Sports Medicine | PRP for Achilles Tendon Injury
The achilles tendon is the largest tendon in the body that connects the calf muscle to the heel bone and helps you perform activities like walking, running, and jumping. Although it can withstand stress due to running or jumping, sometimes it is prone to development of tiny tears due to overuse or great amounts of repetitive stress.
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Some patients have poor blood circulation to the achilles tendon. With poor blood supply and repetitive stress on the tendon, it’s very difficult for these tiny tears to heal. It can lead to thickening and weakening of the tendon that can be very painful. This condition is defined as Achilles tendinosis.
Middle-aged adults, athletes, and the elderly are likely to get this kind of injury. Achilles tendinosis is seen in approximately 6-18% of athletes. Playing sports such as basketball, soccer, and racket sports (tennis) can contribute to the cause of this condition. Dancers and gymnasts are also prone to developing this condition. Running produces forces up to eight times the bodies weight, which places significant repetitive stress on the tendon. Over time, the achilles tendon may become weak and can develop tiny tears which potentially could lead to rupture of the tendon.
Achilles Tendinosis Causes
As stated earlier, Achilles tendinosis is most often caused by overuse or repeated movement on the tendon which may occur during sports, work, or other activities. Tiny tears of the tendon can also develop while exercising, particularly if you practice for long periods of time. Because of this constant strenuous movement, these tears may not be able to heal quickly or completely.
Certain activities at work and at home can also put stress on the Achilles tendon, which makes it more of a risk to develop this injury. If you are overweight, you are more likely to develop Achilles tendinosis as the tendon has to bear the weight of your body. If high cholesterol runs in your family, you are at a risk of developing Achilles tendinosis.
Achilles Tendinosis Symptoms
You may experience mild to severe pain around the ankle or up the leg. You may notice swelling around the ankle area as well. There may be a sense of weakness of the tendon when you try to push off with the affected foot while walking.
Achilles Tendinosis Diagnosis
Your doctor will ask you certain questions on your condition. He/she will do an examination of the back of your leg. He may be able to feel the thickening of the tendon with his fingers. If your symptoms are severe, your doctor may want you to get an X-ray, ultrasound scan, or MRI. Generally other investigations are not required and he can diagnose it based on clinical symptoms and history of the condition.
Achilles Tendinosis Complications
Xanthoma (skin condition in which fat builds up below the skin) can develop in the Achilles tendon in patients with high cholesterol.
Achilles Tendinosis Treatment
As always, initial treatment lies in conservative approach. Rest should be given to the leg by not exercising or performing sports. Over-the-counter pain medications can be taken to alleviate the pain. You may need to wear well-cushioned shoes and change the way you play sports so that you reduce stress on the tendon. The earlier the treatment is given, the better the chance of healing.
Even mild cases of achilles tendinosis can take weeks to months of rest for the tendon to repair itself. Patients need to give enough time for the injury to heal and not be in a hurry to rush back to sports and activities that stress the tendon.
Your physiotherapist may ask you to perform certain exercises which can help the lower leg get strong and flexible again.
Your doctor may suggest that you wear a night brace to keep your foot flexed, if your Achilles tendon shortens and stiffens while you sleep. If you continue to have pain or stiffness, your doctor may prescribe a walking boot or similar device for 4 to 6 weeks to keep your lower leg and foot from moving, thus allowing your tendon to heal.
Treatment for severe problems such as a larger tear or rupture may include surgery or any device that keeps the lower leg from moving.
You cannot smoke during the treatment period as smoking slows healing by decreasing blood supply and delaying tissue repair.
If you have other medical conditions like diabetes or heart disease that raises the risk associated with surgery, then your doctor may prescribe modalities of treatment other than surgery.
Generally treatment for Achilles tendinosis takes time, but most people can return to sports and other activities.
PRP for Achilles Tendonitis / Tendinosis
PRP (platelet rich plasma) is a breakthrough therapy that professional athletes, weekend warriors and regular men and women alike are turning to to heal painful injuries naturally and more quickly than traditional treatment methods. PRP is a procedure that is quickly becoming mainstream primarily because of the seemingly miraculous results it has yielded for world class athletes. The medical industry is taking thing a bit slower. They continue to study the therapy.
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There are still some in the medical community who aren’t yet ready to crown PRP as the next big medical breakthrough. However, many major athletes swear by the treatment. The athletes who have undergone PRP therapy with great success reads like a who’s who of the sports world. Tiger Woods, Hines Ward, Troy Polamalu and Alex Rodriguez are just a few of the athletes who have sung the praises of PRP therapy.
Platelet rich plasma therapy is very simple but effective. It involves the use of the body’s platelets to speed up the healing and recovery process. The platelets are taken from a small amount of the patient’s blood.
After a patient’s blood is drawn, it is placed in a centrifuge where the platelets are separated from the rest of the blood’s components. The highly concentrated platelets are then injected in the injured area of the body. Studies have shown that platelets do indeed speed up the healing process because of the growth factors they contain.
Achilles tendonitis/tendinosis is an injury that responds well to PRP therapy as some studies have exploited. The condition is one that is difficult to treat and difficult for a sufferer to deal with. It is an injury that can take months to heal, even if the injury is a minor one. PRP therapy can be helpful in speeding up the healing process. When platelets are injected directly into the Achilles tendon the growth factors they contain help it to heal. Growth factors are badly needed because of the lack of inflammatory response characteristic of tendinosis. Platelets help increase the amount of growth factors in the injured area, which promotes healing.
A doctor may decide to use PRP rather than traditional treatment methods when a patient isn’t responding to conservative treatment. A PRP doctor treating an individual that needs to quickly recover from their injury may suggest that they undergo PRP therapy for achilles.
On average, PRP therapy costs between $500 and $1000 per injection. Most insurance plans will not cover PRP because it considered be semi-experimental. Therefore, those individuals interested in undergoing a treatment or series of injections will have to pay for it themselves.
PRP Injection Protocol and Procedures
FAQ about PRP Treatment for Achilles
1. Is PRP completely natural?
Yes, PRP is a completely natural treatment. It uses platelets taken from the patient’s own blood and injects them directly into the site of the injury.
2. How can PRP heal my Achilles tendinosis?
PRP can help heal a person’s Achilles tendionsis largely because of the high concentration of growth factors contained in the platelets, which help to speed up the healing process.
3.How long will my recovery take if I use PRP?
There is no way to determine definitively how long a person’s Achilles tendon will take to heal. While PRP has the potential to speed up the process, there are no set timetables. The therapy, has however, helped numerous people return from injuries faster than they would have otherwise. Some clinical studies have reported success rates of up to 93% when using PRP to treat Achilles tendinosis.
Achilles Tendinosis Prevention
Most Achilles tendinosis injuries occur during sports and can be prevented. You can gradually warm up your body before exercise by doing 5 to 10 minutes of walking or biking. You may also do exercises that stretch the tendon. After intense exercise, gradually cool down with about 5 minutes of easy jogging, walking, or stretching. Wear shoes that cushion your heel during sports or any strenuous activity. You may also try wearing heel pads or other orthotics that are designed to reduce stress on the Achilles tendon.
Questions your physician may ask you about Achilles Tendinosis
- When did you develop this pain?
- Do you have stiffness in your leg when you get up in the morning?
- Are you able to walk comfortably?
- Did you try giving rest to your leg?
- Did you try any other treatment like medicines or physiotherapy?
- What is your occupation?
- Are you involved in sports? If yes, what kind of sports?
- Do you have any other illness?
- Do you regularly exercise? If yes, what kind of exercise?
