Achilles Tendinopathy

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Achilles tendinitis is an overuse injury of the Achilles tendon, the band of tissue that connects calf muscles at the back of the lower leg to your heel bone.

Achilles tendinitis most commonly occurs in runners who have suddenly increased the intensity or duration of their runs. It's also common in middle-aged people who play sports, such as tennis or basketball, only on the weekends.

Symptoms

The pain associated with Achilles tendinitis typically begins as a mild ache in the back of the leg or above the heel after running or other sports activity. Episodes of more-severe pain may occur after prolonged running, stair climbing, or sprinting.

Risk factors

A number of factors may increase your risk of Achilles tendinitis, including:

• Your sex. Achilles tendinitis occurs most commonly in men.
• Age. Achilles tendinitis is more common as you age.
• Physical problems. A naturally flat arch in your foot can put more strain on the Achilles tendon. Obesity and tight calf muscles also can increase tendon strain.
• Training choices. Running in worn-out shoes can increase your risk of Achilles tendinitis. Tendon pain occurs more frequently in cold weather than in warm weather, and running on hilly terrain also can predispose you to Achilles injury.
• Medical conditions. People who have psoriasis or high blood pressure are at higher risk of developing Achilles tendinitis.
• Medications. Certain types of antibiotics, called fluoroquinolones, have been associated with higher rates of Achilles tendinitis.

Complications

Achilles tendinitis can weaken the tendon, making it more vulnerable to a tear (rupture) — a painful injury that usually requires surgical repair.

MINIMALLY INVASIVE TREATMENT

• Platelet-rich plasma injection

PRP THERAPY

Platelet-rich plasma is a form of regenerative medicine. It uses injections of your own blood platelets to help with healing.

What Is Platelet-Rich Plasma?

Platelets, or thrombocytes, are a type of blood cell. Their main function is clotting blood. They’re produced in your bone marrow. Platelets contain growth factors. These are proteins that may be helpful in healing injuries.

How Does Platelet-Rich Plasma Work?

A healthcare professional will collect a small amount of your blood (approx. 15-20 ml only). They will place your blood into a centrifuge. This spins your blood at different speeds until it separates into different layers. One layer is the platelet-rich plasma. This layer of plasma may have as much as three-four times more platelets than regular blood.‌

The platelet-rich plasma will then be injected into your affected area. We will first numb the area with a local anesthetic. The pain at the site may increase for the first 1-2 days. It could take 1 week before you feel any improvement.‌

After your treatment, we will recommend you to:

• Avoid taking non-steroidal anti-inflammatory medications ( NSAIDs) after your treatment as this may block the effect
• Avoid activities that put stress on the area of treatment for a few days

Is Platelet-Rich Plasma Treatment Effective?

The effectiveness of platelet-rich plasma treatment depends on several factors, including:

• Your overall health
• Whether your injury is chronic (it developed over time) or acute (sudden and serious)
• Which part of your body needs treatment
• The preparation of the platelet-rich plasma treatment

Many clinical trials have supported its use.

Some studies have found that platelet-rich plasma injections significantly reduced pain compared to placebos. People’s physical function also improved significantly. These benefits continued at 3, 6, and 12-month follow-ups.

There’s no chance of an allergy or immune reaction to platelet-rich plasma treatment because the plasma is taken from your own blood. Side effects and complications are rare

What does the procedure involve?

The doctor will clean the area over the joint and insert a small needle into the fluid-filled area around the joint bones under imaging guidance. When it is in the correct position, they will inject the PRP into the joint. They will remove the needle and cover the injection site with a small dressing.

Why Not (Contraindication)?

Occasionally it is difficult to inject much medicine into the joint space, especially if the joint is extremely swollen. If this is the case, other medicines may be prescribed to reduce the swelling before the injections are tried again.

What you are to do before the procedure (Preparation)?

1. Book a prior appointment if elective or get admission in causality if the emergency
2. Lab investigation (*PT/INR, CBC), XRAY, CT/MRI scan, and previous records.
3. 2-3 Hours fasting.
4. If you are on a blood thinner like Aspirin, inform us during the appointment.
5. One accompanying person
6. Need to sign a consent form for the procedure

Approx. Stay in the hospital?

We have a very fast and competent working team (Consultant, fellow, clinical assistant, technician, and ward assistant) which provides you with a comfortable atmosphere and eases your nerves. The usual time of stay is around a few hours.

Complications

Every procedure carries a risk, although this is extremely small. The risk of infection with this procedure is extremely small as no incisions are made in the skin.

Resume working?

You can resume your work after 1 day if the existing disease allows.