Achilles Tendon Debridement and PRP

After a long hot and trying summer – I could not outrun my achilles tendonitis. A new MRI revealed that the tendon simply was not in condition to get better on its own. There was substantial long term inflammation and poor healing in the tendon. Dr. Armendariz recommended debridement and PRP.

He also said that the amount of damage may indicate the need to relocate a tendon! That would involve moving the extensor tendon which controls what essentially is curling your big toe down. They cut it proximal to the ankle and attach it to the back end of the achilles tendon to act as reinforcement. This was not exactly something I was expecting to hear. He said some big toe flexion would be lost but the other toes and rest of the foot would not be effected and I indeed would resume running once again regardless. He also said he would not know if it was necessary until he got inside… so it would be a “game day decision”.

The procedure is done in an outpatient surgery center. Interesting that the first time I had achilles tendon surgery (calcaneotomy) in 1982 I was in the hospital 3 days! This time – in @ 0600 and home by 1030!!!!

I had anesthesia and popliteal nerve block. The block lasted about 36 hours – basically leaving below my knee mostly numb; the discomfort rose after 36 hours.

My brother Jim was at the helm guiding my post-op activities and recovery. I did not talk to doc afterwards (or if I did I was too out of it to remember anything said) but Jim did. The good news was that the tendon relocation was not necessary! Woohoo!!!

What they did:
After they opened up the tendon sheath doc then did the debridement. This is done by strategically “burning” multiple locations along the tendon which will initiate a healing response which in turn builds the tendon stronger than its former condition.

PRP (platelet rich plasma) is then injected into the tendon in multiple locations. The PRP is drawn from me and then injected into me. This is all done during the surgery.

PRP is a newer procedure for treating tendons. It has had excellent results in the literature and I now know 3 local runners who have had the PRP for various tendon issues – all are back 100%. They draw blood and then extract your own platelets to be re-injected into the effected site. The exact mechanisms on how this works seems to be not entirely understood. It enhances healing – especially in poorly vascularized areas i.e. tendons. The downside to this procedure is that it is NOT covered by most insurance plans at this time. So beware! Though my surgery was covered by insurance the PRP was not.

I actually took my first pain medications on Monday evening. I simply could not do anything to get comfortable. I also decided to change dressing due to wetness and smell (OK, doc said not to touch it until I saw him 10 days post-op but my nursing instincts took over. I was not leaving a wet dressing on).

As you can see the incision is about 8″ which was a bit shocking since he originally intended about 4″.

I have to wear a walking “cam” boot 24/7 for the first 10 days until my first post-op appointment. I can have only partial weight bearing and use crutches to get around. I will then wear the boot for about 4 more weeks at which time rehab begins. During this time I can remove the boot at night and for showering etc.

The doc says the prognosis is good and he anticipates full recovery and I will be back running once again.

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About Dean Hebert

I’m a mental game coach, author and speaker. I work with individual athletes, parents, coaches, and teams on sports performance enhancement. Beyond my academic post-graduate work in sports psychology - the psychology behind athlete performance – I am a certified Mental Games Coaching Professional (MGCP) and certified hypnotherapist. I’ve authored several books and hundreds of articles. “Coach, I didn’t run because…” (2008) is a seriously light-hearted look at making excuses not to workout and how to overcome them. “Focus for Fitness” (2009) and “Screw the Goals Give me the Donut” (2010) are two of my eBooks on mental game approaches for the everyday athlete. I wrote these because I believe that everyone can benefit from the powerful mental techniques that the world’s best athletes use. I have been cited in Runners World, Best Health magazine (CN), SWEAT Magazine, and the Washington Examiner amongst many other publications. I have been a featured mental games coach in Runner’s World and for the internationally acclaimed trail running resource - trailrunningclub.com. I also regularly appear on sports and fitness talk shows such as LTKFitness, Runnersroundtable and for more than three years I have co-hosted a weekly video series with Coach Joe English for Running-Advice.com. I specialize in mental toughness training. My clients include tennis, synchronized swimming, golf, race-kart, soccer, motocross, volleyball, MMA, cycling (road, off-road, time-trialist), running, duathlon and triathlon, basketball, football and baseball athletes. I have coached world-class athletes and athletes internationally. I have a passion for working with youth athletes and helping them apply mental game skills and techniques to all areas of life. Most importantly, my aim is to have people enjoy sports and life to their fullest through peak performances.
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5 Responses to Achilles Tendon Debridement and PRP

  1. Rob Nichols says:

    Fascinating stuff. It’s good to hear about other “regular” folk’s experience with PRP. I’m kind of dreading your coming back. Gotta feeling workouts are going to get harder!

  2. David Gunther says:

    I had my op 10 months ago and unfortunately after to go through more injections and surgery – not a success!!!!!

  3. Sian says:

    Unfortunately, my op wasnt a success either, and it was 18months ago. Now i am classified as disabled, cant walk long distance, cant stand too long, and cant squat, and cant carry loads. I was deemed no longer capable of doing my job – therapy co ordinator in aged care. I have pain 24/7, which I am learning to live with, but some days it gets bad, and I cant deal with it.

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