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Heel pain is one of those issues that can affect most of what you do in a day, and can be disabling. A common cause of heel pain is the Achilles tendon. What is the Achilles tendon?  What is Achilles tendonitis?  What are the different injuries?  Is stem cells Achilles tendon treatment a viable option?  Let’s dig in.

Where & What Is the Achilles Tendon?

A tendon is a thick fibrous band of connective tissue that connects a muscle to bone. There are more than 30 million tendon and ligament injuries annually (1).   The Achilles tendon, which is the thickest tendon in the body connects the calf muscles to the heel bone (2).  It consists of the gastrocnemius and soleus muscles that unite to form a thick band that is immediately above the heel tab on your shoe.  It enables the downward movement of the foot, and bending of the knee.

Injuries to the Achilles Tendon

Injury to the Achilles tendon is common and can be a significant source of pain and dysfunction.    There are three principles injuries to the Achilles tendon

Inflammation

Inflammation of the Achilles tendon is called Achilles tendinitis.  The most common symptom is pain and swelling of the tendon (3).  Onset can occur due to overuse but has also been associated with high heel shoes, steroids, and fluoroquinolone class antibiotics (3).  Ciprofloxacin and Levaquin are examples of this class of antibiotics.

Degeneration

If left untreated, the Achilles tendon inflammation can progress to degeneration of the tendon.  This is called tendinosis. It can occur with tears in the tendon.  Pain, swelling and impaired function are common.  It may affect 9% of recreational runners and cause up to 5% of professional athletes to end their careers (4)

Rupture stem cells achilles tendon treatment

Tendon rupture occurs when the tendon pulls off the bone to which it is attached or when the tendon breaks apart.   The rupture may involve all or just a portion of the tendon.  It results in the creation of two tendon ends which are physically apart.  Rupture can occur with long-standing Achilles degeneration, direct trauma or abrupt bending of the foot (5).  It is most common in cyclists, runners, and volleyball players.  Most Achilles tendon ruptures occur in young males between 20-39 years old (6).  Surgery is required with full Achilles tendon ruptures.

Does Stem Cell Therapy Work for Tendonitis?

Yes!  Stem cells Achilles tendon treatment is a viable treatment option

Tendons can be difficult to heal because they have poor blood flow.  Without blood, an injured or damaged tendon has a difficult time healing.  Bone marrow concentrate is rich in a number of cells including stem cells.  Clinical and laboratory studies have both demonstrated that bone marrow concentrate can accelerate and improve the quality of tendon healing (7).  Inflammation is one of the central problems in tendonitis.  A 2017 study demonstrated that stem cells can improve tendon healing by reducing inflammation (8).

Can Stem Cells Repair Tendons?

Yes!  In 2020 stem cells Achilles tendon treatment is an option.  There are three types of tendon tears.

Partial Thickness Tear

The tendon tear involves only a portion of the tendon.

Full-thickness Tear

The tendon tear that involves the entire tendon but the tendon fibers remain intact and have not separated.

Full-Thickness Tear with Retractions

The tear involves the entire tendon and the tendon is torn away from the bone or snapped into two pieces.

Partial-thickness and full-thickness tendon tears can be treated with stem cells whereas full-thickness tears with retractions require surgery. PRP is platelet-rich plasma which is rich in growth factors that can accelerate healing.

Bone marrow concentrate, when combined with PRP, has been effective in healing tendon tears, decreasing pain and increasing function (9).  Hernigou, the grandfather of stem cell therapy has clearly demonstrated that bone marrow-derived stem cells significantly improve tendon healing (10).

At the Centeno-Schultz Clinic, we have extensive experience in the treatment of Achilles tendon injuries.  Our most recent publication demonstrated that contrary to conventional wisdom, a higher concentration of PRP is better for tendon repair than lower concentrations (11).  This is critical as a higher concentration of PRP is only available in clinical practices like the Centeno-Schultz Clinic who have a state of the art PRP and stem cell laboratory.

 

To better understand why for the best clinical outcome a flexible, state of the art laboratory is essential please click on the video below

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In Conclusion

A tendon is a thick band of connective tissue that connects a muscle to bone.  The Achilles tendon connects the calf muscles to the heel, and is susceptible to injury.   Injuries to the tendon include inflammation, degeneration, and rupture.  Pain, swelling and restricted movement are common. Tendons have poor blood flow and therefore are difficult to heal.  Stem cells Achilles tendon treatment is a viable treatment option.  Stem cells are effective in the treatment of Achilles tendonitis, and most tendon tears.

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1.Maffulli N, Wong J, Almekinders LC. Types and epidemiology of tendinopathy. Clin Sports Med. 2003;22(4):675–692. DOI: 10.1016/s0278-5919(03)00004-8
2.Doral MN, Alam M, Bozkurt M, Turhan E, Atay OA, Dönmez G, Maffulli N (May 2010). “Functional anatomy of the Achilles tendon”. Knee Surg Sports Traumatol Arthrosc18 (5): 638–43.doi:10.1007/s00167-010-1083-7
3.Hubbard, MJ; Hildebrand, BA; Battafarano, MM; Battafarano, DF (June 2018). “Common Soft Tissue Musculoskeletal Pain Disorders”. Primary Care. 45 (2): 289–303. Hubbard, MJ;  doi:10.1016/j.pop.2018.02.006

4. Li HY, Hua YH. Achilles Tendinopathy: Current Concepts about the Basic Science and Clinical Treatments. Biomed Res Int. 2016;2016:6492597. doi: 10.1155/2016/6492597

5.Yang X, Meng H, Quan Q, Peng J, Lu S, Wang A. Management of acute Achilles tendon ruptures: A review. Bone Joint Res. 2018;7(10):561-9. doi: 10.1302/2046-3758.710.BJR-2018-0004.R2

6.Lemme NJ, Li NY, DeFroda SF, Kleiner J, Owens BD. Epidemiology of Achilles Tendon Ruptures in the United States: Athletic and Nonathletic Injuries From 2012 to 2016. Orthop J Sports Med. 2018;6(11):2325967118808238. doi: 10.1177/2325967118808238.
7. Costa-Almeida R, Calejo I, Gomes ME. Mesenchymal Stem Cells Empowering Tendon Regenerative Therapies. Int J Mol Sci. 2019;20(12):E3002.DOI: 10.3390/ijms20123002.
8.https://www.sciencedaily.com/releases/2017/05/170523104330.htm.
9.Kim SJ, Song DH, Park JW, Park S, Kim SJ. Effect of Bone Marrow Aspirate Concentrate-Platelet-Rich Plasma on Tendon-Derived Stem Cells and Rotator Cuff Tendon Tear. Cell Transplant. 2017;26(5):867-78. DOI: 10.3727/096368917X694705.

10. Hernigou P, Flouzat Lachaniette CH, Delambre J, et al. Biologic augmentation of rotator cuff repair with mesenchymal stem cells during arthroscopy improves healing and prevents further tears: a case-controlled study. Int Orthop. 2014;38(9):1811-8.DOI: 10.1007/s00264-014-2391-1.

11. Berger DR, Centeno CJ, Steinmetz NJ. Platelet lysates from aged donors promote human tenocyte proliferation and migration in a concentration-dependent manner. Bone Joint Res. 2019;8(1):32-40.DOI: 10.1302/2046-3758.81.BJR-2018-0164.R1

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