Partial Achilles tendon ruptures or tears – Symptoms and tests

Understand what a partial Achilles tear feels like, how you can tell whether you might have one, and which tests and scans are most useful for diagnosing it.

Remember, if you need help with an Achilles injury, you're welcome to consult one of our team via video call.

The terms tendinitis, tendonitis, tendinosis, and tendinopathy mean the same thing for all practical purposes, and we use these interchangeably in most of our articles.

In this article:

1. Partial Achilles tendon tear vs. partial Achilles rupture – what's the difference?

2. How can I tell whether I have a partial Achilles tear?

3. The in-depth conversation

4. Physical tests for partial Achilles tears

5. Scans

6. How we can help

We've also made a video about this:

Partial Achilles tendon tear vs. partial Achilles rupture – what's the difference?

There is no difference – in medical terms, "tear" and "rupture" both refer to a structure where some of the cells and fibres have been torn apart. Some people prefer the word "rupture" and others prefer "tear."

💡 In both cases, the word "partial" is the defining one – it means that some of the Achilles tendon's fibres have been torn, but others are still intact. This sets it apart from a "complete" Achilles tear, where all of the fibres have torn.

We tend to favour the word "tear", but you can use either.

How can I tell whether I have a partial Achilles tear?

There are three steps doctors and physios use to diagnose injuries – and these are also the steps we follow during our video consultations.

It's important to form a complete picture rather than relying on just one test or piece of information – none of them (not even scans) are 100% accurate or reliable on their own.

Several injuries share similar symptoms or show up the same on tests, and sometimes scans show changes that look like a possible injury but don't fit at all with the rest of the picture.

The three steps are:

1. An in-depth discussion to understand how the injury happened, what the initial symptoms were, and how it is currently reacting to specific movements and activities.

2. Physical tests – asking you to perform specific movements so we can assess your Achilles.

3. Scans – if the information gathered in Steps 1 or 2 suggests a possible Achilles tear or another injury that requires imaging. Many Achilles injuries (like a tendinopathy) don't require scans at all.

Let's look at each of these in more detail.

Even scans aren't 100% accurate – you need the information gathered in Steps 1 and 2 to properly interpret what you see on a scan and how it fits into the diagnosis and treatment choices.

1. The in-depth conversation

We've broken this down into sections to help you understand how each part of the conversation helps us to piece together the full picture.

How did the injury happen?

Your calf muscles and Achilles tendon work as a unit – when the calf muscles contract, they pull on the Achilles tendon, which lifts your heel when you're upright or points your toes down when you're not on your feet.

When you tear your Achilles tendon, you usually feel a sudden, sharp pain or jolt during an activity that uses your calf muscles – for example, pushing off to move, running, jumping, or stepping off a kerb. Some people describe it as feeling like a razor cut, or as if someone had kicked them in the heel.

If you also heard a loud snap or a sound like a gunshot when it happened, it's very likely that you have a complete Achilles tendon rupture, and you should get it checked immediately.

If your symptoms came on gradually during a training session, several hours afterwards, or you first noticed them after getting up in the morning, it's more likely to be an overuse injury such as Achilles tendinopathy or heel bursitis (inflammation of the small fluid-filled sac near your heel).

What are your current symptoms?

With a partial Achilles tendon tear, you might notice some or all of the following:

• Resting usually helps to reduce the pain, but it can sometimes be uncomfortable even at rest.

• The more you walk and move around, the more painful it tends to become – this is different from Achilles tendinopathy, where movement often helps to loosen things up and makes it feel more comfortable.

• Smaller tears might allow you to do quite a lot of walking before the pain kicks in, while larger tears might be painful most of the time.

• Any movement that uses the calf muscles – such as walking up stairs, rising up onto your tiptoes, running, or jumping – usually causes pain. Smaller tears might just feel a bit uncomfortable, while larger tears may change the way you move and stop you from running altogether.

• Walking barefoot tends to hurt more than wearing shoes where the heel sits higher than the toes.

• Stretching the calf muscles usually hurts, because this also pulls on the Achilles tendon and the injured area.

• The area might look a little puffy or swollen within a few hours of the injury – though not always.

• There might be some bruising, though not always. Bruising often appears a few days after the injury and tends to sit a little lower than where you feel the pain, because gravity pulls the blood downwards.

• In rare cases, you might experience tingling or nerve-like sensations due to irritation of the sural nerve (a nerve that runs close to the Achilles tendon) – though this can happen without a tear as well.

Taking a recently torn Achilles into any position that stretches it usually hurts. 🚨 Please don't do this without guidance from your physio or doctor – you can make your symptoms worse if you're too aggressive with this type of test.

💡 If you've fully torn your Achilles tendon, you might actually be able to walk without pain – because the tendon is completely separated and there is nothing left to pull on. However, you won't be able to push off properly through the ball of your foot. Find more information about complete Achilles ruptures here.

The best thing to do if you suspect you might have a torn your Achilles is to consult a medical professional as soon as possible. Complete ruptures in particular recover much better when treated promptly and correctly.

Your medical history

Here, we're interested in understanding whether any previous injuries, medications, medical conditions, or activities might have made you more vulnerable to this injury. This can also highlight things we may need your doctor to address as part of your treatment plan.

For instance, if you've recently taken – or are currently taking – fluoroquinolone antibiotics, it's worth flagging this to your doctor. These medications are known to affect tendon health, and your doctor might want to switch you to an alternative. Don't stop taking them without speaking to your doctor first, as they're usually prescribed for an important reason.

Some medications can increase your risk of tearing your Achilles.

Some of the factors that might increase your risk of an Achilles tear include:

• Corticosteroid injections into the Achilles tendon (injections into the bursa or other areas around the heel are generally considered safe)

• Fluoroquinolone antibiotics

• Hormone-related conditions such as diabetes

• Chronic Achilles tendinopathy

Your current activities and goals

Understanding what you can still do without aggravating your symptoms tells us a lot – including the likely size of any tear, which activities might be safe to continue during your recovery, and what level of rehabilitation we'll need to work towards so you can get back to doing what you love. (Here our comprehensive article about the treatment for partial Achilles tears.)

💡 We aim to keep our patients as active as possible during recovery – not only does this lead to better physical outcomes, but it also makes a real difference to your mental wellbeing when you're dealing with an injury.

2. Physical tests for partial Achilles tears

The test we describe below is one of the most useful for diagnosing a partial Achilles tear – but it's not the only one, and we won't use it in every case.

💡 No single test is 100% accurate. If, based on our conversation, we suspect you might have any type of Achilles tear, we'll usually recommend that you also get a scan to confirm.

Walking on tiptoes

Your physio will ask you to walk on your tiptoes without letting your heels drop.

Here's how to interpret the results:

• Small partial tear: You'll likely be able to walk on your tiptoes, but it will hurt. It's worth noting that this is also similar to what people experience with tendinopathy, so it needs to be considered alongside the history of how your symptoms started.

• Large partial tear: You may be able to rise onto your tiptoes but struggle to keep your heel fully raised as you walk.

• If you can't keep your heel up at all on the injured side, this could indicate a complete rupture – though severe pain can sometimes also prevent the muscles from working properly, so it's not always conclusive.

Other tests your physio might use include:

• Asking you to repeatedly raise up and down on your toes (on two legs or one)

• Asking you to gently stretch the Achilles and describe what you feel.

X-rays only show bone – they cannot be used to view or diagnose a partial Achilles tear.

3. Scans

If anything in our conversation suggests that you might have a partial Achilles tear, we'll usually recommend a scan to get a clearer picture. The only exception is if your symptoms and physical tests indicate that it is likely to be a very small tear, in which case it's not really needed.

Understanding the extent of any tear helps us to choose the best treatment approach and set realistic recovery expectations. It's also important to rule out a complete rupture, as that requires very different treatment.

💡 Both ultrasound and MRI scans can identify partial Achilles tears. Ultrasound is usually more affordable and easier to access, so it's often the first step.

One important thing to be aware of: Partial Achilles tears do not show up on X-rays. An X-ray cannot rule out a partial tear, so it's not a recommended test for this type of injury.

How we can help

Need help with your Achilles or related injury? You’re welcome to consult one of the team at TMA online via video call for an assessment of your injury and a tailored treatment plan.

We're all UK Chartered Physiotherapists with Master’s Degrees related to Sports & Exercise Medicine or at least 10 years' experience in the field. All of us have a wealth of experience working with athletes across a broad variety of sports and ranging from recreationally active people to professional athletes. You can meet the team here.

About the Author

Maryke Louw is a chartered physiotherapist with more than 20 years' experience and a Master’s Degree in Sports Injury Management. Follow her on LinkedIn and ResearchGate.

References

Gatz, M., Spang, C. and Alfredson, H., 2020. Partial Achilles tendon rupture—a neglected entity: a narrative literature review on diagnostics and treatment options. Journal of Clinical Medicine, 9(10), p.3380.