Achilles Tendon Tears

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Overview

The Achilles tendon, the strongest tendon in the body, connects the calf muscles and the heel bones. Without the Achilles tendon, performing simple activities including walking, running or jumping becomes quite the challenge. While the Achilles tendon may be strong, it is susceptible to injuries such as an Achilles tendon tear. When an Achilles tendon tear occurs, the tendon may tear completely or partially. Anyone can sustain such injuries, especially individuals who actively participate in recreational sports. An Achilles tendon tear is typically indicated by a pop sound, followed by an immediate sharp pain at the back of your ankle or lower leg.

Symptoms

As mentioned above, the first instance of Achilles tendon tear starts with a pop, followed by a sharp pain down the ankle. Acute tendon tears are very noticeable with a gap felt at the back of the heel and an inability to bear weight fully on the ankle. Patients may present with swelling and bruising around the area of injury. 

Delaying Achilles tendonitis treatment in Singapore could eventually lead to other symptoms including swelling and pain near the heel, tenderness where the tendon is torn and inability to stand on the toes of the injured leg. These are considered chronic Achilles tendon tears and will result in a limp and chronic pain. This can hinder a patient’s everyday lifestyle and may be particularly detrimental to professional athletes, negatively impacting their sports performance. Should you experience any of these signs, it is highly recommended to visit a healthcare professional immediately to get the treatment you require.

Causes

The primary cause of Achilles tendon tears lies in sudden movements that result in an increase in the stress being exerted on the Achilles tendon. Certain sports involving sudden stops, starts and pivots such as soccer and basketball can increase the risk of Achilles tendon tears. Though Achilles tendon tears in Singapore are often associated with sports, they can be caused by other accidents as well including missing a step while walking down the stairs, falling into a ditch or from a height. There are also certain medications like steroid injections that may weaken the Achilles tendon, thus, increasing the likelihood of sustaining Achilles tendon tears. Periodic activities like cycling and running also lead to chronic Achilles tendon tears known as microtears. Lack of proper stretching and warm-ups can lead to contraction of the tendon and predispose it to a full tear when sudden force is applied to the tendon.

Risk Factors

Apart from sports, another lifestyle element that is a risk factor for Achilles tendon tears is obesity. This is because the excess weight puts more strain on the Achilles tendon. When there is greater pressure on the Achilles tendon, it is more predisposed to tearing. While some causes of Achilles tendon tears can be controlled by making certain lifestyle changes, uncontrolled risk factors include age and gender. Individuals between 30 to 40 years of age are at greater risk and men are 5 times more likely to experience Achilles tendon tears compared to women.

Prevention

Prevention is always better than cure and while Achilles tendon tears may not be completely preventable, there are things you can do to reduce your risk of this injury. For one, start by stretching and strengthening your calf muscles. Since the Achilles tendon connects calf muscles and heel bone, building up a strong calf should not be overlooked. It can help the Achilles tendon absorb greater force and minimise injuries. The best way to stretch your calf muscle is to stand near a wall with one foot in front of the other. Use your hands to lean against the wall, bend your front knee and keep your back leg straight. Continue stretching till you feel a pull and remain in position for 20 to 30 seconds.

 Another way to reduce your risk of Achilles tendon tears is to adopt good exercising habits. Rather than going full force into the sports activity you are engaged in, slowly increase training intensity, so that your tendon gets used to the pace and rate. Remember to wear the appropriate workout wear from shoes with proper cushioning to well-fitting athletic attire and always avoid running on slippery surfaces if possible. You can also vary your exercises and focus on other sports that do not place excessive stress on your Achilles tendons including brisk walking, biking or swimming.

Treatment

 

When it comes to Achilles tendon tears, there are many treatment options from surgical to non-surgical methods. In milder cases, where there is a partial tear of the tendon, your doctor may recommend a brace or walking cast. This is usually done after an MRI scan to determine the extent of the partial tear and to determine the immobilisation protocol. This will help keep your foot and ankle flex downward, keeping them in place so that the Achilles tendon can heal effectively. Following a period of immobilisation, the patient is started on physical therapy. During physical therapy, your physiotherapist or doctor will chalk up exercises and offer insight and advice tailored to your condition. This not only helps to alleviate symptoms but may also aid in minimising the risk of recurrence.

More commonly, an Achilles tendon is completely torn and will require surgical treatment. The surgery involves stitching the torn tendon ends back together. The latest modality of surgical repair is by way of percutaneous incisions using jigs and sutures that bring the tendon ends together. If the tendon has degenerated, the damaged tendon may be removed while the healthy tendon ends are stitched.

Ultimately, the type of treatment you receive depends on your condition and the advice of your doctor. It is ideal to get a healthcare professional’s opinion and expertise on suitable Achilles tendonitis treatment in Singapore.