Achilles Tendinopathy

If calf or ankle pain is preventing you from getting on with life, then minimally invasive regenerative treatments could help you get back to doing the things you enjoy.

Achilles tendinopathy and tendinitis are a common overuse injury resulting in repetitive injury to the Achilles tendon, the band of tissue at the back of the lower leg which connects the calf to the heel bone. Achilles tendinopathy causes pain and stiffness to the back of the heel making it hard for you to move freely and to play sports. If the pain and stiffness are accompanied by swelling, this is referred to as Achilles tendinitis.

What treatments does The Regenerative Clinic offer?

Our renowned medical team provides a range of treatments, from the traditional to the innovative:

This is an effective and well-researched procedure that’s a potential alternative to surgery. It takes advantage of the blood’s natural healing properties to reduce pain and improve joint function. It uses a specially concentrated dosage of platelets prepared from your own blood to repair damaged cartilage, tendons, ligaments, muscle and bone. Patients usually see their symptoms improve in one to two weeks of having the injections. Read more clinical evidence supporting PRP here.

This treatment involves a selective filtration of your blood which harnesses Monocytes and their reparative properties for sporting injury and soft tissue damage. 

In the degenerated tendons, Monocytes contribute to the repair of the damage by promoting the release of enzymes that help remove the damaged parts and consequently help the formation of a new matrix to promote the healing of the tendon. They perform a similar function in muscle injuries and promote the repair of damaged muscle fibres as a result of injury. There is some evidence to show these cells reduce inflammation in joints and have a beneficial effect in inflammatory forms of arthritis. Read more.

This day case treatment is exclusively offered to our patients. It uses pioneering technology using your body’s own adipose (fat) cells to treat pain and inflammation with MFAT Injections. Injections using MFAT Injections are minimally invasive and are carried out under ultrasound guidance. Altogether the procedure takes about an hour to perform with a minimal recovery time. As well as being a potential alternative to surgery, MFAT Injections can also aid post-surgery recovery.

Bone Marrow Aspirate Concentrate (BMAC) is a non-surgical, minimally invasive, regenerative treatment that harnesses the natural ability to heal the body through the assistance of biological growth factors. BMAC utilises the regenerative stem cells collected from bone marrow to aid in the acceleration of healing moderate to severe osteoarthritis and tendon injuries. Read more here.

What causes Achilles tendinopathy & tendinitis?

Achilles tendinopathy commonly occurs in those who play racquet sports and football and also in runners who have suddenly increased the intensity or duration of their running. The incidence of Achilles tendinopathy has dramatically increased as a result of people leading a more active lifestyle.

However, age can also be a cause, because as you get older the Achilles tendon becomes less flexible and less able to cope with rigorous movement. In fact, up to a third of people who suffer from Achilles tendinopathy don’t play any sport at all.

Genetics, lifestyle and the overall state of your health can also be a cause of Achilles tendinopathy. For instance, it can occur in people who:

  • have a family history of the condition
  • have previously suffered from it
  • are overweight
  • have other medical conditions, particularly high cholesterol, high blood pressure, diabetes and arthritis
  • continually wear shoes that don’t fit properly or who regularly wear high heel shoes
  • have ‘flat feet’ or high-arched feet

If left untreated the Achilles tendon can deteriorate over time.

What are the symptoms of Achilles tendinopathy & tendinitis?

Symptoms you may experience with Achilles tendinopathy and tendinitis include:

  • pain and stiffness in the back of the ankle
  • a grating noise or a cracking feeling when you move the ankle
  • pain in the Achilles tendon first thing in the morning or after exercise
  • stiffness in the Achilles tendon after a prolonged period of sitting or first thing in the morning

If the heel or calf suddenly becomes sore, swollen or bruised you may have developed a tear in the tendon. If you hear a snapping noise, it could be you’ve ruptured the Achilles tendon and you should seek medical care straight away.

How is Achilles tendinopathy & tendinitis diagnosed?

If you are experiencing pain or stiffness in the back of the calf or in the ankle first thing in the morning or following exercise, a doctor will examine your leg, heel and ankle to determine what is causing this.  They may ask you to perform a series of movements to see how freely you can move your leg. In some cases, the doctor may refer you to have an: 

  • MRI – using a magnetic field and radio waves a detailed image of the Achilles tendon is created which can reveal subtle changes in the tendon
  • Ultrasound – sound waves are used to create an image of your Achilles tendon which can reveal any tears

What are the non-surgical options for Achilles tendinopathy & tendinitis?

Initial treatment may include medications such as analgesics which help reduce the pain, non-steroidal anti-inflammatory drugs – NSAIDS – which reduce the pain and inflammation and steroid injections which reduce inflammation and provide short-term relief.

Lifestyle modifications, such as losing weight can be used to relieve the symptoms of Achilles tendinopathy and tendinitis as this will reduce the strain on the tendon. You may be advised to restrict the amount of exercise you do and getting plenty of rest can help in the treatment of Achilles tendinopathy and tendinitis. You may still be able to exercise but your doctor may suggest some alternative exercises such as swimming which puts less strain on the Achilles tendon. 

Applying ice can help relieve the pain, particularly after exercise. If you do this, it’s important to place a cloth between the ice and your skin to prevent you from getting an ice-burn. 

You may be referred to a podiatrist who will study the way you walk and offer guidance on things to change. The podiatrist may recommend that you wear special shoe insoles to support the foot arch so that less strain is put on the tendon. 

A range of physiotherapy techniques can help with Achilles tendinopathy. These include performing resistance exercises every day to strengthen the tendon. They may advise you to wear ‘night splints’ which are used to hold your foot in a certain position while you sleep.

Our expert team specialises in treating tendinopathy using advanced non-surgical techniques including Platelet Rich Plasma (PRP) therapyAMPP® )Monocytes therapy and Activated Mesenchymal Pericyte Plasma (using Lipogems® technology.

What are the surgical options for Achilles tendinopathy & tendinitis?

In the majority of cases, surgery is not required. However, if improvement is not seen following several months of non-surgical treatment options, surgery may be needed. The surgery involves the removal of any damaged areas of tendon and repairing what is left using tissue which is taken from further up the Achilles tendon or from other tendons. 

While the surgery is a routine procedure, it will involve a period of rehabilitation afterward. 

Why have a consultation at The Regenerative Clinic?

Our innovative range of treatments goes beyond what’s available on the NHS. As well as providing a full opinion on your condition that includes all the traditional non-surgical and surgical options, our experienced consultants will also assess your suitability for our alternative biological therapies, Platelet Rich Plasma (PRP)Monocytes therapy and Activated Mesenchymal Pericyte Plasma (AMPP).

Who will my consultation be with?

Your consultation will be with one of our foot and ankle specialists, Mr. Nima Heidari and Mr. Nicholas Savva and it will last approximately 30 minutes. You may be asked to attend for an MRI scan, prior to your appointment. 

As well as undertaking an examination, our specialists will take details of your medical history and discuss your symptoms. They will also detail all your treatment options and cover their potential benefits and risks. 

Our expert team comprises of highly experienced surgeons, sports medicine doctors and physiotherapists who are committed to delivering a high level of care and the correct treatment option so you can quickly get back to moving around.

What is the autologus biological approach and when should it be considered?

Autologous translates as ‘from the same person.’ In brief, it involves using your own cells to encourage healing. The major benefits are that there is no chance of rejection, infection or contamination as you are using cells from your own body rather than a donor. 

We offer a range therapies based on this principle which can be considered if traditional treatments including surgery aren’t relieving your pain. 

Clinical evidence

Biological treatments are pioneering procedures and we’re continuously monitoring and recording its effectiveness. Patients undertaking these treatments are asked to complete pre-operative and post-operative questionnaires. 

The information obtained from these questionnaires allows us to monitor your progress and it also contributes to our evidence-based database and other global studies on biological treatments. All information gathered is anonymised. 

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