Sports and exercise medicine is a discipline that deals with many different sports related injuries from the weekend warrior to the avid athlete. Clinicians who specialize in this category apply their expertise in order to get you better, faster!

Many injuries can happen to individuals who take part in physical fitness routines and sports, it takes a thorough understanding of how to treat these injuries. Sports and exercise medicine specialists, orthopedic surgeons, physiatrists, chiropractors, physical therapists, and athletic trainers are all instrumental in developing treatment plans for the patient to heal.  At Performance Rehabilitation & Regenerative Medicine we take an integrated collaborative approach in management and treatment of sports related injuries.

A common injury in individuals is Achilles tendinitis. The Achilles tendon is a strong thick ligament located at the base of the calf muscle and attaches to the heel. You may have erunners kneesxperienced pain in this area, which is commonly referred to as Achilles tendonitis.   This is a common overuse injury commonly 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. Overtime 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 injur
y 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 worsens throughout the day especially with prolonged walking and or standing.

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 some often difficult to identify without further testing, can also cause irritation. The issues that can predispose us to Achilles tendinitis may include bone spurs and 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 also put added stress on the tendon, making the tendon susceptible to injury.

Conventional Treatments

Achilles tendon injuries typically respond very well to the conservative non surgical treatment options available at Performance Rehabilitation & Regenerative Medicine. 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 from high power intensity 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.

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 TX™ therapy is now available at Performance Rehabilitation  & Integrated Medicine to treat this chronic injury for patients who do not respond to conservative treatment.   Designed by the MayoClinic, Tenex Health TX™ 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 Tenex Health TX™ procedure includes very quick pain relief, local anesthetic, and no sutures or stitches.

If you, or someone you know, are suffering from chronic heel pain, or would like more information on non-surgical options available, please feel free to contact one of our patient care coordinators at 908-754-1960 or you may contact us online.

Performance Rehabilitation & Regenerative Medicine – Getting Patients Better – Faster!

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 & Regenerative 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 & Regenerative Medicine.