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If you suddenly feel a strong impact above the heel along with a snapping sound while walking or running, many describe the sensation as if someone momentarily kicked them from behind. If extreme pain follows immediately and it becomes difficult even to stand on tiptoes, an Achilles tendon rupture should be suspected.

The Achilles tendon is the largest and strongest tendon in the human body, connecting the calf muscles to the heel bone. As it plays a key role in all movements such as walking, running, and jumping, damage or rupture of this tendon causes significant disruption to daily life, making walking itself difficult. While it commonly occurs during sudden acceleration, changes in direction, or landing from a jump in sports, it can also happen to those who do not usually exercise. In particular, the risk of rupture increases when sudden movements are applied after middle age, when the elasticity of the tendon has decreased.

The problem is that many patients mistake the condition as having healed on its own once the initial pain subsides, thus delaying treatment. However, once the Achilles tendon is ruptured, it is difficult for it to recover completely by itself. If left in a ruptured state, the tendon hardens without attaching properly, making recovery more difficult over time and increasing the scope and difficulty of surgery. This is why not missing the timing for treatment is more important than anything else.

Achilles tendon disorders are largely divided into Achilles tendonitis and ruptures. Achilles tendonitis is a condition where inflammation occurs in the tendon due to repetitive irritation, with stiffness and pain in the back of the ankle appearing gradually. On the other hand, a rupture refers to a state where the tendon is partially or completely torn. If a snapping sound occurs at the moment of injury, followed by severe swelling above the heel, difficulty standing on tiptoes, and a sunken feeling when pressing the Achilles area, a rupture should be strongly suspected. Even if symptoms are similar, the direction of treatment changes completely depending on whether it is inflammation or a rupture; therefore, accurate diagnosis is the first step of treatment.

Director Hong-Joon Choi of Seoul Gunwoo Orthopedic Clinic, located near Gangil Station in Gangdong-gu, Seoul, emphasizes, "An Achilles tendon rupture is not recovered just because the initial pain has subsided. If left ruptured, the tendon tissue degenerates and may require much more complex treatment later, so it is crucial to receive a precise examination quickly if you have suspicious symptoms."

The treatment direction for an Achilles tendon rupture is determined by comprehensively evaluating the degree and location of the rupture, the time elapsed after the rupture, and the patient's age and activity level. Seoul Gunwoo Orthopedic Clinic accurately identifies the scope and status of tendon damage through ultrasound and MRI scans and provides a full explanation while reviewing the results with the patient. It is a medical principle of Seoul Gunwoo Orthopedic Clinic for patients to clearly understand their own condition and decide on the treatment direction together.

If it is a partial rupture or if the patient is elderly or has a low activity level, non-surgical treatment through brace fixation and rehabilitation can be considered first. However, surgical treatment is recommended for complete ruptures, young patients with high activity levels, or those aiming to return to sports activities. Directly suturing the ruptured tendon through surgery lowers the risk of re-rupture and allows for a more complete recovery of the tendon's strength and function. Recently, surgical methods have advanced to allow stable suturing while reducing the risk of scars and complications by applying minimal incision techniques. Director Choi explains, "Neither surgical nor non-surgical treatment can be said to be absolutely superior; the key is to choose the most suitable method by comprehensively judging the patient's age, activity level, degree of rupture, and time elapsed after the injury."

In Achilles tendon rupture treatment, rehabilitation is a process as important as the surgery itself. After surgery, the flexibility and strength of the tendon must be restored and walking function normalized through a step-by-step rehabilitation program. In the early stages of rehabilitation, weight-bearing is gradually increased while wearing a brace, followed by calf muscle strengthening and balance training with the goal of returning to daily life and sports activities. If rehabilitation is not sufficiently carried out, the risk of re-rupture remains even if the surgical result is good.

The feet and ankles are the starting point for the balance of the entire body. A problem with a single Achilles tendon can change the entire gait and affect the knees and back. If pain in the back of the heel repeats or a sudden rupture is suspected, it is wise to receive an accurate diagnosis first rather than waiting.

Director Hong-Joon Choi of Seoul Gunwoo Orthopedic Clinic holds a Ph.D. from Korea University and is a foot and ankle specialist who served as an exchange professor at the Foot and Ankle Center of Massachusetts General Hospital (MGH), affiliated with Harvard Medical School. He is also a co-author of the revised medical textbook "Foot and Ankle" published by the Korean Foot and Ankle Society. To date, he possesses extensive clinical experience, having treated over 80,000 foot and ankle patients and performed approximately 9,000 surgeries. Dedicated to the diagnosis and treatment of all foot and ankle disorders—including hallux valgus, ankle ligament and cartilage damage, plantar fasciitis, Achilles tendonitis, ankle arthritis, Morton's neuroma, and tailor's bunion—Seoul Gunwoo Orthopedic Clinic does its best for the foot health of patients in the Hanam and Misa areas, centered around Gangil Station in Gangdong-gu.