Part of Achilles tendinopathy
Does Achilles tendonitis lead to rupture? What the numbers say
Warning signs, and when to get help
If it has just happened, start here
If you felt something snap, pop or give way at the back of your ankle or heel, or it felt as though someone kicked you there, and pushing off that foot has suddenly gone weak or impossible, treat it as a possible torn Achilles tendon. That holds whether it happened an hour ago or a few days ago and nobody has looked at it yet. Take the weight off that leg and go to an urgent care center or emergency department the same day, even if you can still walk, and even if the pain settled after the first few minutes. You do not need to be certain. If you are not sure whether what you felt counts, treat it as though it does.
Four things protect the tendon until you are seen, and they are the opposite of what instinct suggests. Do not stretch the calf or pull your foot up toward you, and let the foot rest in a relaxed, toes-down position instead. Do not keep testing whether you can rise onto your toes; once is enough, and each attempt pulls on it again. Keep your weight off that leg, leaning on someone, or on a stick or crutches if you already have them. Get someone else to drive you, or take a taxi, rather than driving yourself.
One thing on this page is not for you today. Further down it explains that loading a sore tendon is the treatment for it, which is true of a tendon that has ached for weeks and wrong for one that may have just torn. The signs of a rupture, and what to do has the rest of the detail, including what the signs feel like on your own leg.
The rest of this page answers the commoner question: an Achilles tendon that has been sore for weeks or months, and whether it is heading for a tear.
Can Achilles tendonitis lead to a rupture?
Yes, it happens. The figure comes from one study, so here it is in full. Yasui and colleagues (2017) used the United Healthcare orthopedic dataset from the PearlDiver patient record database, covering 2007 to 2011, and searched it for diagnosis codes. They found 180,421 patients with a coded diagnosis of Achilles tendinopathy. Of those, 7,232 later had a coded Achilles tendon rupture, which is 4.0 percent.
The age pattern inside that 4.0 percent needs reading carefully, because it is not a line that climbs with every decade. The 50 to 59 group was most affected, at 4.3 percent, and the 40 to 49 group came next at 3.9 percent. Both were significantly higher than the 20 to 39 group and, which is the part that gets lost, significantly higher than the 60 to 69 group.
The authors summed this up as older patients being the most susceptible, and that phrase travels further than their figures do: in their own data the peak is in the fifties, the forties are just behind it, and the oldest decade they studied sat lower than both. So "older" here means late middle aged. If you are in your sixties and reading this, the number behind you in that dataset is lower than the number behind someone of 55, not higher.
Now the qualifications, which are the part that gets dropped. This is an insurance claims database, so everyone in it is a United States patient with insurance and a diagnosis code, not a clinically examined cohort, and everyone counted was aged 20 to 69, so the figure says nothing about anybody older. The authors state plainly that the time between each diagnosis was unknown, so 4.0 percent is not a risk per year and cannot be turned into one. They also had no information on injury mechanism, symptom severity, how long symptoms had lasted, other medical conditions, how degenerate the tendon was, or whether anyone had corticosteroids or fluoroquinolone antibiotics, and they could not account for the treatments people received.
What that leaves you with is a reasonable order of magnitude: in a large coded population, around 1 in 25 people with Achilles tendinopathy later had a rupture recorded, most often those in their fifties. It does not tell you your own risk, and a page that quotes 4 percent as though it did is overstating what the study can carry.
If the frightening version of this question brought you here at two in the morning, the useful sentence is this one: the pain you can feel today is not the thing that ruptures a tendon. Push-off is. The next section explains why those are different events.
How is a rupture different from the pain you have now?
Achilles tendinopathy is a gradual problem of load and tissue change. It builds over weeks, hurts with use, stiffens overnight, eases as you warm up, and is still there tomorrow. Nothing about it happens in a single second.
A rupture is an event. OrthoInfo describes ruptures as occurring when the calf muscle is stretched too quickly, for instance landing from a jump or making a cutting movement in sport. People describe a bang or a snap, or the sensation of being kicked in the back of the calf, and severe pain and swelling near the heel can follow. OrthoInfo adds that you may not be able to walk on the injured leg and may be unable to stand up on the toes of that leg. So these are two different kinds of thing, and running them together is what makes the question feel so threatening.
Walking does not rule out a rupture: other muscles can still point the foot down, which is one reason a torn Achilles is sometimes missed at first (Maffulli and colleagues, 2017). And a rupture needs assessing the same day, walking or not, which is the first line on the warning list on this page. Achilles tendon rupture covers what happens after a diagnosis, including the treatment choice and the rehab stages. We do not set out the treatment choice, repair techniques, boot settings or weight bearing limits here, because those belong with the surgeon and the team looking at your tendon. The one thing this page does say about surgery comes further down, where it explains why a rupture found late is harder to fix than one found on the day.
The sudden push-off moment is the one to name by sport. A first game back after months off, a sprint for a train, a lunge for a drop shot. Achilles and calf pain in pickleball deals with that moment and what it looks like on a court.
What makes a rupture more likely?
Only the documented factors are listed here, because this is a question where speculation does real harm. Age is in the data, though not as a straight climb. Yasui and colleagues (2017) found the subsequent rupture rate highest in the 50 to 59 group at 4.3 percent, with the 40 to 49 group next at 3.9 percent, and both of those significantly higher than the 20 to 39 and the 60 to 69 groups. Late middle age is where it peaked in that dataset, not the oldest decade in it.
Fluoroquinolone antibiotics are the clearest of them. OrthoInfo names ciprofloxacin and levofloxacin as antibiotics linked with tendon tearing. The UK medicines regulator advises prescribing fluoroquinolones with special caution in people older than 60 and in those with kidney problems or a solid organ transplant, because they are at higher risk of tendon injury. It also says tendon damage can occur within 48 hours of starting treatment, or be delayed for several months and appear after the course has finished (MHRA, 2024). The line on the warning list below tells you what to do if your tendon pain started on one of these.
A steroid injection into or around the tendon comes next. OrthoInfo states that corticosteroid injections given for Achilles tendinitis have been linked to an increased risk of tendon rupture, that cortisone injections into the tendon itself are not recommended because they can cause the tendon to rupture, and that research has shown significantly decreased tendon strength after a steroid injection. The Kent Community Health NHS leaflet advises against steroid injections for insertional pain, saying they may give temporary relief but are not a cure and could lead to tendon rupture. The leaflet's own conclusion is that they are best avoided. The MHRA also advises avoiding a corticosteroid alongside a fluoroquinolone, since the combination can worsen fluoroquinolone-related tendinitis and rupture.
Then the other medical conditions and medicines. OrthoInfo lists rheumatoid arthritis, lupus, diabetes, infection, obesity and metabolic disease among the things that weaken tendons, along with corticosteroids and anabolic steroids.
What is not on this list matters too. We have no source that shows running causes rupture, that heel drops cause rupture, or that one type of Achilles tendinopathy ruptures more often than the other. Where the site it hurts matters is for your exercises rather than for this question, and insertional or midportion Achilles tendinopathy covers that.
Does exercising a sore tendon make it more likely to snap?
Everything in this section is about a tendon that has been sore for weeks or months. If your pain started in a single sudden moment, with a snap or a sudden loss of push-off, none of it applies to you yet: go back to the top of this page and get the tendon looked at today before you load it at all.
For the long-sore tendon, this is the real question behind most searches on this topic, and the guideline answers it in the opposite direction from the fear.
The Dutch multidisciplinary guideline on Achilles tendinopathy puts progressive calf muscle strengthening exercises for at least 12 weeks at the front of non-surgical treatment, and tells patients with chronic symptoms that little or no improvement is expected in the short term from a wait-and-see approach (de Vos and colleagues, 2021). A systematic review of 16 randomized trials found eccentric exercise had the most evidence of effectiveness in midportion tendinopathy, and that it beat a wait-and-see approach in both trials that compared the two (Magnussen and colleagues, 2009). The 2024 US clinical practice guideline reaches the same conclusion on strong evidence, recommending tendon loading with loads as high as tolerated as the first-line treatment, at least 3 times a week, and advising that complete rest is not indicated (Chimenti and colleagues, 2024). Loading is the treatment, not a gamble. In the Swedish trial, the group who kept running and jumping during their program, guided by a pain rule, did as well as the group who stopped those activities for 6 weeks, and the researchers found no negative effects from carrying on (Silbernagel and colleagues, 2007).
There is one qualifier and it matters. None of that evidence was gathered on tendons anybody suspected of having been weakened by a medicine. A tendon that started hurting while you were on a fluoroquinolone antibiotic, or soon after a steroid injection, is exactly that situation, and the warning list below asks you to get checked before you carry on with calf exercises.
The flip side needs saying too, because resting a sore tendon feels like the safe choice. A tendon that is given no load does not become stronger while it waits. The honest position is that neither exercising nor avoiding exercise has been shown to change the chance of a rupture, and exercising is the one that is actually recommended for the problem you have.
What are the signs of a rupture, and what do you do?
The line below is the one to act on, and it is on the warning list at the end of this page in the same words.
A sudden pop or snap at the back of your ankle or heel, a feeling that someone kicked you there, or sudden pain there after which you cannot push off or rise onto your toes on that leg. Stop, take the weight off that leg carefully and go to an urgent care center or emergency department the same day, even if you can still walk, as this can be a torn Achilles tendon.
Before anything else, what to do while you are on your way to be seen, because a few things protect the tendon and they are the opposite of what instinct suggests. Do not stretch the calf or pull your foot up toward you; let the foot rest in a relaxed, toes-down position instead. Do not keep testing whether you can rise onto your toes, because every attempt pulls on it again. Checking once tells you what you need to know. Keep your weight off that leg on the way, leaning on someone, or on a stick or crutches if you already have them, and get someone else to drive you, or take a taxi, rather than driving yourself.
Both the stretching and the repeated toe rises pull the torn ends further apart, and a torn Achilles is held with the toes pointed down while it heals rather than lengthened. None of that is treatment. It is just not widening the gap before somebody has looked at it.
Now the three things about that line that need spelling out. It says you cannot push off or rise onto your toes, and push-off that has suddenly gone weak rather than impossible counts the same way, with the same timing. Weakness is the version people talk themselves out of. A snap is not required either, because some ruptures happen with sudden pain and no noise at all.
And a gap you can feel belongs on the list with the rest: sit with the leg relaxed and the foot hanging free, run a finger gently along the cord at the back of your lower leg, from the top of the heel bone up toward the calf muscle, and compare the same spot on the other side, which should feel like a firm cord. A gap, a dip or a soft spot where the other leg is firm is usual in a fresh rupture, and it becomes hard to feel later once scar tissue bridges it, which is part of why a late one is harder to diagnose (Maffulli and colleagues, 2017).
Two things about checking yourself. Feel the tendon with light pressure while sitting, not while standing on that leg, and do not push or pull the foot around to find the gap. And not one of those three signs has to be there for this to be a rupture: a tendon you cannot feel a gap in, with no snap, that you can still limp on, can still be torn. Any one of them is enough to act on, and so is the sudden moment on its own if you are unsure.
Most ruptures do happen during recreational sport, but about a quarter happen in people who are not sporty at all (Maffulli and colleagues, 2017), stepping off a curb, missing a step on the stairs, or pushing off to catch something. If your moment did not look like the version in the sport examples above, the warning line still applies to you.
What goes wrong afterward is predictable. People wait because they can still walk, which does not rule it out. They wait because the pain settled after the first few minutes, which also happens. Or they book a physio appointment for next week rather than being seen today, when being seen today is what the line says. If you are not sure whether what you felt counts, treat it as though it does.
One more route, because this injury is missed more often than most. Up to 25 percent of acute Achilles ruptures are misdiagnosed and turn up later as chronic injuries (Maffulli and colleagues, 2017). So if you were seen, told it was not a rupture, and push-off on that leg is still weak, or you still cannot rise onto the toes of that foot, or you can feel a gap in the tendon, go back and say exactly that. Ask for the tendon to be examined again, and ask for that within days rather than accepting a routine appointment several weeks out. Being checked once does not settle it when the function has not come back.
The reason for the hurry is not that something dramatic is about to happen. It is that what can be done about it changes. A rupture is counted as chronic once diagnosis or treatment has been delayed beyond about 6 weeks, and by then the torn ends have usually pulled apart far enough that stitching the two ends back together is generally no longer possible, so repair becomes a reconstruction using another tendon, and wound breakdown and infection are more common after that bigger operation (Maffulli and colleagues, 2017). Lasting calf weakness and a limp are the other cost. The same injury found in the first days is a far more ordinary problem, which is the whole reason the first line on this page says the same day.
What lowers the risk?
We have no source showing that any treatment reduces the chance of an Achilles rupture, and nothing on this page is going to promise you that. What the sources do support is worth doing anyway, because it is the same list that gets a painful tendon better.
Get the strength back before the sudden stuff comes back. Silbernagel and colleagues (2020) give a rule of thumb for this: before running and jumping return, pain during daily walking should be minimal, 1 to 2 out of 10. Calf strength deficits are treated as something to close first, because reduced calf strength is one of the few risk factors here you can change. The single leg heel raise and then the weighted calf raise are how that strength is usually built, inside the staged Achilles tendinopathy program.
The same guidance uses a hopping test as well, and the precautions that go with hopping come first, because a hop is easy to try on the spot and it is not for everybody. Jumping and hopping also load the joints, the bones and the pelvic floor. If you have osteoporosis or have had a fall in the past year, ask your physio before you do any hopping. If you have had a hip or knee replacement, get the go-ahead from your surgeon before you try hopping. Many surgeons advise against jumping and hopping after a joint replacement for good, not just for the first months, because each landing sends high impact through the new joint. If you are pregnant, have had a baby in the past year, or leak urine when you jump, cough or sneeze, check with your midwife or physio before you start this stage. Stop the hopping and speak to your physio if urine leaks while you are doing it, or if you feel pressure or heaviness low in your pelvis. After having a baby, postnatal guidance usually leaves jumping and hopping until at least 3 months after the birth, once a pelvic floor check shows you are ready. With a heart condition or high blood pressure, check with your doctor before you start.
With those cleared, or if none of them applies to you, the test is this: someone whose pain goes above 2 out of 10 over 20 single leg hops will struggle to start running while staying inside the pain monitoring limits (Silbernagel and colleagues, 2020). It is a readiness check and not an exercise, so it is done once, on a tendon that is already comfortable in daily walking, and a physio watching the first attempt will tell you more than the number does.
The mechanism OrthoInfo describes for rupture is a calf stretched too quickly, and the archetype is the first game back, which is the argument for building up rather than returning to full speed in one session. Running with Achilles pain sets out the pain rule for doing that sensibly. The Dutch multidisciplinary guideline asks clinicians to tell patients that, as a rule, a return to full symptom-free sports loading is only possible after a few months of active treatment at a minimum, and that going back within days carries a greater likelihood of the problem returning (de Vos and colleagues, 2021).
If your tendon pain began on a fluoroquinolone antibiotic, that is a conversation with your doctor, not a program adjustment. If a steroid injection is being discussed, the sources above are the ones to put on the table.
On boots, braces and crutches as treatment: we are not advising for or against any of them. Whether a tendon needs protecting, and with what, is a decision for the clinician examining it.
When to see a physio or doctor
See a physio (physical therapist) or doctor if the pain is severe, stops you walking normally, keeps getting worse, or has not improved after a few weeks of looking after it yourself. If the worry about rupture is what is keeping you awake, that is itself a reasonable reason to be assessed: a clinician can feel the tendon, test your push-off strength and compare the two sides, which is far more informative about your own tendon than any figure on this page.
Go sooner if you are over 50, have had an Achilles problem on either side before, have taken a fluoroquinolone antibiotic recently, or have had a steroid injection around the tendon. If months of loading have changed nothing, why Achilles pain is not getting better goes through the usual reasons, and how long Achilles tendonitis lasts covers the timeframe. The warning signs below each carry their own timing, and the first one is the same day.
Related exercise programs
Warning signs
Get emergency help now
- A sudden pop or snap at the back of your ankle or heel, a feeling that someone kicked you there, or sudden pain there after which you cannot push off or rise onto your toes on that leg. Stop, take the weight off that leg carefully and go to an urgent care center or emergency department the same day, even if you can still walk, as this can be a torn Achilles tendon.
Get help now, day or night
- Your tendon pain or swelling started while you were taking a fluoroquinolone antibiotic, such as ciprofloxacin or levofloxacin, or in the months after a course. Contact your doctor straight away. The UK medicines regulator (MHRA) advises stopping the antibiotic at the first sign of tendon pain or swelling and talking to your doctor. Hold off the calf exercises until you have been checked.
Get help today
- A calf or thigh that is newly swollen or getting more swollen, warm, tender, red or darker than usual, has swollen veins that are sore to touch, or has a throbbing or cramping pain that does not fit your injury or condition, or that feels different from normal muscle soreness after exercise. This can be a sign of a blood clot (deep vein thrombosis), especially after surgery, an injury, time in a cast or boot, a long trip or a spell of being much less mobile than usual. Get medical advice the same day. If you are also short of breath or have chest pain, call emergency services.
- The tendon or heel is hot, red and swollen, or you have a fever or feel unwell. Get medical help the same day, and go to an emergency department if you feel very unwell. If you have a very high or very low temperature, shivering you cannot control, you are breathing very fast or finding it hard to breathe, you are confused or your speech is slurred, your skin, lips or tongue look blue, gray, pale or blotchy (on brown or black skin this can be easier to see on the palms of the hands or soles of the feet), or you have a rash that does not fade when you press it, call emergency services, as this can be sepsis.
- The pain started with a fall or a blow to the back of the ankle, and there is bruising or you cannot put weight on the foot. Get it checked the same day.
- The pain is there at night or at rest as well as with activity and keeps getting worse. If you are being treated for cancer now, contact your cancer team the same day.
Book an appointment
- Your heel or Achilles pain comes with back pain and stiffness that is worse in the morning and at night, or with painful, swollen joints elsewhere, or both heels became painful without an obvious reason. The same applies if you also have psoriasis, Crohn's disease or ulcerative colitis, or have had a red, painful, inflamed eye (iritis). This is not an emergency, but see your doctor in the next week or two, as it can be a sign of an inflammatory arthritis such as ankylosing spondylitis.
- You have numbness, tingling, burning or loss of feeling in the foot, often along the outer edge. Book an assessment with a doctor or physio in the next week or two. If it came on over hours or days, started after an injury, is spreading, or comes with weakness in the foot, get medical advice the same day.
- The pain is there at night or at rest as well as with activity and keeps getting worse. If you have had cancer, now or in the past, or are losing weight without trying, see your doctor sooner, within a day or two, and mention it. This applies even if the pain is not getting worse.
- The pain is there at night or at rest as well as with activity and keeps getting worse. See your doctor within a few days.
Common questions
Can Achilles tendonitis turn into a rupture?
It can happen, and for most people it does not. The one figure we can trace is from Yasui and colleagues (2017), who looked at a United States insurance database from 2007 to 2011: of 180,421 people with a coded diagnosis of Achilles tendinopathy, 7,232, which is 4.0 percent, went on to have a coded rupture. The study tells you nothing about the interval between the two, nothing about how severe anyone's symptoms were, and nothing about who had steroid injections or fluoroquinolone antibiotics, because none of that was in the data. Everyone in it was aged 20 to 69, so it says nothing about anybody older. So it is a useful order of magnitude and not a personal prediction.
How often does Achilles tendonitis lead to a rupture?
The 4.0 percent from Yasui and colleagues (2017) is the figure that circulates, and what it describes is narrow: insured patients aged 20 to 69 in one United States database, identified by diagnosis codes, between 2007 and 2011. It is not a yearly risk, because the authors state that the time between each diagnosis was unknown. A number quoted without that qualifier sounds more precise than it is, which is why most of the pages repeating it are more frightening than informative.
Will exercising my sore Achilles make it snap?
Loading the tendon is the recommended treatment rather than a risk you are taking. The 2024 US clinical practice guideline makes tendon loading, at loads as high as the tendon tolerates, the first-line treatment on strong evidence, and advises that complete rest is not indicated (Chimenti and colleagues, 2024). The Dutch multidisciplinary guideline on Achilles tendinopathy puts progressive calf muscle strengthening for at least 12 weeks at the front of non-surgical treatment, and tells patients with chronic symptoms that little or no improvement is expected in the short term from waiting and seeing (de Vos and colleagues, 2021). In the Swedish trial, people who kept running and jumping within a pain rule did as well as people who stopped, and the researchers found no negative effects from carrying on (Silbernagel and colleagues, 2007). The one qualifier that matters: none of that is written for a tendon somebody suspects has been weakened by a medicine, which is why a tendon that started hurting on a fluoroquinolone antibiotic goes to the warning list first.
How do I know if I have ruptured my Achilles rather than strained it?
A rupture is an event with a time stamp. People describe a bang, a snap, or the feeling of being kicked in the back of the calf, after which push-off is suddenly weak or impossible. AAOS OrthoInfo says you may hear a popping noise, that severe pain and swelling near the heel can follow, that you may not be able to walk on the leg, and that you may be unable to stand up on the toes of that leg. Three things catch people out. A snap is not required, and some ruptures come with sudden pain and no noise. Push-off that has suddenly gone weak counts as much as push-off that is impossible. And a gap or soft spot you can feel in the tendon above the heel, where the other leg feels like a firm cord, is usually there in a fresh rupture (Maffulli and colleagues, 2017). Being able to walk afterward does not rule it out either, because other muscles can still point the foot down and ruptures do get missed at first (Maffulli and colleagues, 2017). Not one of those signs has to be present: no gap you can feel, no noise and a leg you can still limp on does not mean the tendon is intact. The first line on the warning list on this page says what to do, and it is the same day. Until you are seen, do not stretch the calf or pull the foot up, do not keep testing the toe rise, and keep your weight off that leg.
Who is most at risk of an Achilles rupture?
The documented factors, and only those. Yasui and colleagues (2017) found the subsequent rupture rate peaked in the 50 to 59 group at 4.3 percent, with the 40 to 49 group next at 3.9 percent, and significantly lower rates in the 20 to 39 and the 60 to 69 groups, so late middle age rather than the oldest readers. OrthoInfo lists corticosteroid injections for Achilles tendinitis as linked to an increased risk of rupture, names ciprofloxacin and levofloxacin as antibiotics linked with tendon tearing, and lists rheumatoid arthritis, lupus, diabetes, infection, obesity and metabolic disease among conditions that weaken tendons, alongside corticosteroid and anabolic steroid use. The UK medicines regulator advises special caution with fluoroquinolones in people over 60 and in those with kidney problems or a solid organ transplant, because of the higher risk of tendon injury (MHRA, 2024).
Does a steroid injection make a rupture more likely?
The sources we cite treat it as a real concern rather than a theoretical one. OrthoInfo states that corticosteroid injections given for Achilles tendinitis have been linked to an increased risk of tendon rupture, that cortisone injections into the tendon itself are not recommended because they can cause the tendon to rupture, and that research has shown significantly decreased tendon strength after a steroid injection. The Kent Community Health NHS leaflet advises against steroid injections for insertional Achilles pain, saying they may give temporary relief but are not a cure and could lead to tendon rupture. The leaflet's own conclusion is that they are best avoided. The MHRA also advises avoiding giving a corticosteroid together with a fluoroquinolone antibiotic, because that combination can make fluoroquinolone-related tendinitis and tendon rupture worse. Any injection is a decision to make with the doctor assessing your tendon, and this page is not advice either way.
References
- Yasui Y, Tonogai I, Rosenbaum AJ, Shimozono Y, Kawano H, Kennedy JG. The Risk of Achilles Tendon Rupture in the Patients with Achilles Tendinopathy: Healthcare Database Analysis in the United States. BioMed Research International. 2017;2017:7021862. https://doi.org/10.1155/2017/7021862
- de Vos RJ, van der Vlist AC, Zwerver J, Meuffels DE, Smithuis F, van Ingen R, van der Giesen F, Visser E, Balemans A, Pols M, Veen N, den Ouden M, Weir A. Dutch multidisciplinary guideline on Achilles tendinopathy. British Journal of Sports Medicine. 2021;55(20):1125-1134. https://doi.org/10.1136/bjsports-2020-103867
- Chimenti RL, Neville C, Houck J, Cuddeford T, Carreira D, Martin RL. Achilles Pain, Stiffness, and Muscle Power Deficits: Midportion Achilles Tendinopathy Revision - 2024. Journal of Orthopaedic and Sports Physical Therapy. 2024;54(12):CPG1-CPG32. https://doi.org/10.2519/jospt.2024.0302
- Magnussen RA, Dunn WR, Thomson AB. Nonoperative treatment of midportion Achilles tendinopathy: a systematic review. Clinical Journal of Sport Medicine. 2009;19(1):54-64. https://doi.org/10.1097/JSM.0b013e31818ef090
- Silbernagel KG, Thomee R, Eriksson BI, Karlsson J. Continued sports activity, using a pain-monitoring model, during rehabilitation in patients with Achilles tendinopathy: a randomized controlled study. American Journal of Sports Medicine. 2007;35(6):897-906. https://doi.org/10.1177/0363546506298279
- Silbernagel KG, Hanlon S, Sprague A. Current Clinical Concepts: Conservative Management of Achilles Tendinopathy. Journal of Athletic Training. 2020;55(5):438-447. https://doi.org/10.4085/1062-6050-356-19
- Maffulli N, Via AG, Oliva F. Chronic Achilles tendon rupture. Open Orthopaedics Journal. 2017;11:660-669. https://doi.org/10.2174/1874325001711010660
- American Academy of Orthopaedic Surgeons. Achilles tendon rupture (tear). OrthoInfo. https://www.orthoinfo.org/en/diseases--conditions/achilles-tendon-rupture-tear/
- American Academy of Orthopaedic Surgeons. Achilles tendinitis. OrthoInfo. https://www.orthoinfo.org/en/diseases--conditions/achilles-tendinitis/
- Kent Community Health NHS Foundation Trust. Achilles insertional tendinopathy. Patient leaflet 01271. Published 2 December 2024. https://www.kentcht.nhs.uk/leaflet/achilles-insertional-tendinopathy/
- Medicines and Healthcare products Regulatory Agency. Fluoroquinolone antibiotics: must now only be prescribed when other commonly recommended antibiotics are inappropriate. Drug Safety Update. 22 January 2024. https://www.gov.uk/drug-safety-update/fluoroquinolone-antibiotics-must-now-only-be-prescribed-when-other-commonly-recommended-antibiotics-are-inappropriate
- NHS. Deep vein thrombosis (DVT). Page last reviewed 30 April 2026. https://www.nhs.uk/conditions/deep-vein-thrombosis-dvt/
- NHS. Symptoms: Ankylosing spondylitis. Page last reviewed 5 January 2023. https://www.nhs.uk/conditions/ankylosing-spondylitis/symptoms/
Written and checked by the PocketPhysio editorial team. Last updated 2026-10-16.
This page is general education, not a diagnosis or a personal treatment plan. See a physiotherapist or doctor for advice about your own situation.