Achilles Tendonitis Specialist

Gotham Footcare

Podiatrists located in Downtown & Midtown, New York, NY

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 Q & A

What is Achilles Tendonitis? 

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).

What causes Achilles Tendonitis?

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:

  • Increasing the amount or intensity of physical activity too quickly
  • Wearing high heels (which can place stress on the tendon)
  • Having tight calf muscles
  • Running on hard surfaces such as concrete
  • Frequent jumping activities (such as in volleyball, basketball, dancing, football, baseball, tennis)
  • Using shoes with improper support
  • Formation of a bone spur-Extra bone growth where the Achilles tendon attaches to the heel bone which can rub against the tendon and cause pain.

What are the symptoms of Achilles Tendonitis?

  • A burning pain or stiffness along the lower leg above the heel in the morning especially when stretching your ankle or standing on your toes
  • Pain along the tendon or back of the heel that worsens with activity
  • Severe pain or swelling the day after exercising
  • Thickening of the tendon
  • Bone spur

How is Achilles Tendonitis diagnosed?

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.

What is the treatment for Achilles Tendonitis? 

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: 

  • Resting: The first step in reducing pain is to decrease the activities that aggravate one’s symptoms. Switching to low-impact activities until the acute inflammatory phase has passed will put less stress on the Achilles tendon.
  • Cross-training activities such as biking, elliptical exercise, and swimming are low-impact options to help you maintain being active.
    Icing. This can be done up to twenty minutes interval through the day as necessary.
  • Stretching exercises
  • Strengthening exercises with eccentric contractions of the Achilles.
  • Supportive shoes and Heel lifts
  • Custom-made orthotic devices, which are made at Gotham Footcare using a state of the art laser scanner.
  • Non-steroidal anti-inflammatory medications (NSAIDs): Drugs such as ibuprofen and naproxen reduce pain and swelling.
  • Physical therapy: At Gotham Footcare physical therapy modalities such as electrical stimulation, ultrasound, hydrotherapy, and shock-wave therapy will be administered to the Achilles tendon. These modalities are very effective in treating Achilles Tendonitis.

What happens if conservative treatment fails?

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

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.

How is the Tenex procedure performed?

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

How long does it take to recover from the Tenex procedure?

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. 

What are the benefits of Tenex treatment?

· 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

 

Protein Rich Plasma (PRP) Injection Therapy

What is PRP therapy used for?

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.

How does PRP work?

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.

What are the advantages of PRP injections to treat Plantar Fasciitis and Achilles Tendonitis?

· No risks

· No side effects

· Effective for a year

· Non invasive

 

Amniotic Fluid Injections

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.

Aetna
Allied Benefit Systems
Amerigroup
Blue Cross Blue Shield
Cigna
Harvard Pilgrim Health Care
MagnaCare
Oscar Health Insurance Co.
Oxford United Healthcare
UMR
United Healthcare
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