Written by Dr Gowreeson Thevendran, MBChB (Bristol), MRCS.Ed, Dip. Sports Med.Ed, FRCS.Ed (Trauma & Ortho. ), FAMS (Singapore)
What is Achilles Tendonitis?
Achilles tendonitis is an overuse injury causing pain and swelling in the Achilles tendon, the body's largest tendon that connects the calf muscles to the heel bone. It is essential for running, jumping, and standing on your tiptoes. Athletes frequently experience this condition due to repetitive strain, but it can also arise from regular wear and tear over time.
The condition is categorised into two types: non-insertional, affecting the midsection of the tendon, and insertional, impacting the lower part where the tendon attaches to the heel bone. Both types result from overuse, leading to the tendon's inflammation and degeneration.
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
Immediate Self-Care for Achilles Tendonitis
For those experiencing Achilles tendonitis, the initial approach should include Rest, Ice, Compression, and Elevation (RICE). It is crucial to pause exercise or any activities that might aggravate the condition for several days. To manage pain and swelling, apply an ice pack to the affected area. Wraps or compressive elastic bandages can also be effective in reducing swelling. Moreover, elevating the foot above heart level, particularly while sleeping, can aid in decreasing inflammation. Following these steps can offer significant relief and prevent further strain on the Achilles tendon.
Causes of Achilles Tendonitis
Achilles tendonitis stems from repetitive stress on the tendon, often due to a sudden increase in physical activity without adequate conditioning. Tight calf muscles can impose additional strain on the tendon at its heel bone insertion point. Haglund's deformity, an enlargement of the heel bone, may also irritate and inflame the tendon. If you're encountering these risk factors or experiencing symptoms of Achilles tendonitis, seeking medical assistance promptly in Singapore is advised to receive timely treatment and avert more serious injuries.
Diagnosing Achilles Tendonitis
Diagnosing Achilles tendonitis begins with a detailed review of your medical history and a physical examination. An orthopaedic specialist will inquire about your athletic activities, symptoms, and any past treatments. During the physical exam, the specialist may observe your walk to assess gait abnormalities and palpate the tendon for swelling or irregularities. Your calf muscles, which connect to the Achilles tendon, will also be evaluated.
For a more in-depth analysis, imaging tests such as X-rays or MRI scans may be performed. These tests provide a clear image of the Achilles tendon structure and help to exclude other potential causes of pain, such as bone fractures.
Achilles Tendonitis Treatment
The treatment for Achilles tendonitis varies according to the severity of the tendon condition. The orthopaedic specialist may suggest conservative treatments or other therapies to facilitate healing. Here's a breakdown:
- Physical Therapy - Tailored exercise programmes will be provided to strengthen the Achilles tendon and its supporting structures. Special devices such as orthotics, which correct foot alignment, or walking boots, which lessen tendon load, may be recommended, especially for more serious injuries.
- Extracorporeal Magnetic Transduction Therapy (EMTT) - For persistent pain and inflammation unresponsive to conservative measures, EMTT offers a non-invasive solution using magnetic pulses. Sessions last about 5-10 minutes over 6-8 appointments, depending on the condition's severity.
- Extracorporeal Shockwave Therapy (ESWT) - Another non-surgical option, ESWT, applies shock waves to the injured tissue to alleviate pain and encourage healing, usually in under 30 minutes per treatment. It's an option when traditional methods haven't provided relief.
- Surgical Repair - Surgery is considered when non-surgical approaches fail to improve the condition, particularly for severe cases involving tears in the tendon and muscle.
Recovery Period for Achilles Tendonitis
The recovery time for Achilles tendonitis varies, often depending on the severity of the condition and the treatment approach. For non-surgical treatment, patients may start to see improvement within a few weeks. However, complete recovery could take several months, especially if the tendonitis is more severe.
Patients undergoing surgery generally face a longer recovery period. Post-operative healing can range from 10 months to over a year. Initial weeks post-surgery often involve managing pain and swelling, with the use of crutches to avoid putting weight on the foot. Wearing a cast or protective boot is also common during this period.
Dr. Gowreeson Thevendran
Orthopaedic and Trauma Surgery Specialist in Singapore with 15+ Years Experience
Dr. Gowreeson Thevendran is a fellowship-trained orthopaedic surgeon specialising in minimally invasive techniques for the foot, ankle, knee, hip, and thigh, as well as in trauma and fracture surgery. With his extensive training from the UK to Canada, he is a leader in both the operating room and global orthopaedic education.
Why Do Patients Choose Dr. Gowreeson Thevendran?
Fellowship-trained in foot & ankle surgery, sports surgery, and complex trauma.
Fluent in English, Malay, and Tamil, allowing for diverse patient communication.
Expertise in minimally invasive surgical techniques.
Specialises in comprehensive lower limb orthopaedics and trauma surgery.
Recipient of multiple awards, including the SICOT PIONEER Founders Award.
Chair of the Education Academy of SICOT, enhancing global orthopaedic education.
Introduced Magnezix bioabsorbable screws in Singapore, leading advancements in surgical materials.
Renowned for his scientific contributions and roles as an international faculty member.
Committed to detailed aftercare plans for long-term patient recovery.
Part of Healthway Medical Group, offering convenience and excellence in orthopaedic treatment.
Frequently Asked Questions about Achilles Tendinitis Treatment in Singapore
Achilles tendonitis can affect people of all ages and genders. Some factors, however, may make you more susceptible. These 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
The best way to reduce the risk of developing Achilles Tendonitis is to know your body’s limits. Warming up your muscles through stretches and strengthening exercises before a workout is essential. When in doubt, it is better to rest than to overexert yourself. Remember to wear appropriate and well-fitting footwear with enough cushioning and support for your sporting activities.
Achilles tendonitis often develops after a rigorous increase in activity. If you are training professionally, it is important to slowly scale up the intensity of your exercises over a period of weeks. Try to alternate between high-impact sports and activities that are less strenuous on your Achilles tendon.
OrthofootMD is associated with various health insurance plans and accepts Medisave for treatment costs in Singapore. Coverage for Achilles tendinitis treatments can vary among different insurance policies. To determine if your specific plan covers our services, we encourage you to speak with our staff. They can assist in verifying your eligibility and provide detailed information about the extent of coverage offered by your insurance and Medisave.
Like knee replacements, Achilles tendinitis surgery has potential risks and complications. These may include infection at the surgical site, bleeding, nerve damage, and reactions to anaesthesia. Post-operative risks include the possibility of blood clots, prolonged swelling, and difficulty regaining full strength and mobility in the affected area. In some cases, there may be a need for additional surgery if the initial procedure doesn't yield the expected results or if complications arise.
It's crucial to discuss these potential risks thoroughly with your surgeon to make an informed decision about the procedure. Following post-operative care instructions carefully and attending all follow-up appointments are vital steps in minimising these risks and ensuring a successful recovery.
Clinic Location
OrthofootMD@Novena
- Mount Elizabeth Novena
38 Irrawaddy Road #05-42 Mount Elizabeth Novena Specialist Centre Singapore 329563
OrthofootMD@Mount Alvernia Hospital
- (Mount Alvernia Hospital)
820 Thomson Road #01-01/02 Mount Alvernia Medical Centre A Singapore 574623
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.