The patient was a 30-year-old man who was referred to a physical therapist for a chief complaint of a painful, swollen left lower leg that had caused difficulty with walking in the previous 3 weeks. Prior to physical therapist referral, the patient's primary care provider ordered radiographs of the left ankle, which were interpreted as normal. Due to history and physical examination findings that were concerning for an Achilles tendon rupture, the physical therapist immediately referred the patient to an orthopaedic surgeon. Magnetic resonance imaging confirmed the presence of a complete rupture of the Achilles tendon. J Orthop Sports Phys Ther 2013;43(2):105. doi:10.2519/jospt.2013.0403