Achilles Tendonitis

Achilles tendonitis is a condition characterised by inflammation of the Achilles tendon, which connects the calf muscles to the heel bone. It is common among athletes and people who engage in activities that place significant stress on the tendon. Achilles tendonitis can cause pain, stiffness, and swelling, impacting daily activities and athletic performance.

Experiencing pain, stiffness, or swelling in your achilles tendon area? Consult our achilles tendon specialist today for an accurate diagnosis & personalised treatment plan.

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Dr Dennis Ng Zhaowen
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Causes of Achilles Tendonitis

Achilles tendonitis can result from a variety of factors, primarily related to overuse and strain on the Achilles tendon. Common causes include:

  • Overuse Frequent, intense physical activities such as running, jumping, and rapid directional changes can lead to overuse of the Achilles tendon. This is particularly common in athletes who increase their activity level suddenly without adequate preparation or conditioning.
  • Wearing Improper Footwear Wearing shoes that do not provide adequate support or cushioning can place additional stress on the Achilles tendon. High heels and poorly fitting shoes are common culprits.
  • Sudden Increase in Activity Level A rapid increase in physical activity, intensity, or duration without proper conditioning can overload the Achilles tendon. This is often seen in people who start a new exercise regimen or significantly ramp up their training.
  • Inadequate Stretching and Warm-Up Failing to properly stretch and warm up before engaging in physical activities can lead to tight calf muscles, increasing the strain on the Achilles tendon and contributing to the development of tendonitis.

Symptoms of Achilles Tendonitis

Achilles tendonitis presents with a range of symptoms that can vary in intensity. Recognising these symptoms early can help in seeking timely medical intervention. Common symptoms include:

  • Pain
    Pain is typically experienced along the back of the leg near the heel. The pain may start as a mild ache and gradually worsen with activity. It is often more severe after prolonged periods of inactivity, such as first thing in the morning.
  • Stiffness
    Stiffness in the Achilles tendon, especially in the morning or after periods of rest, is a common symptom. The stiffness usually improves with mild activity or stretching.
  • Difficulty Walking
    Severe pain and stiffness can make walking difficult. Activities that involve pushing off the foot, such as climbing stairs or running, may become particularly challenging.
  • Tenderness
    Tenderness to the touch along the Achilles tendon, particularly when pressed, is a frequent symptom. This tenderness may extend from the heel to several inches above the heel.
  • Swelling
    Inflammation can cause swelling along the Achilles tendon. The area may feel warm to the touch and appear visibly swollen.

Diagnosis of Achilles Tendonitis

Diagnosing Achilles tendonitis involves a combination of a thorough medical history, physical examination, and imaging studies. The following steps are typically taken to confirm the diagnosis:

Medical History

The doctor will begin by taking a detailed medical history, asking about the onset of symptoms, activity levels, recent changes in physical activity, and any previous injuries to the Achilles tendon or calf muscles.

Physical Examination

During the physical examination, the doctor will inspect the affected area for signs of swelling, tenderness, and thickening of the tendon. They will also assess the range of motion and strength of the ankle and calf muscles. Specific tests, such as the Thompson test, may be performed to evaluate the integrity of the Achilles tendon.

Imaging Studies

Imaging studies are often used to confirm the diagnosis and assess the extent of the injury. Common imaging techniques include:

  • Ultrasound: Ultrasound imaging uses sound waves to create detailed images of the Achilles tendon. It is useful for detecting inflammation, tears, and degenerative changes in the tendon.
  • Magnetic Resonance Imaging (MRI): MRI provides detailed images of the Achilles tendon and surrounding structures. It is particularly helpful in identifying the severity of the tendonitis, including the presence of partial or complete tears.

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Treatment Options for Achilles Tendonitis

Treatment for Achilles tendonitis aims to reduce pain, inflammation, and promote healing of the affected tendon. The treatment approach can be conservative or, in severe cases, surgical. Here are the common treatment options:

Non-Surgical Treatment Options

Below are some of the most commonly recommended non-surgical treatment options for Achilles tendonitis:

  • Rest and Activity Modification: Resting the affected leg and reducing activities that exacerbate the pain, such as running or jumping, are crucial initial steps. Gradually reintroducing activities and avoiding sudden increases in intensity can prevent further strain on the tendon.
  • Ice Therapy: Applying ice packs to the affected area for 15-20 minutes several times a day can help reduce inflammation and alleviate pain. Ice should be wrapped in a cloth to avoid direct contact with the skin.
  • Medications: Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, can help manage pain and reduce inflammation. These medications should be used as directed by a doctor.
  • Orthotics: Custom orthotic devices or shoe inserts can provide better support and alignment for the feet, reducing strain on the Achilles tendon. Heel lifts can also help decrease tension on the tendon.
  • Physiotherapy: A tailored exercise programme can be developed to strengthen the calf muscles and improve flexibility, which can aid in the recovery process. Stretching and eccentric exercises are particularly beneficial.
  • Supportive Footwear or Braces: Wearing supportive footwear or braces can help reduce stress on the Achilles tendon during activities. These aids can provide additional stability and support, facilitating the healing process.
Surgical Treatment Options

Surgery is considered when conservative treatments fail to provide relief or if there is a significant tear in the tendon. Surgical options include:

Debridement

This procedure involves removing damaged tissue from the Achilles tendon, which can help reduce pain and improve function. The goal is to excise the unhealthy portions of the tendon to promote healing and restore normal function.

Tendon Repair

For severe tears, the doctor may need to repair the tendon by stitching the torn ends together or using a graft to reinforce the tendon. Grafts can be taken from other parts of the body or be synthetic. This procedure aims to restore the tendon’s integrity and strength, allowing for better movement and less pain.

Prevention of Achilles Tendonitis

Preventing Achilles tendonitis involves adopting habits and practices that reduce the risk of overuse and strain on the Achilles tendon. Here are some strategies to help prevent this condition:

  • Proper Footwear - Wearing shoes that provide adequate support, cushioning and fit well can reduce stress on the Achilles tendon. Avoid high heels and shoes that are worn out or lack proper arch support.
  • Gradual Increase in Activity - It is important to start a new exercise regimen or gradually increase the intensity of physical activities. Sudden increases in activity levels can overload the Achilles tendon.
  • Regular Stretching and Strengthening - To maintain flexibility, incorporate regular stretching exercises for the calf muscles and Achilles tendon. Strengthening exercises, particularly eccentric exercises, can help build resilience in the tendon.
  • Warm-Up and Cool-Down - Always perform a thorough warm-up before engaging in physical activities and a cool-down afterwards. This helps prepare the muscles and tendons for activity and reduces the risk of injury.
  • Cross-Training - Engage in a variety of physical activities to avoid repetitive strain on the Achilles tendon. Cross-training with low-impact exercises, such as swimming or cycling, can provide a balanced workout and reduce the risk of overuse injuries.
  • Proper Technique - Ensure that sports and exercise techniques are performed correctly. Poor form can place additional strain on the Achilles tendon and increase the risk of injury.
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Our Patients' Feedback

Learn what our patients have to say about our treatments and services.

Jeremy Teo
Jeremy Teo
2024-05-16
I tore my left pec muscle after a bench press accident and had the fortune of getting help from Dr Dennis. He is a very caring and helpful individual that you can tell wants the best healing progress for you and actively follows up with you sincerely. I initially had a two month delay and misdiagnosis at Ktph and it caused my tendon to retract. Should have went to Dr Dennis from the start.. 5/5
Emily Loo
Emily Loo
2024-05-16
I felt that doctor Dennis is very experienced and he skilfully aligned my fractured toe after my accident so that I didn’t need to do a minor surgery. He was friendly and professional and I felt his fees were reasonable without additional overselling of tests, supplements etc. that I have experienced elsewhere. Overall it was a smooth and effective experience and I would highly recommend doctor Dennis.
Ming W
Ming W
2024-04-20
Wonderful experience with Dr. Dennis and his team. The staff were attentive and efficient. Dr. Dennis is professional, caring and knowledgeable. I had a shoulder injury and knee injury that required surgery. The whole journey, including pre and post surgery, Dr. Dennis and his team made sure I received the best treatment possible. Really thankful for the team and I definitely will recommend this place to others.
Jermy Tan
Jermy Tan
2024-04-02
Saw Dr Dennis for my lumbar slipped disc. Great doctor and he explained clearly the different options available. Went with surgery and have been recovering well since then.
Amanda Seah
Amanda Seah
2024-03-02
I came in with a shoulder injury that meds from a GP did not relieve one month ago. Dr Dennis and his team were great in diagnosing the exact injury with an mri, and he prescribed physio. My shoulder condition has greatly improved and I can now move my arm almost completely! Thank you Dr Dennis!
Jaslyn HENG (Kenrick)
Jaslyn HENG (Kenrick)
2024-02-19
A very friendly and nice doctor who manage to cure my elbow issue whjch has been bothering me for more than 6 months! Thank you Doctor Dennis!
Xianmin Jiang
Xianmin Jiang
2024-02-07
I had severe left shoulder pain due to exercise. After MRI checking , it was shown high-grade tendon tearing. Dr Dennis did the surgery for my left should calf repair. After surgery, I strictly follow what he suggested. The recovery was really amazing and fast. I was curious about what happened to my shoulder, he explained in details and with great patience. Now, I am fully recovered in a very fast speed and come back to my loved sports and exercises. I definitely recommend Dr Dennis for his profession, patience and delicate skills. Last not the least, thank for his medical team. The nurses are always prompt to reply when I need help and message them.
Omar Lechuga
Omar Lechuga
2023-12-27
Dr. Dennis helped me with an elbow pinch coming from a trauma. His attention to detail confidence and great empathy really helped me to fully recover. Thank you Dr. Dennis.
Benjamin Mah
Benjamin Mah
2023-12-09
Dr Dennis has been helpful in the diagnosis and explanation of my injury

Dr Dennis Ng Zhaowen
Mount Elizabeth Novena Specialist Centre
38 Irrawaddy Road #08-41,Singapore 329563

Dr Dennis Ng Zhaowen

  • Senior Consultant Orthopaedic Specialist
MBBS (Singapore)
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MRCSEd
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MMED
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FRCSEdOrth (Gold Medal Award)

Before private practice, Dr Dennis Ng was the former Deputy Head of the Shoulder & Elbow Division and Sports Knee Division in National University Hospital.

He completed his fellowship at the prestigious Fowler Kennedy Sports Medicine Centre in London, Ontario, Canada, and has rich experience treating professional athletes and returning them to sports. 

His special areas of interests include management of sports injuries such as ankle sprains, ligament and ATFL tears, achilles tendinitis etc.

 

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    Mount Elizabeth Novena Specialist Centre

    38 Irrawaddy Road #08-41
    Singapore 329563

    Monday – Friday: 9am – 1pm; 2pm – 5pm
    Saturday: 9am – 1pm
    Sunday & PH: CLOSED

    Other Clinic Location

    Gleneagles Medical Center

    6 Napier Road #07-15
    Singapore 258499

    Monday – Friday: 9am – 1pm; 2pm – 5pm
    Saturday: 9am – 1pm
    Sunday & PH: CLOSED

    Frequently Asked Questions (FAQs)

    How can Achilles tendonitis be prevented?

    Preventative measures include wearing proper footwear, gradually increasing activity levels, regular stretching and strengthening exercises, proper warm-up and cool-down routines, cross-training, maintaining proper technique, listening to your body, and maintaining a healthy weight.

    When should I seek medical attention for Achilles tendonitis?

    Seek medical attention if you experience persistent pain, significant swelling and stiffness, difficulty walking, an audible popping sound, limited range of motion, no improvement with conservative treatments, or recurring symptoms.

    Can Achilles tendonitis lead to complications?

    Yes, if left untreated, Achilles tendonitis can lead to more severe complications, such as tendon ruptures, which may require surgical intervention.

    Is Achilles tendonitis the same as Achilles tendinosis?

    No, Achilles tendonitis refers to inflammation of the tendon, often due to acute injury or overuse. Achilles tendinosis involves degeneration of the tendon tissue, typically resulting from chronic overuse.

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