03 Jan Causes and Management of Achilles Tendonitis
The Achilles tendons are the thick, fibrous tissue bands that connect the calve muscles in the lowers legs to the heel bones of the feet and are the largest tendons in the body. Inflammation of these tendons may occur due to overuse of the lower legs resulting in repetitive or intense strain on the Achilles tendons.
Individuals who are more likely to be affected include:
- Runners, dancers, and athletes who suddenly increase the duration or intensity of their activities.
- Those who perform physical activities and sports only over the weekends due to the tendon not being conditioned to its sudden use.
- Middle-aged individuals, especially men.
- Having flat feet or arches, being obese, or having tight calve muscles may increase the strain on the Achilles tendons.
- Training or performing physical activities in old, worn-out shoes.
- Running on hard or hill-type terrains.
- Working out in cold weather.
- Patients who are diagnosed with conditions such as hypertension and psoriasis.
- Those who use antibiotics such as the fluoroquinolones.
Signs and symptoms
- A mild ache that begins at the back of the leg or above the heel after being physically active.
- More severe pain may be experienced after prolonged activities such as sprinting, stair-climbing, and running.
- Stiffness or tenderness that comes on in the morning and which improves with mild activity.
Achilles tendonitis is managed conservatively with:
- Over-the-counter and prescription oral medications such as acetaminophen, non-steroidal anti-inflammatories such as ibuprofen or naproxen, narcotics such as codeine, or steroids to help reduce pain and inflammation.
- Physical therapy to perform stretching and strengthening exercises to promote healing and improving the strength of the Achilles tendon and its surrounding structures to offer support to the tendon.
- Orthotic devices such as shoe inserts or wedges to elevate the heel may be prescribed to help reduce the strain exerted on the Achilles tendon.
If these therapies haven’t been effective, or the patient ends up sustaining a ruptured tendon due to persistent inflammation and damage to the tissue, then surgical intervention may be warranted to repair the affected Achilles tendon.
Regenerative medicine in the form of stem cell therapy has been used in many individuals and athletes with Achilles tendinitis to help reduce the inflammation and damage that occurs in the tissue.
The process involves extracting stem cells from the affected individual themselves, to reduce any risk of tissue incompatibility issues that may cause adverse reactions. This is done by using tissue from the body such as:
- Bone marrow.
- Adipose tissue.
Adipose (fat) tissue is easier to extract though and also yields a higher concentration of stem cells than the bone marrow so this is the chosen method in most cases for extracting stem cells.
Once the stem cells have been extracted and prepared, they are directly administered around the affected Achilles tendon. The stem cells perform two activities to help reduce inflammation and speed up the repair of the tissue:
- Stem cells can convert into tissue cells that are necessary to take the place of the damaged tissue. In this case, the stem cells will convert into those that resemble the cells of the Achilles tendon.
- The stem cells stimulate the release of anti-inflammatory factors that travel to the affected area to reduce the inflammatory process that is taking place, thereby reducing damage to the Achilles tendon.