Achilles tendinosis or tendonitis
There are two variants of the condition: mid-portion Achilles tendinopathy and calcaneal attachment tendinopathy. The pressure of the shoe edge often also plays a role in the condition of the attachment to the heel.
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What happens in the tendon
In tendinopathy, the structure of the tendon is damaged by continuous loading and microtrauma, in combination with incomplete recovery. This negative balance is the cause of the degeneration. If this process is too advanced, the tendon can become vulnerable to further injury, such as rupture.
Treatment with prolotherapy
To interrupt this process and make the tendon stronger again, we treat the Achilles tendon with prolotherapy. These are local injections of glucose, which stimulate the body's own healing capacity. After a series of treatments, the aim is for the tendon to recover sufficiently to reduce complaints and reduce vulnerability to further injury.
Other treatments
Anti-inflammatories in tablet form (ibuprofen, diclofenac, naproxen) can mask the pain in some cases, but do not lead to a cure. Nowadays, an injection with an anti-inflammatory agent is almost never given for this condition.
One of the most commonly used treatments is eccentric stretching exercises for mid-portion tendinosis. You can do this independently or have it taught by a physiotherapist.
Recognizable symptoms
- Pain in the Achilles tendon when running
- A swelling of the Achilles tendon
- Pain in the middle of the tendon or at the attachment to the heel
- Pain due to the pressure of the shoe edge on the heel
Scientific references (3)
- Sanderson LM, Bryant A. Effectiveness and safety of prolotherapy injections for management of lower limb tendinopathy and fasciopathy: a systematic review.Journal of Foot and Ankle Research. 2015;8:57. doi:10.1186/s13047-015-0114-5.
- Maxwell NJ, Ryan MB, Taunton JE, Gillies JH, Wong AD. Sonographically guidedintratendinous injection of hyperosmolar dextrose to treat chronic tendinosis ofthe Achilles tendon: a pilot study. AJR Am J Roentgenol. 2007 Oct;189(4):W215-20.PubMed PMID: 17885034.
- Ryan M, Wong A, Taunton J. Favorable outcomes after sonographically guidedintratendinous injection of hyperosmolar dextrose for chronic insertional andmidportion achilles tendinosis. AJR Am J Roentgenol. 2010 Apr;194(4):1047-53.doi: 10.2214/AJR.09.3255. PubMed PMID: 20308509.
