31/07/2025
Recently, I treated a patient who ruptured their Achilles tendon while playing pickleball, a sport that’s increasing in popularity, particularly among older adults.
A 2024 study by McCahon et al. (McCahon et al., 2024) highlights a rising trend in Achilles injuries linked to pickleball, especially in older individuals. The sport involves rapid starts, stops, and lateral movements, which place intense stress on the Achilles — often in tendons already degenerating due to age and reduced elasticity.
In this case, we caught the injury quickly. Classic signs included:
• A sudden “pop” or the feeling of being shot or kicked in the back of the leg
• Difficulty with plantarflexion or pushing off the injured side
• A palpable gap in the tendon
• A positive Thompson test (no plantarflexion with calf squeeze)
• Point-of-care ultrasound (POCUS) clearly confirmed the rupture
We’ve referred the patient for urgent surgical repair, which offers a better outcome in active individuals when diagnosed early.
Takeaway: For those enjoying sports like pickleball later in life — don’t skip the warm-up, strengthen the calf complex, and never ignore tightness or sharp pain in the Achilles. Early recognition can be the difference between rehab and long-term disability.
Slide 1: Positive Thompson test
Slide 2: Visible gap where the injury has occurred on the Achilles
Slide 3: POCUS comparing symptomatic Achilles against asymptomatic
McCahon JAS et al. (2024). Pickleball and the Rising Incidence of Achilles Tendon Injuries in the Elderly, Foot Ankle Spec.
