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Background: Achilles tendon ruptures are common musculoskeletal injuries. Treatment options include surgical repair and non-operative rehabilitation with outcomes being similar between both options. Despite extensive rehabilitation during both treatment options, functional impairments can persist for years following the injury. This suggests that current rehabilitation protocols could be improved. Case Description: The patient was a 68 y.o male who presented to physical therapy 7 weeks following a full thickness Achilles tendon rupture that was managed non-operatively. Intervention: The patient was seen once a week. During weeks 8 through 13 following the injury blood flow restriction (BFR) training was utilized. Starting week 14 treatment consisted of progressive closed kinetic chain (CKC) strengthening. Outcomes: Ultrasound measurements of the medial gastrocnemius bilaterally was used to determine the effect of the BFR training. Conclusion: This case describes the use of BFR training during the early stages of non-operative treatment of an older adult with an Achilles tendon rupture. In this case BFR was well tolerated and safe. Furthermore, this case highlights the potential for BFR training to decrease disuse atrophy during the early management of Achilles tendon ruptures.