Achilles Tendinitis Treatment and Prevention

The Achilles tendon is the largest tendon in the human body. It is prone to injuries due to the limited blood supply it receives and the forces it is subjected to in our everyday activities. Achilles tendinitis is an inflammation of the Achilles tendon. It can happen to anyone but is more prevalent in males and in the elderly.

Achilles Tendinitis in Singapore

Achilles tendinitis is common in Singapore. The number of Singaporeans who may develop Achilles tendinitis increases as the population continues to age. Sedentary lifestyles, obesity, and physical inactivity can also contribute to the risk of developing Achilles Tendinitis.

What is Achilles Tendinitis?

Achilles tendinitis is an injury to the Achilles tendon, typically the result of overuse. It is mostly seen in runners who have suddenly increased the intensity or duration of their run, putting sudden extra strain on the Achilles tendon. It is also common among people who participate in sports on an irregular basis.

Symptoms of Achilles Tendinitis

Swelling, irritation and inflammation occurs when you have Achilles tendinitis. Symptoms of Achilles tendinitis include:

Pain in your heel
Pain in your ankle
Swelling in the area where pain is experienced
Discomfort in the back of your heel
Stiffness and soreness in the Achilles tendon
Weakness in one or both legs

If left untreated, symptoms of pain may worsen and become severe.

Risk Factors for Achilles Tendinitis

Achilles tendinitis is a common sports injury. Risk factors for Achilles tendinitis include:

Participating in sports or physical activities involving quick starts and stops.
Running or dancing
Occupations that put stress on your feet and ankles, usually involving hard labour.
Participating in sports on an irregular basis, which results in the body being less accustomed to stress.
Tight or weak calf muscles
Bone spur
Flat arches

Complications of Achilles Tendinitis

Achilles tendinitis is rarely severe and can go away on its own after 2 or 3 months. However, Achilles tendinitis can be associated with a rupturing of the Achilles tendon, a medical emergency which may require specialist treatment and possibly surgery.

Diagnosing Achilles Tendinitis

To diagnose Achilles tendinitis, your doctor or physiotherapist will conduct a physical examination. They will attempt to find out the location of pain, tenderness or swelling. Bone spurs will also be checked for. In addition, the flexibility, range of motion and reflexes of your foot and ankle will be assessed. They will also need to rule out the possibility of an Achilles tendon rupture.

In certain cases, in which a physical examination is insufficient, imaging tests, such as an X-ray, Ultrasound or MRI (Magnetic Resonance Imaging) will be required to accurately assess your condition.

Preventing Achilles Tendinitis

Achilles tendinitis is a common injury that can happen to anyone, making it difficult to avoid. However, there are some steps that you can take to reduce your risk:

Increase your physical activity level progressively

Allow your body to slowly get accustomed to the intensity of your activity. This is especially important if you are a beginner or have not exercised regularly for an extended period of time.

Pick shoes that fit

Shoes support your feet and are especially important when it comes to sports. Wearing a pair of shoes that fit you well can help you avoid unnecessary injuries, additional strains and relieve tension in your Achilles tendon.

Stretching

Improving the flexibility of your Achilles tendons can go a long way in preventing Achilles tendinitis.

Strengthen your calf muscles

Stronger calf muscles will help to reduce the strain put on your Achilles tendons as well as making them more resistant.

Warm up properly before exercising

This will help prevent injuries that could potentially weaken your Achilles tendons.

Treatment Methods for Achilles Tendinitis

Achilles tendinitis can generally be treated using nonsurgical methods. It may take a few months for the symptoms of pain to fully disappear. Treatment methods for Achilles tendinitis include:

RICE Method:

Rest. Give your injured tendons time to rest and recover. If you want to remain physically active, opting for low-impact activities that put less stress on your Achilles tendon should be considered.
Ice. Putting ice against your injured tendon for up to 20 minutes at a time can help with relieving pain.
Compression. Compressing, or putting pressure on the tendon using surgical tape or an athletic wrap can help support the injured tendon and aid the recovery process.
Elevation. Elevating your feet while lying down can help to reduce swelling.

Protecting your injured tendon

It is important to protect your injured tendon so as to ensure that the injury is not aggravated. In very severe cases, Achilles tendinitis can lead to the rupturing of the tendon, which will require surgery and a long period of recovery.

As much as possible, avoid straining the Achilles tendon. This can be done by avoiding walking up steep inclines that would put excess pressure on the tendons.
Supportive shoes, heel lifts and custom orthotics can help to protect your Achilles tendon. Avoid walking barefoot if possible.
Using a split at night to help your Achilles tendon remain stretched while sleeping can help aid recovery.

Physiotherapy for Achilles Tendinitis

Physiotherapy plays a crucial role in the management of Achilles tendinitis, offering a range of treatments aimed at reducing pain, inflammation, and improving tendon strength and flexibility. By addressing both the symptoms and underlying causes of Achilles tendinitis, physiotherapy helps individuals recover from injury, restore function, and prevent recurrence.

Manual Therapy and Exercises

Hands-on physiotherapy techniques such as a massage, myofascial release, and joint mobilisation can be used to reduce muscle tension, improve tissue flexibility, and enhance blood flow to the affected area.

Specific stretching exercises targeting the calf muscles and Achilles tendon can help to improve flexibility and reduce tension. Strengthening exercises for the calf muscles and intrinsic foot muscles can also be beneficial for improving tendon strength and stability.

Ultrasound Therapy

Ultrasound therapy can help alleviate pain associated with Achilles tendinitis by increasing blood flow and stimulating the release of endorphins, the body's natural pain-relieving chemicals. The deep heat generated by ultrasound therapy can help reduce inflammation in the Achilles tendon, promoting the resolution of swelling and discomfort. It may also accelerate tissue healing and improve flexibility.

Cold Therapy

Cold therapy may be applied to relieve pain and swelling.

TCM for Achilles Tendinitis

Traditional Chinese Medicine (TCM) offers a holistic approach to treating Achilles tendinitis, aiming to restore the body's balance through acupuncture, herbal medicine, cupping, and lifestyle adjustments. It addresses both symptoms and underlying causes for long-term relief.

TCM Acupuncture

Acupuncture involves the insertion of fine needles into specific acupuncture points along the meridians of the body to stimulate Qi (vital energy) flow and promote healing. Acupuncture can help reduce pain, inflammation, and improve blood circulation in the Achilles tendon area.

TCM Cupping

Cupping therapy involves placing cups on the skin to create suction, which helps increase blood flow, reduce muscle tension, and promote healing. Cupping therapy can be effective in relieving pain and inflammation associated with Achilles tendinitis, particularly when applied to acupuncture points and meridians related to the affected area.

Medication

Nonsteroidal anti-inflammatory drugs (NSAIDs) may be prescribed by your doctor to help you relieve symptoms of pain.

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