthopedic specialist as quickly as is possible.

Steven Andriola, MD

The symptoms of a torn Achilles tendon rupture are pain in the heel or calf, weak push down of the foot and difficulty in running and jumping. Physical examination reveals a defect at the heel cord. The MRI of the ankle can confirm the Achilles tendon tear easily. Since you are young, you should have your tendon surgically repaired if it is ruptured.

If you cannot plantar flex your ankle/foot, meaning you cannot point your foot down, it is possible you have torn your Achilles tendon. You can also passively start your ankle/foot in a dorsiflexed or neutral position by laying on your stomach with your knee bent and leg in the air, then squeeze your calf muscle with your hands and see if your ankle/foot does not move towards the ceiling. If it doesn’t, it may also be torn. However, you can have a torn tendon with an intact periosteal sleeve and still be able to point your foot down. If you feel a gap in the tendon by comparing it to the other leg, have difficulty pushing off the foot, or pain with walking, it may also be torn. A good physical examination by a qualified orthopedic or sports medicine physician should be able to tell you with high certainty, but an MRI scan can be used to image the tendon to be certain.

Ron Noy, MD, FAAOS