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Achilles Tendonitis

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Home > Pain Conditions > Achilles Tendonitis

About Achilles Tendonitis

The Achilles tendon connects your heel bone to your calf and is the largest and strongest tendon in the human body. Named after the Greek god Achilles, the Achilles tendon helps you walk, run and jump by raising the heel off the ground.

What Causes Achilles Tendonitis?

Achilles Tendonitis is the acute inflammation of the tendon due to excessive use. It can be caused by mechanical or non-mechanical factors.

Mechanical Factors

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Running related sports
Athletes in sports such as sprinting, basketball, badminton, soccer, and gymnastics are more likely to be exposed to Achilles Tendinitis, studies have shown that it has an injury incidence of up to 24% in athletes.
Direct Trauma
Jumping or any form of sudden impact on the heel can result in excessive pressure on the foot.
Obesity
Being overweight increases the chances of Achilles Tendinitis due to more stress on the tendon.

Non-Mechanical Factors

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Muscle Weakness, Imbalance or Lateral instability of the ankle
Biological factors can result in uneven distribution of weight on the feet and the heel, this places stress on parts of the feet which leads to Achilles Tendinitis. Other factors include an anatomical variation of the plantaris muscle which also contributes to increased risk.
Medical conditions
Medical conditions such as diabetes (DM) increase the risk of Achilles Tendinitis. Long-standing DM can lead to glycosylation of the muscle tendon, resulting in stiffness and weakness of the tendon fibers.
Gender and Age
Statistically, Achilles’ injuries are more prevalent in men than women, and it is more common as one age.

Symptoms Of Achilles Tendonitis

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Heel pain

Achilles Tendonitis usually results in heel pain and can be severe in the morning. The pain can also occur anywhere along the tendon’s path, from the heel up to the calf, it is improved somewhat with motion but worsens with increased activity.

Stiffness

The area is likely to feel tender, swollen and stiff due to the inflammation.

Limited range of motion
You might have a limited range of motion when flexing the foot, this includes difficulties in bending your ankle or walking.

When Should I Seek Medical Attention?

You should seek medical help when:

  • Pain or stiffness at the back of the heel
  • Mild aches at the back of the heel
  • Tenderness near the affected area
  • Pain in the middle of the tendon. Associated with swelling and oedema
  • Limited Range of motion

A Message About Achilles Tendonitis

Long-standing heel pain arising from Achilles Tendonitis can result in tears and rupture of the Achilles Tendon (AT). Pain is the first sign of injury. Further aggravation of the tendonitis will result in microtears and subsequently a gap in the tendon. Once that happens, you will lose the ability to run, jump or tiptoe. When there is a complete tear or rupture of the AT, surgical repair is often needed to sew and appose the frayed ends together. The post recovery is long drawn up to 4 – 6 months of keeping the ankle flexed in a cast.

Early intervention with Myospan PRP injection is helpful to reverse the inflammation and early tears. Combined with adequate muscle relaxation to reduce the tension of the AT at night, giving it adequate rest, relaxation and recovery of the overused tendon.

Diagnosing Achilles Tendonitis

Here at Singapore Paincare, our team of experienced primary care physicians and pain care specialists will conduct a thorough diagnosis. This includes a physical exam, questions about your symptoms and an evaluation of your medical history. An X-ray, MRI or CT scan may be needed to evaluate or confirm the degree of Achilles tendinitis.

What Treatments Are Available for Achilles Tendonitis?

At Singapore Paincare, we strive to treat your pain with the least invasive option possible after accurately identifying the cause. Our approach to pain resolution focuses on the removal of pain generators via specialised injection and minimally invasive procedures. Combined with pharmacological treatments and cognitive and physical rehabilitative therapies, we help patients improve functions and prevent pain from recurring.

Non-Surgical Treatments for Achilles Tendonitis

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Orthotics
Doctors may recommend pads to be worn in shoes to improve the foot problem. Orthotics can be custom-made or standard-sized.
Physiotherapy
A variety of exercises can improve the elasticity, strength and support of the feet and ankles. Muscle exercise can also reduce pain and prevent damage from worsening.
Non-steroidal anti-inflammatory drugs (NSAIDs)

Over-the-counter or prescription pain medications can relieve pain and inflammation.

Myospan PRP injection

Injecting PRP can help reduce pain and swelling in the inflamed bursa and the tendinitis. Early treatment is important to prevent tears or rupture from occurring.

Extracorporeal shock wave therapy
The procedure involves using high-energy sound waves to treat the affected area.

Surgical Treatments for Achilles Tendonitis

Sometimes, Achilles Tendonitis may be severe enough to cause a partial tear or rupture, this may require surgery to fix the damaged tendon. As surgery always comes with associated risks, complications and downtime – it may not be suitable for everyone.

Foot surgery
The procedure involves making an incision at the back of the ankle to remove the infected area of the tendon and stitch or sew up the frayed ends of the tendon tears.

How Can I Prevent Achilles Tendonitis?

Reduce your risk of Achilles tendonitis by:

  • Doing a proper warm-up before engaging in any exercise or sports
  • Having a variety of exercises to avoid repetitive stress in the Achilles tendon
  • Keeping your muscles active
  • Wearing proper shoes that fit well
  • Avoid running uphill or on uneven ground

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