For New York City patients dealing with Achilles tendonitis, doctors at Gotham Footcare can help. Miguel Cunha, DPM, and the team of phycisians can work with patients to determine the underlying cause of the discomfort and craft a personalized treatment plan. Patients can visit the two convenient locations in Midtown and Downtown Manhattan, New York.
Achilles tendonitis is inflammation along the Achilles tendon. The Achilles tendon is the largest tendon in the body and is, therefore, susceptible to overuse injuries from running and jumping type exercises. It is responsible for plantarflexion of the ankle (causing the front of the foot to lower and lift the heel off the ground).
Achilles Tendonitis is usually due to excessive repetitive stress to the tendon. Typically, this condition is not related to a specific injury but rather due to over exertion of the Achilles tendon in specific situations including:
At Gotham Footcare, your doctor will conduct a thorough physical exam of your foot and ankle. Your doctor will determine the location of your pain, tenderness or swelling, and evaluate the flexibility, alignment, range of motion, and reflexes of your foot and ankle.
Your doctor may order one or more of the following tests to assess your condition:
X-rays. Our in-office digital X-ray system will provide your doctor with clear images of your foot bones. Radiographic evaluation can demonstrate whether the lower part of your Achilles tendon has calcified, or become hardened, indicating insertional Achilles tendinitis.
Ultrasound: This in-office device uses sound waves to visualize soft tissues like tendons. Ultrasound can also produce real-time images of the Achilles tendon in motion, which may allow for visualization of inter-tendinous tearing and inflammation of the tendon.
Magnetic resonance imaging (MRI): An MRI may be prescribed if further evaluation is warranted. An MRI uses radio waves and a very strong magnet to produce more detailed images of the Achilles tendon.
Most cases of Achilles Tendonitis can be treated conservatively with nonsurgical treatments, although it may take several months for symptoms to completely subside. This involves a number of modalities including:
Gotham Footcare prides itself on offering the latest minimally invasive surgical treatments. Two of the latest and most effective surgical management techniques are Tenex and Platelet Rich Plasma (PRP) or Amniotic Injections.
Platelet Rich Plasma PRP is derived from a patient’s own blood, which has been processed to concentrate the platelets. These concentrated platelets contain powerful growth factors that can jumpstart the healing of injured tendons and ligaments by stimulating tissue repair and regeneration. This procedure is done in conjunction with Tenex to maximize healing and repair of the Achilles Tendon.
Tenex is a minimally invasive procedure to identify and remove the pain generating scar tissue from the foot, which can occur due to various musculoskeletal conditions such as plantar fasciitis and achilles tendonitis.
The Tenex procedure involves the following steps:
1. A local anesthetic is given to numb the affected area
2. Ultrasound imaging identifies precisely the location of damaged scar tissue within the tendon
3. A small incision is made to allow the TX1 Tissue Removal System to go in and break up the damaged scar tissue with the use of high-frequency vibrations, while not affecting the surrounding healthy tissue.
4. The Tenex system gently removes the broken up scar tissue and an adhesive bandage is used to close the incision
Recovery time is significantly reduced from several months (with traditional surgery) to only one to two weeks with the Tenex procedure. Most patients can begin light weight-bearing exercises within two weeks.
· Chronic pain relief
· Faster recovery time
· Small incision
· No scarring
· No risks from complications of surgery or general anesthesia
· Enabling patients to return to vigorous activities
PRP injection therapy is a non-invasive treatment and uses your body’s own healing mechanism. Since it is involving your own blood, there are no risks or side effects. Studies have shown that PRP injection is very effective in healing Plantar Fasciitis and the effects are far superior then a cortisone injection because it delivers a month’s worth of blood nutrient supply in a day to promote fast healing to an area like the plantar fascia that usually has a limited amount of blood supply at its disposal.
The PRP Injection for Plantar Fasciitis procedure involves the following steps:
1. Draw blood from your arm and spin it in a centrifuge to extract PRP
2. The PRP is then directly injected into the plantar fascia with the help of Ultrasonic imagery.
3. A CAM (Controlled Ankle Movement) shoe is worn for two weeks to limit movement.
· No risks
· No side effects
· Effective for a year
· Non invasive
Amniotic stem cells are also used to aid in the repair of bone fractures, arthritis, and other conditions affecting the foot and ankle. The treatment is performed by injecting the afflicted area. For cases where there is a severe break, the injection will occur over a period of time.
The difference in stem cell treatment versus the traditional treatment with cortisone shots is that stem cell therapy treats the root cause of the condition, seeking to change the course of the condition and create healing. Cortisone shots only lessen the pain and do not have the ability to change the course of the actual condition.
The amniotic stem cell therapy can help patients avoid surgery and obtain pain relief with achilles tendonitis, ankle arthritis, difficult to heal wounds, plantar fasciitis and more. The results of this treatment are amazing. In most cases, within two weeks there is a marked improvement in skin condition.
In an effort to minimize out-of-pocket expense, we participate with most managed care plans and insurance providers. For any questions regarding insurance, please contact our offices.
"Dr. Cunha is kind, takes the time to answer all my questions, and helps me find alternative solutions when my insurance doesn't cover what he first suggests."
"The staff was extremely friendly their positive vibes were contagious! Dr. Cunha was great, he took his time to answer all of my questions."
"Dr. Cunha truly cares for the well-being of his patients. He is extremely professional and knowledgeable."
"Dr. Cunha was attentive, accommodating, and willing to answer any and all questions I had through my recovery process. I would highly recommend Gotham Footcare."
"All of the staff are super friendly, energetic and efficient. Dr. Cunha is attentive and finds solutions quickly, offering more than one option for treatment."
"Dr. Cunha is knowledgeable, personable and really cares about his patients. His staff is wonderful; They are always friendly and helpful."