You could be suffering from something known as Achilles tendinitis.
Today we will take a look at a chronic, often times activity-limiting injury known as Achilles Tendonitis. Whether you are a weekend warrior or an avid athlete, you may have suffered from pain at or near the heel of your foot. This injury can be very challenging to treat as a physician and very frustrating for the patient. A new minimally invasive procedure developed at the Mayo Clinic to eliminate chronic tendon pain is now available at Performance Rehabilitation & Regenerative Medicine.
What is Achilles Tendinitis?
The Achilles tendon is a strong thick ligament located at the base of your calf muscle and attaches to your heel. You may have experienced pain in this area, which is commonly referred to as Achilles tendonitis. This is a common overuse injury seen in runners, and tennis players. Problems can arise when there is an increase in both intensity and duration of workouts. Court based sports is an area that can cause injury due to the constant, multi-directional movements required by the athlete. Over time small tears can occur in the tendon leading to both inflammation and scar tissue formation. Once scar tissue formation occurs this can lead to adhesions in the tendon decreasing the mobility of that tendon. Symptoms of this injury may include: pain and stiffness, along the tendon, into the back of the heel. Severe pain is sometimes noticed the day after an intense workout. In severe cases swelling may be visualized at the site of injury and often times worsens throughout the day especially with prolonged walking.
Causes of Achilles Tendinitis
Due to the overuse of the Achilles tendon, an exact mechanism is difficult to identify when an apparent trauma is not present. Physical exam, diagnostic ultrasound and x-ray imaging help make the clinical diagnosis. A majority of cases of Achilles tendinitis occur due to the repetitive overuse placed on the tendon. Problems arise when we begin pushing too hard through workouts, demanding too much, too soon from our bodies. Predisposing factors, although sometimes often difficult to identify without further testing, can also cause irritation. Some of the issues that can predispose us to Achilles tendinitis may include bone spurs or tight calf muscles. A bone spur often develops on a bone in our foot known as the calcaneus (heel) which can lead to irritation of the tendon. Tightness of the calf can put added stress on the tendon, making the tendon susceptible to injury.
Most injuries to the Achilles tendon respond well to conventional non-surgical treatments if appropriate action is taken. Due to the chronic nature of this condition, it may take several months for problems to resolve. Rest is the first step taken in order to reduce pain. Activity modification is a major factor when dealing with an Achilles tendon injury. This includes switching high power exercises to lower power intensities in order to reduce the demand on the tendon. Healthcare experts will often incorporate cross training, in order to prevent de-conditioning of individuals. Ice is also a great way to help recover from this injury.
At Performance Rehabilitation & Regenerative Medicine we incorporate state of the art vasopneumatic compression therapy (cryotherapy with compression) known as GameReady, to help decrease swelling. Typically Achilles tendon injuries respond very well to physical therapy. This helps to reduce the pain and inflammation initially, and once the early stages of the injury are taken care of, the physical therapist will help re-condition and strengthen the area. Getting you back to a healthy and active lifestyle. Patients who do not respond to conservative treatment may be a candidate for Tenex Health TX tm– a non-invasive procedure with excellent results.
Until now, medical management of chronic severe Achilles tendon injuries included non-steroidal anti inflammatory medications (NSAIDs) and cortisone injection therapy, which is a type of steroid designed to help control inflammation. However, due to the high risk of tendon rupture, cortisone is rarely used on these injuries. In Recent history, medical intervention has been somewhat limited for this injury, but state of the art Tenex Health Txtm therapy is now available to treat this chronic injury. Designed by the Mayo Clinic, Tenex Health TXtm therapy uses high frequency ultrasound to help remove damaged tendon tissue, helping you get back to living an active lifestyle. This procedure involves using ultrasound imaging, the same kind used to see babies in the womb,
allowing the physician to identify the location of the damaged tendon and scar tissue. The physician will make a micro incision at the injured site and then use the TX Microtip (which is the size of a tooth pick). The TX Microtip will then remove only damaged tissue using high frequency ultrasound. The advantages of the Tenex Health TXtm procedure include quick pain relief, rapid return to normal activities, local anesthetic instead of general anesthetia, no sutures or stitches and a short procedure time – just minutes, not hours.
Available at Performance Rehabilitation & Regenerative Medicine, Tenex Health TXtm therapy is the “next level” of interventional medical management for chronic tendon injuries. Since this procedure is not surgery, it can be performed in our office. Recovery time is short and this medical procedure is covered by most insurance. Tenex Health TXtm allows us to help get patients better, faster.
If you have any questions or would like to make an appointment, please feel free to contact one of our Patient Care Coordinators at 908-756-2424 or you may contact us online.
About the Authors:
Joseph Mejia D.O., F.A.A.P.M.& R, is a graduate of University of Michigan and West Virginia School of Osteopathic Medicine. He is Board Certified in Physical Medicine & Rehabilitation and Sports Medicine. Dr. Mejia received his Fellowship Training in Interventional Pain Management from University of Medicine and Dentistry. He has advanced training in Regenerative Medicine and is the Medical Director and Partner of Performance Rehabilitation & Integrated Medicine.
Vincent J. Diana D.C. is a graduate of New York Chiropractic College. He is a Board Certified Chiropractic Physician with licenses held in New Jersey and Pennsylvania. Dr. Diana is a Chiropractic Physician at Performance Rehabilitation & Integrated Medicine.