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BACKGROUND: Achilles tendon rupture incidence has been increasing over the past several decades with management including nonoperative and operative options. Little is known regarding the patient experience in those who transition from nonoperative to operative management due to re-rupture. CASE PRESENTATION: A 22-year-old male physical therapy student heard a “pop” while playing soccer. Per ultrasound imaging findings and patient goals, he trialed nonoperative management. However, he experienced re-rupture and underwent open Achilles tendon repair. OUTCOME AND FOLLOW-UP: After rehabilitation, he demonstrated normalized heel-rise endurance, quadriceps, and hamstring strength. He lacked heel-rise height compared to contralateral side. He resumed recreational running and lifting, but not sports. DISCUSSION: Initial nonoperative management after Achilles tendon rupture does not appear to diminish outcomes after subsequent Achilles tendon repair. However, the patient reported heightened fear of re-rupture after nonoperative management and relief with operative management. JOSPT Cases 2025;5(3):176-182. Epub 10 June 2025. doi:10.2519/josptcases.2025.0023
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Knobel et al. (2025) studied this question.
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