Detailedmedical history
withtypical local pain
Detailed physical examination
with typical positive palpation findings, examination of strength and ligamentous apparatus as well as muscular trigger points
Detailed ultrasound examination (sonography), also X-ray diagnostics.
Bothexaminations are carried out directly at the first visit to the practice.
A magnetic resonance imaging examination
torule out a tendon/fascia tear and changes on the joint side.
Physiotherapy
The main aim here is to treat muscular imbalances and resolve trigger points or detonate myogelosis.
Shoe insoles
to relieve pressure on the structures
Anti-inflammatory treatment
Overnight ointment dressings or oral medication reduce the activity and pain of the Achilles tendon and heel.
Trigger point acupuncture
Stimulation and resolution of trigger points is achieved by inserting needles at defined points.
Shockwave
Can be used to improve blood circulation to reduce pain and improve mobility.
Hyaluronic acid
Thiscan reduce pain, swelling and inflammation.
ACP
can improve the healing of the Achilles tendon and plantar fascia.
Physiotherapy
Themain aim hereis to treat muscular imbalances and resolve trigger points or detonate myogelosis.
Later on, attempts are also made to better counter specific strains by activating other muscles and avoiding overloading.
The healing process is initiated by mobilizing and stretching the tense muscles in daily self-exercises, as well as home training with a fascia roller.
Anti-inflammatorytreatment
Overnight ointment dressings or oral medication with ibuprofen, diclofenac, metamizole etc. reduces the activity and pain of the Achilles tendon and heel. A stronger effect can be achieved with cortisone infiltration into the peritendineum.
Due to the many unfavorable side effects, including tendon rupture after injection, this treatment is the last resort before surgery. However, the treatment is covered by all statutory or private health insurers.
Trigger point acupuncture
Theplacement of needles at defined points stimulates and dissolves the triggers. Neurophysiologically, this results in pain suppression during the course of treatment.
Shockwave
Thiscan be used to improve blood circulation, reduce pain and improve mobility. The shock wave is normally used 5-6 times 1x/week.
Hyaluronic acid
This can reduce pain, swelling and inflammation, resulting in better function.
As a rule, this is carried out once a week over a period of 3 weeks.
ACP
Thiscan improve the healing of the Achilles tendon and plantar fascia radiation. It also leads to a reduction in pain and an improvement in mobility.
Infiltration is carried out once a week for approx. 5 weeks. Thereafter, if necessary, 5 times a month.
Hyaluronic acid is normally applied once a week over a period of 3 weeks.
ACP treatments are infiltrated once a week for approx. 5 weeks. Thereafter, if necessary, 5x once a month.
Depending on the severity, treatment is more intensive. However, we create an individual treatment plan for each of our patients, in which the current damage and expectations (e.g. sporting activities) play a significant role.
Treatments last 6 to 14 weeks.
Inchronic cases, often only after 12-14 weeks, otherwise usually after 5-6 weeks.
ACP often has a clear anti-inflammatory effect immediately after the first injection. The patient usually notices how the tendon reacts after the injections. As with hyaluronic acid, in most cases a clear improvement can be felt after the 3rd injection.
As the injection is inserted into the tendon sheath and our specialists do this on a daily basis, there is very little pain.
ACP treatment also involves a small blood sample, and the tendon can also react slightly when the regeneration processes begin. However, this only lasts for a few days and is described by patients as "working in the tendon" rather than pain.
Both hyaluronic acid and ACP are the body's own substances, and ACP even uses the body's own blood. This is why side effects hardly ever occur.
We avoid the risk of infection from an injection into a joint by disinfecting extremely thoroughly, e.g. we use the same disinfectant that is used for disinfection during operations. This is a very costly disinfection process, but we want to ensure maximum safety for our patients.
Many years ago, autologous blood therapy was also used to treat chronic wounds, so the risk of infections, which are very rare anyway, is significantly lower.
The statutory health insurance companies cover physiotherapy and medication, and recently also three shock waves.
Private health insurance companies often cover the treatment costs. Hyaluronic acid is covered by most private health insurance companies.
As ACP is a new treatment method and is still being researched, unfortunately not all private health insurance companies cover the treatment costs. As several studies have proven the effectiveness of ACP, we therefore recommend that you ask your health insurance provider in advance whether they will cover the treatment. Our entire team will be happy to assist you with applications for your insurance with an additional letter from us. Reference is also made here to the latest literature, which can also be provided in written form at any time.
Our primary aim is always to offer you the best possible treatment and never to withhold options from you.
Of course, you can also cover the costs of tendon treatment yourself. We will be happy to draw up a treatment plan for you in advance.
Surgery is the last resort for chronic persistent pain that is resistant to therapy.
In individual cases, excision of the gliding tissue with simultaneous removal of necrotic areas of the Achilles tendon is necessary.
