Understanding Achilles Tendonitis

There are two types of Achilles Tendonitis:

1. Insertional Achilles Tendonitis that affects the lower portion where the tendon attaches to the heel. This can occur at any age.
2. Non-Insertional Achilles Tendonitis that affects the middle part of the tendon. There is swelling and thickening in this area. This is most common among young active people.

In both types of Achilles tendonitis, hardening or calcification of the damaged tendon fibres can happen.

Achilles Tendonitis symptoms

The main Achilles Tendonitis symptoms are pain and swelling at the back of the heel.

If you experience any of the following symptoms, you should consult your doctor.

• Unable to bend the ankle
• Unable to walk comfortably on the affected side
• Ankle pain that happens at night or while you are resting
• Ankle pain that prolongs for a few days
• An injury that causes deformity around the joint
• Swelling of the calf
• Signs of infection (including fever, redness, warmth) on the affected side

Achilles Tendonitis risk factors

• More common in older people and in men.
• Additional weight in people who are overweight may increase the risk of tendon strain.
• Flat arches of the foot (physical trait) may increase the risk of more strain on the Achilles tendon.
• Bone spurs (bony growth) at the back of the heel can irritate the Achilles tendon, causing pain and swelling.
• Inadequate stretching or warming up before exercise leads to tight calf muscles that contribute to strained tendons.
• Repeated impact of jumping and landing in high-impact sports such as basketball or intensive activities such as running on hard surfaces can increase the risk of tendon strain or injury.
• Wearing shoes with poor support contributes to strained tendons.

Achilles Tendonitis diagnosis

Your doctor would first question your general health and symptoms before conducting a thorough physical examination.

Diagnosis is made based on your reported symptoms, physical examination, and investigations.

High-frequency sound waves are used in ultrasound to help create images of soft tissue such as the Achilles tendon.

Magnetic Resonance Imaging (MRI) scans provide detailed cross-sectional images of soft tissues so that your doctor can determine the extent of injury to the Achilles tendon.

Achilles Tendonitis treatment

Non-surgical treatments can alleviate pain for most people with Achilles tendonitis

1. Non-surgical treatment
   • Rest and avoid activities that may aggravate the pain.
   • Heat pads to relax muscles and stimulate blood flow. Ice packs to minimise swelling.
   • Nonsteroidal anti-inflammatory drugs (NSAIDs) to relieve pain.
   • Physiotherapy to increase strength and regain mobility.
   • Stretching to loosen the calf muscle.
   • Steroid injections to treat inflammation.
2. Surgical treatment

   Surgery is usually only offered for recurrent injuries and persistent pain. However, it may be needed if the tendon tears or there are loose ligaments. Achilles tendonitis may lead to Achilles tendon rupture. This condition usually causes sharp pain, and surgical repair is necessary.

Achilles Tendonitis prevention

There are no specific methods to prevent Achilles tendonitis, but you can minimise the risk.

• Daily stretches to help maintain flexibility and strengthen the calf muscles.
• Adequate stretching and warming up before strenuous exercise.
• Modify your schedule by alternating high-impact sports (running, basketball) with low-impact sports (swimming, cycling) to reduce strain on the Achilles tendon.
• Footwear should have good cushioning and arch support to reduce strain on the tendon.
• Use orthopaedic inserts such as arch supports in your shoes.

Make an appointment at Gleneagles Hospitals

If you are experiencing any of the symptoms of Achilles tendonitis, get in touch with us to find out more about our Orthopaedic Services at your nearest Gleneagles Hospital.

Gleneagles Hospital works with orthopaedic specialists to assist patients through diagnosis and treatment. The caring and multidisciplinary team of healthcare professionals are available for consultation and to provide the best care.