Caring Medical
& Rehabilitation Services
715 Lake Street, Suite 600
Oak Park, Illinois 60301
708.848.7789 Phone
708.848.7763 Fax

Achilles Tendon: The Weak Link for Many Athletes

The Achilles tendon is the largest tendon of the human body and is one of the most commonly injured tendons in sports. It is the tendon responsible for plantar flexing of the foot, which is how athletes are able to spring off of each step.

Athletes in running sports have a high incidence of Achilles tendon overuse injuries. About 75 percent of total and the majority of partial tendon ruptures are related to sports activities involving abrupt repetitive jumping and sprinting movements.

Surgery is supposedly required in about 25 percent of athletes with Achilles tendon overuse injuries, and the frequency of surgery increases with patient age and duration of symptoms, as well as occurrence of tendinopathic changes.

Of those who receive surgery, 20 percent require re-operation. These are sad statistics if one knows the pathology in chronic Achilles problems. The condition begins as a tendonitis because the Achilles tendon is trying to strengthen. Remember, the body is trying to heal itself through this inflammation. But often, because of NSAIDs and cortisone shots, the inflammatory process is halted. The tendon then begins to show signs of cellular damage and collagen degeneration. This is called tendinosis. Tendon pathology such as this can be encouraged to repair itself with Prolotherapy. Prolotherapy can stimulate the growth of the Achilles tendon tissue to make it stronger.

Steroid injections not only do not help the problem, they likely cause the problem. Steroid shots with cortisone have been implicated as a significant cause of Achilles tendon rupture.

Heel Spurs

Many patients with foot pain come to Caring Medical saying they have been diagnosed with "heel spurs." Others were told they had "plantar fasciitis. Patients have anxiety night and day because they have heel spurs and "plantar fasciitis."

Such a diagnosis resulted from an x-ray that revealed some extra bone where the plantar fascia attaches to the calcaneus. This extra bone is called a "spur." Because it involves the heel, it is ingeniously named a "heel spur." It is located where the plantar fascia attaches to the heel, hence plantar fasciitis.

Treatments such as a cortisone shot or, even worse, surgery to remove the spur, have claimed many victims. These treatments do not correct the underlying defect. The plantar fascia supports the navicular, talus, and medial cuneiform bones. When the plantar fascia must also attempt to support the arch, excess pressure is placed on the calcaneus bone. The calcaneal spur forms because the plantar fascia cannot adequately support the arch. The plantar fascia is holding on for dear life to its attachment at the calcaneus. This holding on for dear life causes the body to grow more bone in that area in an attempt to reduce the pressure on the ligament, resulting in a heel spur. The same kind of pressure would occur if you were hanging from a ledge of a tall building by the tips of your fingers. You can bet when you were finally rescued that the ledge might have some marks in it where your fingers were located.

Cortisone may temporarily relieve the pain in some cases, but it will always weaken tissue long-term. Prolotherapy to the fibro-osseous junction of the plantar fascia will cause a permanent strengthening of that structure. Once the plantar fascia returns to normal strength, the chronic heel pain will be eliminated. But what about the heel spur? people complain. Remember, the heel spur is just an X-ray finding. Many people have heel spurs without any pain. Prolotherapy will not remove the heel spur, but it will eliminate the chronic pain by eliminating the cause. So relax and enjoy a foot without pain.