Treatment Options for Achilles Tendon Injuries

In this video we discuss Achilles tendon injuries and the progressive treatments available at UFAI.

 

The best and most effective time to treat any Achilles problem is when the injury or symptoms are new. During that time, your body is still actively trying to fix the problem (tendonitis) instead of after the injury has lingered and your body has accepted this as your new norm (tendinosis).


There are a number of non-invasive conservative treatments that we typically attempt for both new and lingering injuries (with the exception of severe Achilles tears, which we will discuss later). These treatments are effective over 90% of time when the injury is still fresh.

Conservative Achilles Tendon Injury Treatments

Achilles tendonitis often responds well to conservative treatments as long as it’s properly diagnosed and treated promptly. Surgery is rarely prescribed and reserved for chronic or severe cases or if the Achilles has ruptured. Conservative treatment options include:

Physical Therapy

Physical therapy is used to correct irregular walking patterns through muscle training. It is also successful decreasing pain and increasing flexibility in the tendon.

 

Temporarily Modify Activity

High impact activities such as running put much too much stress on the Achilles tendon and should be replaced with low impact sports, including swimming, biking and elliptical exercise.

 

Custom Molded Orthotics

Orthotics are inserted into your shoes and are made just for your individual feet. Once placed inside your shoe, these inserts work as shock absorbers to painful areas while improving balance and correcting foot alignment.

 

 

Minimally Invasive Treatment Options

As stated earlier, conservative treatment is effective more than 90% of the time, however, there are instances where a more aggressive option is necessary. These “minimally invasive treatments”, which do not require surgery, include:

 

Platelet Rich Plasma (PRP)

PRP injections are used to treat both Achilles tendonitis and Achilles tendinosis. PRP is an in-office procedure where we use your use growth factors in your own blood to facilitate an inflammation process in the injured tissue that increases the healing response.

 

Topaz Radiofrequency Energy Therapy

In cases with continued scar formation, Topaz radiofrequency energy therapy may be used to break up the scar tissue and bring new blood to the area. This basically changes the chronic problem (tendinosis) back to a new and acute problem (tendinitis) that can be healed in a controlled environment. After a Topaz treatment, you will be placed in a boot and be on crutches for a several weeks.

 

Tenex for Achilles Tendinosis

A new technique called Tenex has also shown great benefits in Achilles tendinosis cases. A microscopic incision is made and the scar tissue and damaged tendon are broken up and extracted by the Tenex probe. This changes the environment of the tendinosis, from one of poor circulation with scar tissue to good circulation and healthy tissue, which can then heal itself. A boot is usually used for about 2 weeks.

 

Surgical Treatment Options for an Achilles Tendon Injury

The most important thing to remember is Achilles tendonitis surgery is rare.

 

In a small number of cases, however, the calf muscle is found to be very tight and as the Achilles gets stretched, it gets irritated and swollen. It may then be necessary pain to perform a lengthening of the calf muscle to decrease stress on the Achilles tendon.


Achilles Tendonosis Surgery

Though not common, Achilles tendonosis surgery is sometimes needed. Tendonosis, by its very nature, causes a lot of micro-traumas to the Achilles tendon over time, resulting in scar tissue. The outcome is a thickened, damaged and scarred tendon, which can be enlarged and very painful. In this instance, the tendon needs to be cleaned up and scar tissue removed surgically to allow the Achilles tendon to heal and function properly.


Foot and Heel Spurs May Require Surgery

To relieve the tension and stress that the Achilles tendon is placing on the area of the heel spur surgery can be the right choice. The key to a good outcome of heel spur removal is a solid reattachment of the Achilles tendon and complete removal of scar tissue and bone spurs. This is done by splitting the Achilles tendon in the center, cleaning up all scar tissue and reattaching the Achilles tendon to the bone with solid anchors.


Achilles Tendon Tears and Ruptures Usually Require Surgery

Because the tendon ends are fully torn and the Achilles does not function it often requires surgery due to the gapping of the tendon ends and lack of proper tension in the tendon. During surgery, the torn ends of the Achilles tendon are brought together. It is rare to have to augment the repair of the Achilles as then tendon can be pulled together fairly easily. But, If the injury has been left untreated long enough and the ends cannot be united, a donated cadaver leg muscle is placed into the heel at the attachment point of the Achilles tendon to help with Achilles strength.

 

Browse our before and after pictures of Achilles tendon surgeries.

 

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