Background – Achilles tendon

The myth of Achilles, his invulnerability, and the vulnerable Achilles heel

We can’t say which of the many documented mythologies surrounding Achilles that emerged in the fifth century CE are genuine; we’ll leave that to the historians.

Control of adaptive capacity and forecasting (05.10.2020)

35% of Achilles tendon injuries arise during or because of exercise-related stress

On the other hand, the incidence of Achilles tendon vulnerability is well-recorded in scientific analysis with 2.35 of a every thousand patients tendon showing Achilles tendon injury in a study on 57,725 patients at medical offices and practices. Achilles tendon injury had arisen during or because of exercise-related stress in 35% of these patients. Of these, 52.3% were women and 47.7% men at a mean age of 43.5 (7–85) having had symptoms for three months on average before their first medical consultation. (de Jonge, 2011) .  Around 65% of the injuries affected the central third of the tendon.

Importance of high quality imaging

Classifying of the degree of injury to the tendon can be challenging as to the factors involved – classification of symptoms; palpation revealing tenderness, thickening or gaps in continuity; medical examination; and classification using MRI or ultrasound. Imaging quality from MRI and ultrasound – especially vascular activity showing signs of injury or tissue pressure measurement – has led to new approaches towards assessing the degree of injury and indications for treatment.

Course of tendon control: By means of «elastography», a stress test of the tendon tissue (shown on tension) can be performed to assess the load capacity.

Eccentric training of the Achilles tendon in tensile load and relieved

Long periods of suffering and chronification

Classical methods of treating Achilles tendon tenderness include anti-inflammatory drugs, stretching or what is referred to as eccentric exercise, and topical ointments and bandaging. A special shoe may be prescribed to relieve pressure to a torn tendon by keeping the foot in the equinus position depending on the severity of a partial or complete tear; surgery may also be indicated.

Whichever way, a torn tendon usually involves long periods of suffering and chronification, sometimes leading to the patient abandoning a beloved sports or leisure activity or even experiencing restrictions in everyday life.

Targeted measures are successful

One UK study supposedly demonstrating the ineffectiveness of PRP treatment on the Achilles tendon saw untargeted treatment measures performed on tissue damage assumed from palpation without ultrasound to specify a target site for treatment. We on the other hand have seen treatment lead to successful and positive outcomes using targeted therapeutic measures.

Intervention image with needle 13.01.2021, further activation of the healing process without puncture of the tendon fibers.

3 month follow-up after treatments with visualization of the tendon as a connected unit

Wrong comparison

Unfortunately, the topic was also addressed by the Puls health programme broadcast by Swiss channel SRF and insufficiently researched at the time this study was published: The professor quoted and presented in the programme had performed his research as an argument against the use of platelet-rich plasma (concentrate of the blood coagulation factors) using autologous blood. This technique involves injecting whole blood into a muscle, possibly enriched with oxygen or drugs, to boost the immune system in people with skin disorders and allergies. The result is a false and invalid comparison between two methods with misleading findings. We find it regrettable that this well-researched and scientifically proven procedure has been discredited in such a nonchalant fashion.

Orthobiological treatment involves low risk and highly regenerative capabilities

Treatment targeting the damaged structures in the Achilles tendon – the tendon itself, the supply tissue (Kager’s fat pad) and pathological neovascularisation – is able to the tendon’s nutritional supply and resilience to normal. Repair processes may also be reinforced and accelerated. This orthobiological treatment involves low risk and highly regenerative capabilities. After thorough diagnostics, we are usually able to advise our patients at consultation with an excellent prognosis.

Also worth reading «myPRP – One unlucky step too far»

Our myPRP series shares stories from our patients on their very personal experiences with biosignalled healing. We’re fully aware that we can’t take this for granted and would like to thank you very much for your openness.