SPECIALIST PROCEDURES - NEW APPROACHES TO TENDINOPATHY (TENDONITIS)
In sports and leisure chronic strain at the attachments of muscles to bone are common. Where muscles converge on bone at a common point:
e.g. lateral elbow - tennis elbow, lateral epicondylitis
the heel - plantar fasciitis, ‘heelspur’ pain
there can be a build up of excessive loading or strain causing the tendon fibres to degenerate, tear or develop cystic areas. The tendon tends to thicken become very tender and painful and attracts new blood vessels with additional nerve supply causing a “wind up” phenomenon. (The collagen or rope like structure deteriorates in quality and strength).
Common treatments for this include:
- Strengthening: The Scandinavian eccentric loading programme which takes three to six months to work. Gentle stretching and reduced impact loading.
- Glyceryl trinitrate patches also work gradually.
- Local Infiltration with corticosteroid: Traditional method that works but causes temporary weakening and 50% tend to relapse within a few months.
- In the Achilles Tendon – we use a “volume strip” of the sheath around the tendon – under ultrasound guidance. This can also be used around the patella tendon.
- Autologous blood injections are used where there are small cysts or tears in the thickened tendon. 2-3mls of your own blood which contains growth factors for healing under local anaesthetic are injected under image guidance into the tissue defect.
- Platelet rich plasma injections are the latest development to promote tendon healing if delayed or prolonged. 30mls of your own blood is collected, centrifuged and the platelet fraction rich in growth factors is separated. This portion is injected under local anaesthesia into the tendon defects. This way growth factors that promote collagen healing are multiplied by a factor of five increasing the chance of a speedy recovery.
N.B. We have five years experience of Extracorporeal Shockwave Therapy the non invasive way of healing tendons and dispersing calcification. We can help 50% of cases who might otherwise be facing surgery.
If you have further questions about this procedure please contact us.
