Joint Preservation Blog

January 2, 2009

Torn Tendon in Foot

Torn Tendon in Foot. Tendons are the cords that attach muscles to bone. In the foot, there are many tendons broken down into a couple of categories based on how they move the foot. These are tendons that plantar flex (foot pointed down), dorsiflex (toes and foot moving up), pronate and/or invert (bottom of foot points to other foot), and supinate and/or evert (bottom of foot points to the outside). A tear in a foot tendon is usually due to either an injury or overuse. For example, a tear in the tibialis anterior tendon can be due to too much force on the tendon as it tries to keep the foot from slapping on the ground. This type of tear is also usually caused by weakness in the tibialis anterior muscle (front of the shin) from a chronic low back pinched nerve. This muscle helps us control the foot as we walk. As the muscle gets weaker, the tendon gets beaten up trying to keep the foot from slapping while walking. In addition, the extensor hallicus longus (EHL) can get worn out trying to help the weak tibialis anterior muscle. Fixing a torn tendon in the foot can sometimes involve surgery, but newer non-surgical methods are much more promising. The newer treatments for torn tendons involve injecting the patient’s own stem cells into the tendon so that they can repair the damage. This is a full activity or a minimal downtime procedure, unlike surgery.

Achilles Tendon Support Socks

The Achilles tendon can be weakened by injury or being overloaded.  Support socks for the Achilles tendon will add compression around the tendon which may allow it to feel like it has greater support.   In essence, this pressure gives the tendon more structure.  Look for support socks that place pressure on the tendon (the heel cord) without causing pain.  The need for support in the Achilles tendon is usually from a partialtear or chronically frayed tissue in the tendon.  Another way to treat this without surgery or bracing is to use the patients own stem cells to repair the tendon.  These are cells taken from the patient, grown in the lab, and then injected into the tendon so that they can orchestrate a healing response.  With this type of Achilles tendon repair therapy, the need for Achilles tendon support socks can be eliminated.  This type of Achilles tendon treatment is new to the US and holds great promise for making the tendon stronger.

December 15, 2008

supplements that help prevent torn tendons

Supplements that help prevent torn tendons usually involve various components of tendons such as collagen.  Collagen is a natural substance that acts as the mortar for the brick building blocks (cells) that make up much of the body.  Taking more of this collagen “mortar” may help provide better masonry building blocks in areas like tendons.  In addition, another major component of tendons and ligament repair is Vitamin C or ascorbic acid.  Vitamin C is a catalyst for this repair and building up of collagen.  Think of it as the food for the brick mason so he can lay more cellular bricks to make more tendon and ligament using the collagen mortar.  Another major tendon and joint component are GAG’s (glycoaminosglycan’s).  These are the chemicals that help to hold onto water and help provide elasticity to tendons, ligaments, and joints.  GAG’s include glucosamine and hyaluronic acid.  Another major strategy for preventing torn tendons is activity.  Activity helps to build up tendons and ligaments and make them stronger.  In this case, walking the mall may not be enough activity, but walking to the mall is more like the kind of activity levels needed.  Once a tendon tears, avoiding surgery should be the goal.  Sewing a partial tendon tear may make the tendon too tight and cause other problems.  Non-surgical methods to heal the tendon can include prolotherapy or adult stem cell injections.  Prolotherapy involves injecting substances to cause a brief inflammatory healing reaction to try and get the torn tendon to heal.  Injecting stem cells into the tendon provides more building blocks or bricks in our mason example above.

December 14, 2008

Healing Tendon Tears

A tendon is the connection between a muscle and a bone.  It transmits force from the muscle, through a joint to allow movement.  Tendons, like any structure, can be torn or damaged.  Most tears heal, but some need help.  Surgery is an option, but should only be considered when the tendon is completely torn in half and retracted (the two ends don’t come together).  If the tear is not complete, but a partial tear, then surgery may not be needed.  Modern advances in regenerative medicine allow us to undertake healing tendon tears instead of sewing them.  This new 21st century way of healing or repairing a tear in the tendon tear has significant advantages over the older, 20th century surgical methods. 

First, if the tendon is only partially torn, the newer stem cell injection procedure often requires very minimal down time, unlike surgical approaches where the tendon is sewn.  This is because the newer stem cell procedure involves injecting those healing cells directly into the tendon under x-ray guidance.  Without a surgical incision, the area heals more quickly.  Also, the stem cells allow the tendon tear to mend fully.  For more information, see the link above. 

For scientific information on healing tendon tears with adult stem cells, see this link to the National Library of Medicine. 

Older, but still interesting ways of healing tendon tears without surgery include prolotherapy.  Another prolotherapy link here and here.  Prolotherapy is injecting the tendon with a substance to cause a brief, inflammatory healing reaction in the tedon.  This is oftern repeated several times, once every 3-6 weeks.  This works well with smaller tendon tears, in younger patients, who can remain very active.

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