Achilles Tendon Rupture Treatment
in Los Angeles
Medically Reviewed by Dr. Pegah Panirian, DPM, foot and ankle surgeon
Overview
Dr. Pegah Panirian is a top Achilles tendon specialist in Los Angeles, treating torn and ruptured Achilles tendons at The Feet Institute’s Los Angeles/Beverly Hills and Westchester offices. Trained at Cedars-Sinai Medical Center, she offers non-surgical care along with minimally invasive repair of new achilles injuries and reconstruction of older, missed ruptures.
Key points
- An Achilles rupture is a tear of the tendon joining your calf to your heel. Most people feel a pop and a kick-like blow to the back of the leg.
- You can still walk on a completely torn Achilles. Walking does not mean the tendon is intact.
- A suspected rupture should be seen by a foot and ankle specialist within a few days. Treatment options narrow as the torn ends pull apart.
- Next-day appointments are available for suspected Achilles ruptures in Los Angeles, and same-day when the schedule allows.
What is an Achilles tendon rupture?
An Achilles tendon rupture is a tear through the tendon that connects your calf muscles to your heel bone. It usually happens during a sudden push-off, such as a sprint start, a jump or a lunge for a ball.
The Achilles is the largest tendon in the body. Most ruptures happen 2 to 6 centimeters (about 1 to 2 inches) above the heel, where the tendon’s blood supply is weakest. Doctors call this the watershed zone.
When the tendon tears completely, your calf is no longer attached to your heel. You lose the power to push your foot down (plantarflexion), so standing on your toes on that leg becomes impossible.
Achilles ruptures are common across Los Angeles, from weekend basketball and pickleball players in Santa Monica to runners on the Westside and tennis players in Beverly Hills. They most often affect adults between 30 and 50 who play sport occasionally.
What does a torn Achilles feel like?
Most people know something has gone wrong straight away. Common signs of a torn Achilles include:
- A pop or snap at the back of the ankle, which you may hear
- A feeling of being kicked or hit in the back of the leg, even when no one is behind you
- Sudden sharp pain that often settles quickly, sometimes within minutes
- Swelling and bruising above the heel and into the lower calf
- A dip or gap you can feel in the tendon above the heel
- Not being able to stand on your toes on the injured leg
- A weak, flat-footed walk with little push-off
Pain that settles is not a good sign here. Many people with a complete rupture are walking comfortably within hours, which is why the injury is often missed at urgent care or mistaken for an ankle sprain.
Is my Achilles partially torn or completely ruptured?
Three exam findings tell a complete rupture apart from a partial tear:
- A gap in the tendon. A dip or notch you can feel, usually 2 to 6 centimeters above the heel bone.
- A changed resting position. Lying face down with your knees bent, an injured foot hangs flatter than the other, which rests slightly pointed down.
- No movement with a calf squeeze. When the calf is squeezed, a healthy foot points downward. After a complete rupture it barely moves. This is called the Thompson test.
Who is at risk of an Achilles rupture?
An Achilles rupture can happen to anyone, but the risk is higher if you:
- Are between 30 and 50, when the tendon starts to lose elasticity
- Are male. Men rupture the Achilles several times more often than women
- Play sport occasionally. Weekend warriors in stop-start sports such as basketball, tennis, pickleball, soccer and volleyball are most at risk
- Have had Achilles tendonitis. Long-standing Achilles tendonitis or tendinosis weakens the tendon
- Have had steroid injections near the tendon
- Have taken fluoroquinolone antibiotics, such as ciprofloxacin (Cipro) or levofloxacin
- Have diabetes, gout or inflammatory arthritis, or carry extra body weight
If you have Achilles pain that has been building for weeks, see a specialist before it becomes a rupture. Dr. Panirian also treats Achilles tendonitis and insertional Achilles tendinopathy (heel pain where the tendon meets the bone, often with a Haglund’s bump).
How is a torn Achilles diagnosed?
Most Achilles ruptures are diagnosed at the first visit, with a hands-on exam. Dr. Panirian will:
- Ask how it happened: the movement, whether you felt a pop, and how long ago it was.
- Examine the tendon: feel for a gap, compare how both feet rest, and perform the Thompson (calf squeeze) test.
- Order imaging if needed: ultrasound or MRI when the exam isn’t clear or when planning surgery.
Ultrasound is often the more useful scan for an Achilles tear. It shows the torn ends moving in real time, including how close they come together when the foot is pointed.
The exam answers three questions that shape your treatment: where the tear is, how far apart the ends are, and how long ago it happened.
Do I need surgery for a torn Achilles?
Not always. Both surgical and non-surgical treatment aim to hold the torn ends together at the right length while the tendon heals. Dr. Panirian, a leading Achilles surgeon in Los Angeles, recommends the approach that fits your tear, your health and your activity goals.
| Non-surgical treatment | Surgical repair | |
|---|---|---|
| Often suits | Fresh ruptures where the ends meet with the foot pointed down; lower sports demands; higher surgical risk | Active patients and athletes; ends that don’t meet; tears seen late; re-ruptures |
| What’s involved | A walking boot with heel wedges, starting with the foot pointed down and flattened in stages | Stitching the tendon ends together through an open, mini-open or percutaneous (small-incision) approach, then the same boot program |
| Re-rupture risk | Slightly higher in most studies; the gap is small with modern early-rehab protocols | Slightly lower |
| Other risks | Tendon may heal a little long, with weaker push-off | Wound healing problems, infection, nerve irritation |
| Physical therapy | Yes, several months | Yes, several months |
Dr. Panirian also weighs smoking, diabetes and circulation, which affect wound healing, before recommending surgery.
Achilles tendon repair surgery options
Dr. Panirian performs all three main types of Achilles repair, choosing the technique best suited for your tear and goals.
- Percutaneous repair: a minimally invasive repair through a few very small incisions. It suits many fresh mid-tendon ruptures and usually means a smaller scar and lower wound risk.
- Mini-open repair: a short incision over the tear, combined with small stitch openings. It lets the surgeon see the tendon ends while keeping the approach small.
- Open repair: a longer incision along the back of the ankle. It is used for complex tears, tears near the heel bone and re-ruptures.
All three are outpatient procedures, so most patients go home the same day.
Missed or old Achilles rupture? Reconstruction is still possible
About one in five Achilles ruptures is missed at first, often diagnosed as a sprain. If your tear is more than four to six weeks old, the ends have usually pulled apart and filled with scar tissue, and they can no longer be stitched together directly.
Dr. Panirian is one of the few Los Angeles foot and ankle surgeons who regularly reconstructs chronic and neglected Achilles ruptures. Depending on the size of the gap, she may use:
- FHL tendon transfer: a nearby tendon that bends the big toe is moved to strengthen and bridge the Achilles.
- V-Y advancement: the tendon above the tear is lengthened in a V-to-Y pattern to close the gap.
- Allograft reconstruction: donor tendon tissue is used to bridge a large gap.
If you were told months ago that you had a sprain and still can’t push off or stand on your toes, a second opinion is worthwhile.
How long is recovery from a torn Achilles?
Most people are walking in a regular shoe by about 10 to 12 weeks, back to jogging at 4 to 6 months, and back to full sport at 6 to 12 months. Recovery is similar after surgical and non-surgical treatment; what matters most is a well-run rehabilitation program.
| Stage | Typical timing | What happens |
|---|---|---|
| Protection | Weeks 0 to 2 | Walking boot with heel wedges, foot pointed down. Crutches, with weight added as comfort allows. |
| Early loading | Weeks 2 to 6 | Wedges removed step by step to bring the foot flat. Full weight in the boot. Gentle ankle movement starts. |
| Out of the boot | Weeks 6 to 12 | Back into a supportive shoe, often with a small heel lift. Physical therapy builds calf strength and balance. |
| Strengthening | Months 3 to 6 | Heel raises, cycling and gym work. Jogging usually starts once you can do single-leg heel raises. |
| Return to sport | Months 6 to 12 | Running, jumping and court sports, cleared by strength testing rather than the calendar. |
Desk work is often possible within 1 to 2 weeks. Driving with a right-leg injury usually waits until you are out of the boot. Age, smoking, diabetes, the delay before treatment and how closely you follow physical therapy all change the timeline.
How soon should a torn Achilles be seen?
Within a few days. The torn ends start pulling apart and filling with scar tissue straight away, so the longer you wait, the fewer options you have and the harder the repair becomes.
The Feet Institute offers next-day appointments for suspected Achilles ruptures, and same-day visits when the schedule allows. Until you are seen, keep weight off the leg, use crutches if you have them, and keep the foot pointed slightly down.
Why choose Dr. Panirian for your Achilles injury?
Dr. Pegah Panirian is a trusted Los Angeles foot and ankle surgeon who treats everything from a fresh Achilles rupture to complex reconstruction.
- Cedars-Sinai trained. Surgical residency and chief resident at Cedars-Sinai Medical Center, where she is now a teaching attending.
- Board certified by the American Board of Podiatric Medicine and board qualified by the American Board of Foot and Ankle Surgery.
- Every repair option. Non-surgical care, percutaneous, mini-open and open repair, and chronic rupture reconstruction.
- Seen fast. Next-day appointments for suspected ruptures, and same-day when available.
- Speaks English, Spanish and Farsi.
As a leading Achilles tendon specialist, Dr. Panirian will evaluate your injury to determine whether nonsurgical treatment or Achilles tendon repair offers the best path forward for you. You’ll receive a clear, individualized plan for restoring strength and mobility including what to expect from treatment, rehabilitation and your return to work, exercise or sport.
Common questions about Achilles rupture treatment
Can a torn Achilles heal on its own?
A partial tear often heals well without surgery. A complete rupture can heal without surgery only if it is treated: the foot must be held pointed down in a boot so the ends touch. Left untreated, the ends heal too far apart, leaving a longer tendon and a permanently weaker calf.
Can I walk on a torn Achilles?
Often, yes, and that is why the injury gets missed. Other ankle muscles let you walk flat-footed even when the Achilles is completely torn. Keep weight off the leg until a specialist has examined it.
How long will I be in a boot after Achilles surgery?
Usually 6 to 10 weeks. You start with the foot pointed down, and heel wedges are removed in stages until the foot is flat and your calf can take load.
Is Achilles surgery painful?
Most pain is in the first few days and is controlled with medication, elevation and rest. Minimally invasive repairs usually cause less wound pain than open surgery.
What happens if an Achilles tear goes untreated?
The tendon heals long and the calf stays weak. Everyday walking usually returns, but stairs, slopes, running and standing on your toes often don’t. After four to six weeks, reconstruction may be the only way to restore strength.
What kind of doctor treats a torn Achilles?
A foot and ankle surgeon: either a podiatric surgeon (DPM) or an orthopedic foot and ankle surgeon. Dr. Panirian is a Cedars-Sinai trained podiatric foot and ankle surgeon who treats Achilles ruptures across Los Angeles.
Sources
- Achilles Tendon Rupture (Tear), OrthoInfo, American Academy of Orthopaedic Surgeons. Accessed September 15, 2026.
- Position Statement: Management of Acute Achilles Tendon Ruptures, American Orthopaedic Foot & Ankle Society, November 2024. Accessed September 15, 2026.
- Clinical Consensus Statement: Acute Achilles Tendon Pathology, American College of Foot and Ankle Surgeons. Accessed September 15, 2026.
- Nonoperative or Surgical Treatment of Acute Achilles Tendon Rupture, American College of Foot and Ankle Surgeons. Accessed September 15, 2026.
- Early versus late weightbearing in conservative management of acute Achilles tendon rupture: a systematic review, American College of Foot and Ankle Surgeons. Accessed September 15, 2026.
- Comparable Recovery and Compensatory Strategies in Heel-Rise Performance After a Surgically Repaired Achilles Tendon, American College of Foot and Ankle Surgeons. Accessed September 15, 2026.