What is Achilles Tendonitis?

The Achilles tendon is the large tendon in the back of the ankle that connects the calf muscles to the heel bone. These muscles are essential for walking, running, and jumping. The Achilles Tendon withstands a great deal of stress during normal daily life.

Achilles Tendonitis occurs when the muscles and tendon are overused, causing irritation and inflammation of the tendon.

There are two types of Achilles Tendonitis:

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

Hardening (calcification) of the damaged tendon fibres can occur in both types of Achilles tendonitis.

What are the symptoms of Achilles Tendonitis?

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

You should consult your doctor if you experience the following:

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

What are the risk factors of Achilles Tendonitis?

Achilles Tendonitis is usually caused by continuous stress (a repetitive minor impact) on the affected area or from a sudden injury. Poor stretching or conditioning before exercise or playing sports also increases the risk.

Risk factors of developing Achilles Tendonitis include:

• Age & gender: More common in older people and in men.
• Overweight: Additional weight may increase the risk of tendon strain.
• Certain physical trait: For example, having flat arches place more strain on the Achilles tendon.
• Bone spurs (bony growth): These bony growths at the back of the heel can irritate the Achilles tendon, causing pain and swelling.
• Inadequate stretching or warming up before exercise: This leads to tight calf muscles that contribute to strained tendons.
• High-impact sports or intensive activities: Repeated impact of jumping and landing in sports such as basketball or running on hard surfaces can increase the risk of tendon strain or injury.
• Wearing worn-out shoes: Wearing shoes with poor support contributes to strained tendons.

How is Achilles Tendonitis diagnosed?

Diagnosis is made based on various investigations. Your doctor will first evaluate your medical history and symptoms before conducting a physical examination.

• Ultrasound: High-frequency sound waves are used in ultrasound to help create images of soft tissue such as the Achilles tendon.
• Magnetic Resonance Imaging (MRI) scan: MRI scans provide detailed cross-sectional images of soft tissues so that your doctor can determine the extent of injury to the Achilles tendon.

How is Achilles Tendonitis treated?

Treatment depends on the cause of the problem. You may be treated as follows:

• Heat pads to relax muscles and stimulate blood flow.
• Ice packs to minimise swelling.
• Non-steroidal anti-inflammatory drugs to treat pain.
• Physiotherapy to increase strength and regain mobility.
• Rest to treat inflammation.
• Steroid injections to treat inflammation.
• Stretching to loosen the calf muscle.

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.

How to prevent Achilles Tendonitis?

There are no specific methods to prevent Achilles Tendonitis. However, you can minimise the risk by practising the following:

• Do daily stretches to help maintain flexibility and strengthen the calf muscles.
• Ensure you have adequate stretching and warming up before strenuous exercise.
• Make gradual changes to the frequency and intensity of your activities. Practice moderation by alternating high-impact sports (e.g., running, basketball) with low-impact sports (e.g., swimming, cycling) to reduce strain on the Achilles tendon.
• Ensure your footwear has good cushioning and arch support to reduce strain on the tendon, or use orthopaedic inserts such as arch supports in your shoes.

Book an appointment at Pantai Hospitals

Early detection of Achilles Tendonitis makes it easier to treat the condition with effective and appropriate treatment. A dedicated and expert team of Orthopaedic specialists at Pantai Hospital is available for consultation to provide the best care and assistance. 

Get in touch with us to book an appointment today if you have concerns or questions regarding Achilles tendonitis. We assure you the best possible care tailored to your specific needs.

Pantai Hospital has been accredited by the Malaysian Society for Quality in Health (MSQH) for its commitment to patient safety and service quality.