Achilles Tendon Rupture Recovery: Treatment, Rehabilitation and Physiotherapy

A sudden snap at the back of the ankle, a feeling that someone has kicked your calf, and difficulty pushing off the foot can all point to an Achilles tendon rupture. This injury needs prompt assessment because the position of the ankle in the first days and the way rehabilitation is progressed can affect how the tendon heals.

What is an Achilles tendon rupture?

The Achilles tendon joins the calf muscles to the heel bone. It stores and releases energy when you walk, climb stairs, run or jump. A rupture is a partial or complete tear, usually a few centimetres above the heel. It is different from Achilles tendinopathy, which more often develops as gradual pain and stiffness rather than a sudden tear.

Rupture often occurs during a quick push-off, change of direction or jump, but it can also happen during everyday activity. Some people have had no warning symptoms. Others have noticed previous tendon pain, stiffness or reduced calf strength.

Common symptoms of a ruptured Achilles tendon

Typical signs include:

• a pop or snap at the back of the ankle;
• sudden pain in the lower calf or above the heel;
• swelling and bruising;
• difficulty pushing off, walking normally or standing on tiptoe;
• a feeling that the foot or ankle has lost power; and
• sometimes a gap that can be felt in the tendon.

Pain can settle surprisingly quickly, so reduced pain does not rule out a rupture. A clinician may use a calf-squeeze test and examine the tendon. Ultrasound is sometimes used when the diagnosis or the size and position of the tear are uncertain.

What should you do immediately?

Stop sport or strenuous walking and arrange urgent assessment through NHS 111, an urgent treatment centre, an emergency department or a fracture clinic pathway. Until you have been assessed, protect the ankle and avoid stretching the calf or pulling the toes towards the shin. A confirmed rupture is commonly immobilised in a cast or walking boot with the foot pointed down so the torn ends can meet.

Follow the exact weight-bearing advice you receive. Some modern pathways allow early walking in the boot as comfort permits, often with crutches, while others begin with a short non-weight-bearing period. The correct approach depends on the local protocol and your individual case.

Surgery or non-operative treatment?

Both surgical repair and non-operative treatment are established options. Non-operative care normally uses a cast followed by a specialist boot with heel wedges, combined with a structured rehabilitation plan. Surgery joins the torn tendon and is followed by protection and staged rehabilitation.

The decision is made with an orthopaedic or specialist team. It can be influenced by the location and gap of the rupture, how long ago it happened, skin and circulation, other health conditions, activity goals and the risks of surgery. There is no single treatment that is right for everyone. A physiotherapist can explain rehabilitation, but should not replace the specialist assessment that determines whether surgery is appropriate.

Why the boot and heel wedges matter

At first, the boot and heel wedges hold the foot in a toe-down position. The wedges are removed gradually according to the clinic's schedule, allowing the tendon to adapt as it heals. NHS pathways differ in their precise timings, but many protect the tendon for roughly nine to ten weeks.

During this phase:

• wear the boot for the hours instructed, including at night if your team has told you to;
• do not remove wedges early or walk without the boot;
• do not stretch the calf or force the ankle upwards;
• use crutches and weight-bear only as advised;
• check the skin daily for rubbing, pressure or broken areas; and
• take prescribed blood-thinning medication exactly as directed.

Stretching too soon can allow the tendon to heal in a lengthened position, leaving the calf weaker. If the boot feels wrong, contact the treating service rather than changing the wedges yourself.

Achilles tendon rupture rehabilitation: the main stages

Your own orthopaedic and physiotherapy protocol takes priority. Timings vary between hospitals, between surgical and non-operative care, and according to healing. The following stages explain the general direction of rehabilitation rather than a self-treatment schedule.

1. Protect the repair and maintain general movement

In the early weeks the priority is to protect the tendon. You may be given safe movements for the toes, knee and hip, as well as advice on swelling, crutches and everyday tasks. Do not add ankle exercises from the internet: ankle movement and loading must stay within the limits set by your team.

2. Progress walking in the boot

As the wedges are reduced, walking can become more even. A physiotherapist may check crutch height, step length and how you load each leg. The goal is controlled walking in the boot, without sudden push-off or an unprotected step. Pain and swelling should be monitored rather than used as a challenge to push through.

3. Relearn walking after the boot

When the specialist team clears you to come out of the boot, the ankle and calf will usually feel stiff and weak. Rehabilitation may include active ankle movement within the permitted range, gait practice, seated calf raises and balance exercises. Shoes may need a temporary heel raise if prescribed. Avoid forceful calf stretching, deep lunges or walking barefoot until your clinician says they are safe.

4. Rebuild calf strength and endurance

Loading usually progresses from seated calf raises to supported double-leg raises, then to heavier and more demanding work. The quality and height of the heel raise matter, as does the tendon’s response the next day. Hip, knee and trunk strength are often trained alongside the calf to restore confidence and control.

5. Return to running, jumping and sport

Running and hopping are late-stage activities. They should start only when walking is comfortable, ankle control is adequate, and calf strength and endurance meet agreed criteria. Sport-specific changes of direction, acceleration and jumping follow gradually. A date alone is not enough: strength, movement quality, symptoms and the demands of your activity all matter.

How long does Achilles tendon rupture recovery take?

A confirmed rupture commonly needs about nine to ten weeks of protected healing. That does not mean the leg is fully recovered when the boot comes off. Calf size, strength, balance and confidence can take many more months to return, and full rehabilitation can take up to a year.

Return to work depends on your role. Desk-based work may be possible earlier if you can travel safely and manage swelling. Work involving driving, ladders, uneven ground, lifting or prolonged standing takes longer. Do not drive in a boot. Resume driving only when you are out of the boot, can safely control the vehicle and perform an emergency stop, and your clinician, insurer and licensing requirements are satisfied.

Return to sport is based on function rather than a promised week. Recreational running may be many months away; explosive or competitive sport often takes longer. Recovery can also be slower after a delayed diagnosis, re-rupture or wound problem, and in people who smoke or have conditions affecting healing.

Warning signs that need urgent help

A leg injury and immobilisation can increase the risk of a blood clot. Contact NHS 111 urgently if you develop new one-sided calf or thigh pain, swelling, warmth or a change in colour that is not explained by the original injury. Call 999 or go to A&E for chest pain, sudden shortness of breath, coughing up blood, fainting or collapse.

Contact your fracture or orthopaedic service promptly if:

• the boot causes persistent pressure, broken skin, marked numbness or worsening pins and needles;
• the toes become cold, pale or blue;
• a surgical wound becomes more red, hot, swollen, painful or starts discharging;
• swelling or pain suddenly increases; or
• you have another snap, unprotected step or sudden loss of push-off that could indicate re-rupture.

How physiotherapy can help

Physiotherapy after an Achilles rupture is about choosing the right load at the right stage. Assessment can cover walking, ankle movement, calf strength, balance, work demands and sport goals. Your programme can then progress without skipping the protection that healing requires.

Online physiotherapy can help with education, exercise technique, progress reviews and planning around home, work and sport. It cannot apply a cast, adjust a boot, assess a wound or rule out a blood clot or re-rupture. Those concerns require in-person medical care.

If your ankle problem turns out to be a different injury, you may also find our guides to sprained ankle recovery and broken ankle rehabilitation useful.

Discuss your recovery with YourPhysio

If your rupture has already been assessed and you want help understanding your rehabilitation plan, book a free conversation with YourPhysio. You can meet the physiotherapist, describe your symptoms and goals, and understand how the service works before deciding whether you want any paid treatment.

Book your free initial consultation

Paid physiotherapy sessions are optional and secondary.

Authoritative guidance used

Medical guidance checked on 13 November 2026:

• University Hospitals Sussex NHS Foundation Trust: Achilles tendon rupture
• Royal Free London NHS Foundation Trust: suspected Achilles tendon rupture
• Cambridge University Hospitals NHS Foundation Trust: management and rehabilitation
• NHS: blood clots

This article provides general information and does not diagnose an injury or replace advice from your fracture clinic, orthopaedic team or GP.