While the achilles tendon is the strongest and thickest tendon in the body, it also encounters a lot of stress on a daily basis, as well as during athletic activities that involve running, jumping, or sudden changes in direction. This makes the achilles tendon fairly susceptible to injuries in both high-performance athletes and regular people.
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Types of Achilles Tendon Injuries
There are two main types of achilles tendon injuries. Tendonitis, which is due to overuse or damage of the achilles tendon or a rupture which is complete or partial break in your tendon.
Tendonitis causes pain down the back of your leg and around your heel area.It can also lead to thickening and calcification of the tendon. There are two kinds of tendonitis, categorised by the location of the injury. If the fibres of the middle portion of the tendon are torn, then it is diagnosed as noninsertional achilles tendonitis. If the lower part of the tendon is injured then it is known as insertional achilles tendonitis. Both types of tendonitis can occur separately or together.
If the tears in your achilles tendon fibres cause a complete or a partial tear in your tendon, you might hear a pop or experience a popping sensation along with a sudden sharp pain. A tendon rupture requires immediate medical attention.
Risk Factors For Achilles Tendon Injuries
Athletic Activities
Athletes who engage in sports where there is repetitive strain put on their achilles tendon are at higher risk for achilles tendon injuries. A change in competitive or training schedule, playing surface, or intensity of activities can also create a sudden increase in strain to the achilles tendon resulting in a higher chance for tendon injury.
Tight Or Weak Calf Muscles
If you don’t warm up adequately before exercising, your calf muscles may be tight and you may end up overstretching it during your activity. Weak and untrained calf muscles can also cause similar issues. Overstretching your calf muscle can result in soft tissue damage to your achilles tendon.
Bone Spurs
Bone spurs can develop on almost any bone including the heel. Bone spurs on the heel can rub against the tendon, leading to long-term damage.
Wearing Improper Footwear
Wearing the wrong shoes during exercise or other activities can cause injury to your achilles tendon in Singapore. Shoes which don’t support your foot fully, or don’t allow your tendon to fully extend, can over time make your achilles tendon more vulnerable to overstretching and tearing.
Treatments For Achilles Tendon Injuries
RICE
Rest, Ice, Compression, and Elevation is a good at-home treatment protocol for minor strains to the achilles tendon. It reduces swelling and decreases blood flow to the area to decrease inflammation and promote healing.
Physical Therapy
Physical therapy can support achilles tendonitis patients by reducing pain in the heel and restoring strength, flexibility, and mobility to the injured tendon.
Orthotics
Orthotics can be used in combination with other treatment methods for achilles tendon issues. They reduce the load on the achilles tendon and improve recovery timelines.
Night Splinting
Night splints are braces worn on the legs which stretch the achilles tendon at the back of the heel and prevent it from contracting. They have to be worn at night while you sleep to provide a constant stretch to your achilles tendon and enhance healing. They are a conservative but effective long term achilles tendonitis treatment in Singapore.
Platelet Rich Plasma Injections
Platelet Rich Plasma (PRP) Injections are done by taking some of the patient’s blood and spinning it to separate out the different layers. The plasma layer, which contains a high concentration of platelets is then drawn and injected into the injury site of the achilles tendon. These platelets can release growth factors which promote healing.
Extracorporeal Shock Wave Therapy
Extracorporeal Shock Wave Therapy is a non-invasive treatment procedure for achilles tendonitis. It involves delivering low energy sound waves to the affected area to increase blood flow and speed up healing.
Surgery
For more severe achilles tendon injuries, surgery may be the recommended way forward for recovery. Minimally invasive achilles tendon surgery to repair ruptured tendons decrease the risk of complications as compared to traditional surgery. It allows for very strong repair while limiting exposure of the tendon and permits a faster timeline to return to normal activities.
Debridement surgery is an option for patients with achilles tendinopathy that has not responded to non-surgical treatment methods. It involves surgically removing damaged tendon tissue or bone spurs. The remaining tendon is then repaired with sutures or stitches.
A gastrocnemius recession can be used to help patients with chronic achilles tendonitis by lengthening the muscles and tendons at the back of the leg. This in turn allows the foot to flex properly into a more natural position.
As an experienced Orthopaedic Surgeon with experience in reconstructive foot and ankle surgery, Dr Kannan Kaliyaperumal offers a wide range of services and treatments at the Specialist Orthopaedic Centre in Singapore. Contact us today to set up an appointment with our clinic and our support team will get back to you.
