As the largest tendon in the body, the Achilles tendon runs down the back of your leg and is responsible for connecting your calf muscles to your heel bone. This tendon plays an important role in allowing you to jump, run, climb and stand on your tiptoes.
However, when you overuse your Achilles tendon, this will result in swelling and pain at the back of your leg to your heel, a condition known as Achilles tendonitis. Commonly, this injury occurs when people, particularly athletes, put a lot of strain on their Achilles tendons from all the movement they do. However, the Achilles tendon can also degenerate from wear and tear through the years, even if you do not engage in strenuous activity regularly.
There are two different classifications of Achilles tendonitis: non-insertional and insertional. Non-insertional Achilles tendonitis occurs due to the degeneration of fibres in the middle portion of the Achilles tendon, while insertional Achilles tendonitis involves afflicting the lower portion of the heel where the tendon inserts into the heel bone.
Symptoms of Achilles Tendonitis
When you’re experiencing any of these symptoms, you could have Achilles tendonitis and may require treatment from an orthopaedic surgeon in Singapore:
- Pain and stiffness in your Achilles tendon in the morning
- Pain in the Achilles tendon when it is moved or touched
- Pain in your heel and the length of the tendon when running or walking
- Difficulty standing on one toe
- Warmth and inflammation in the heel or along the tendon
Causes of Achilles Tendonitis
Achilles Tendonitis is caused by the repetitive stress to the tendon. This especially happens when you push your body to do too much physical activity without proper conditioning. Another factor that could cause Achilles tendonitis is tight calf muscles, which add extra stress to the Achilles tendon, which inserts into the heel bone. If you have what’s known as Haglund’s deformity, which is the enlargement of the bone on the back of the heel, this can rub on the Achilles tendon, causing inflammation and pain.
When you are experiencing any of these other factors that could result in Achilles tendonitis, it’s advised that you seek medical help in Singapore so that you can get treatment as soon as possible and prevent major injuries in the long run.
How Orthopaedic Physicians in Singapore Diagnose Achilles Tendonitis
The attending orthopaedic specialist will examine your medical history and conduct a physical assessment of your foot in the diagnosis of your condition. For a thorough understanding of your condition, you may be asked questions regarding your athletic activity, symptoms, other underlying medical conditions, ongoing treatment, or previous treatment received. You may be required to walk around the room, so the healthcare professional can visually assess your stride. Another way your Achilles tendon will be checked is by gently pinching it to feel the tendon’s condition, whether it has severe swelling or other abnormalities. Also, your calf muscles will likely be examined as they are connected to your Achilles tendon.
If the orthopaedic specialist wants to check the condition of your Achilles tendon further, they may conduct imaging tests, like X-rays and magnetic resonance imaging (MRI). This allows them to get a clearer picture of your Achilles tendon and rule out other conditions that may be causing similar pain, like bone fractures.
Achilles Tendonitis Treatment Options
Treatment for Achilles tendonitis will depend on your tendon’s condition. You will be prescribed either conservative treatments or other modalities that will help promote healing. Here are some of the treatment options your orthopaedic specialist in Singapore may recommend:
- Rest, Ice, Compression, and Elevation (RICE) - It’s important that you avoid exercise for several days or physical activities that could strain your Achilles tendon. To reduce the pain or swelling, you must apply an ice pack to the tendon. Other ways to reduce the swelling is by using wraps or compressive elastic bandages, as well as raising the affected food above the level of your heart. It’s recommended that you elevate your feet when you sleep.
- Physical Therapy - Should you be advised to undergo physical therapy, you will be given individualised exercise programmes to strengthen your Achilles tendon and its structures to promote healing. You may even be prescribed special devices, like orthotics or walking boots. Orthotics are custom-made devices that improve the alignment of your foot and control joint motions. On the other hand, walking boots help reduce the amount of loading on the Achilles tendon. They are typically prescribed if the injury is severe.
- Extracorporeal Magnetic Transduction Therapy (EMTT) - This is a non-invasive treatment that uses high-energy magnetic pulses to reduce pain and inflammation of the tendon. Treatment generally lasts 5-10 minutes in 6-8 sessions, depending on the severity of the Achilles tendonitis. It will only be recommended if conservative treatment is no longer effective in treating the tendon.
- Extracorporeal Shockwave Therapy (ESWT) - This is another non-invasive therapy that involves using shock waves to treat injured soft tissue to reduce pain and promote healing. Treatment generally lasts less than 30 minutes. ESWT will only be advised if conservative approaches are no longer effective in treating Achilles tendonitis.
- Surgical Repair - If non-surgical treatments are no longer effective, surgery may be considered. This is usually performed for more serious Achilles tendonitis that involves tendon and muscle tears.
How to Prepare for Your Achilles Tendonitis Surgery
Prior to your surgery, you should talk to your orthopaedic surgeon in Singapore about how you can best prepare. However, here is general recommendations on how you can prepare for your surgical treatment:
- Understand more about your procedure, including its benefits, risks, and possible options.
- The general rule is to not eat or drink after midnight the night before your surgery.
- You should also be transparent with your surgeon about your health condition.
- Make sure that you arrange an escort and transportation to help you get home from the clinic.
- And lastly, arrange your home and make it conducive for your recovery.
What Happens During Surgery for Achilles Tendonitis
The main goal of surgical treatment for Achilles tendonitis is to repair the rupture or tear in the Achilles tendon. Depending on the severity of your condition, your orthopaedic surgeon in Singapore may need to remove the ruptured portion and repair your tendon by stitching it back together. In severe cases, your surgeon may suggest removing the affected tendon and grafting a tendon from another part of your foot. On the other hand, a small injury will likely only require minimally invasive surgery with a few small incisions and stitches.
Recovery Period for Achilles Tendonitis Surgery
Individuals who opt for surgery usually have a lower risk of injuring their tendon again. Surgery for Achilles tendonitis will usually take only a few hours and rarely requires hospitalisation. Nonetheless, full recovery from surgery will take anywhere from 10 months to a year or more. You will experience pain, discomfort and swelling around the surgery site in the days following your procedure. Using crutches for the first few months will help keep the weight of your foot as much as possible. You may also need to wear a cast or a protective boot. Your orthopaedic specialist in Singapore may also recommend that you get physiotherapy for your post-surgery treatment.
Possible Risks of Achilles Tendonitis
If your Achilles tendon does not get the treatment it needs, it may eventually progress to the degeneration of your tendon, making it lose its anatomic structure. As a result, it may develop into tendon tears. In some severe cases, the degeneration of your tendon may result in its complete rupture. Therefore, if you’re experiencing symptoms of Achilles tendonitis, have it checked by an orthopaedic specialist in Singapore as soon as possible.
Why Choose OrthofootMD to Provide Treatment for Your Achilles Tendonitis?
If you’re experiencing symptoms of Achilles tendonitis, OrthofootMD, an orthopaedic clinic in Singapore, is here to help. We know that every case of Achilles tendonitis is unique. That’s why we provide you with personalised treatment plans that will be tailored to your needs. Whether your case requires conservative treatment or surgical treatment, we make sure to deliver suitable health solutions for your specific condition. Furthermore, our specialist will work closely with you to prevent the possibility of re-injury so that you can maintain your independence and quality of life in the long run.
About Dr Gowreeson - Foot & Ankle Surgeon
Dr. Gowreeson Thevendran is an orthopaedic specialist and sports injury doctor in Singapore with experience in minimally invasive surgical treatments for foot and ankle injuries, including Achilles tendonitis. He completed his fellowship training at the University of British Columbia, Vancouver, Canada, in foot and ankle surgery. He also completed his fellowship training in sports surgery at the Chelsea & Westminster Hospital London, UK. Dr. Gowreeson has published numerous scientific articles on orthopaedics and continuously promotes the improvement of patient care in orthopaedic post-graduate education.
We Accept Medical Insurance
OrthofootMD is on the panel of different health insurance plans. Our clinic in Singapore also accepts Medisave. To know if our Achilles tendonitis treatments are covered by your insurance, kindly talk to our staff.
Get Your Achilles Tendonitis Treatment in Singapore
Achilles tendonitis can make everyday activities like walking extremely uncomfortable and painful. If you are experiencing severe pain or disability, it is advised to book an appointment with an orthopaedic specialist immediately to rule out the possibility of a rupture or tear of your tendon. OrthofootMD can also treat other musculoskeletal conditions, providing shoulder tendon pain treatment, metatarsalgia surgery, and more. Talk to our orthopaedic specialist today, and we’ll gladly work with you on your road to recovery.
Dr Gowreeson Thevendran
MBChB (Bristol), MRCS.Ed, Dip. Sports Med.Ed, FRCS.Ed ( Trauma & Ortho. ), FAMS (Singapore)
- Orthopaedics and Trauma Surgery
- English, Malay, Tamil
- Bachelor of Medicine and Surgery, University of Bristol, England
- Fellow of the Royal College of Surgeons, Edinburgh
- Diplomate Faculty of Sports and Exercise Medicine, Royal College of Surgeons Edinburgh
- Fellow of the Academy of Medicine, Singapore
- SICOT PIONEER Founders Award 2020
- 2015 European Foot & Ankle Society ‘Best Podium Presentation’ Award
- 2013 Singapore Orthopaedic Association Junior Travelling Fellowship
- 2012 NHG Critical Talent Special Recognition Award
- 1998 Enid Lindt Prize in Clinical Surgery
- 1995 Public Services Department Full Medical scholarship
Frequently Asked Questions About Achilles Tendonitis Treatment in Singapore
Achilles tendonitis can affect people of all ages and genders. Nonetheless, some factors make you more susceptible to Achilles tendonitis. These factors include age, sex, weight, fitness level and side effects of other medical treatments:
- Achilles tendonitis is most prevalent among people in their 30s – 40s
- Males are up to 5 times more susceptible to Achilles tendonitis than females
- People who participate in recreational or professional sports are at higher risk due to rigorous use of the Achilles tendon in sporting activities
- People who have previously received some form of steroid injection in the foot, like the ankle joint, may experience weakened Achilles tendons
- Obesity also puts excess weight on the Achilles tendons
Dr Gowreeson Thevendran is currently an orthopaedic surgeon with Island Orthopaedic, a one-stop care centre for orthopaedic health under Healthway Medical Group. He specialises in treating lower limb orthopaedic conditions, as well as trauma and fracture surgery of both the upper and lower limbs. Prior to establishing his private practice, Dr Gowreeson was Chief of Foot & Ankle Surgery at the Department of Orthopaedics at Tan Tock Seng Hospital (TTSH). Today, he continues to serve the Orthopaedic Department at TTSH as a visiting consultant.