Is Cortisone Appropriate For Achilles Tendon Injury?

Category: Blog, Sports Medicine

Is Cortisone Appropriate For Achilles Tendon Injury?

Frank Fitzpatrick of Philly.com posted “Cortisone and Ryan Howard: Easing the pain, or worsening it?” In his article Fitzpatrick researched the use of cortisone for Achilles tendon and noted that medical evidence suggests cortisone can damage surrounding tissue, fray the Achilles, even trigger a rupture and speculated if the cortisone contribute to or hasten Howard’s tear? Ryan Howard is a professional baseball player with the Philadelphia Phillies who suffered a complete Achilles tendon tear three weeks following the cortisone in 2011 and

You can read Mr Fritzpatrick’s article at http://www.philly.com/philly/sports/152180515.html

While not commenting on this particular case – at the Magaziner Center for Wellness we utilize treatments such as Prolotherapy and Platelet Rich Plasma Therapy for Achilles tendon problems because these treatments strengthen connective tissue.

Do you have an Achilles Tendon tear or fraying? Look at this research:

In 2010 researchers looked at 99 patients who presented 108 “bad” achilles tendons. What is remarkable is that these patients were listed as “failed previous medical treatment.”

When treated with Dextrose Prolotherapy, the researchers noted significant improvement stating, “Dextrose injections appear to present a low-cost and safe treatment alternative with good long-term evidence for reducing pain from pathology at either the insertion or midportion of the Achilles tendon.” (1)

In other research, Prolotherapy and eccentric loading exercises for painful Achilles Tendon found great improvements in the patient’s condition (2)

And in further research, Dextrse Prolotherapy resulted in significant reduction in pain at rest and during tendon-loading activities (3).

How about Platelet Rich Plasma Therapy?
New York Jet LaRon Landry spoke to the Washington Post in this article from October 4, 2011 when Landry played for the Redskins.

“When his trainer advised him to try a popular but unproven healing therapy for his injured Achilles’ tendon last year, Washington Redskins safety LaRon Landry did not hesitate. He wanted to get back to work.
It did not concern him that the recommended treatment, platelet-rich plasma (PRP) therapy, lacks scientific validation, has shown mixed results in a limited number of studies and involves drawing a dose of one’s own blood and reinjecting it.

Landry now evangelizes like a PRP prophet. Since using the treatment for three different injuries, he’s been spreading the word to teammates.

Landry’s attitude is shared by increasing numbers of injured athletes in locker rooms and clubhouses nationwide, who are grasping at non-surgical options for fast healing. For men whose livelihoods depend on staying healthy, the occasional, and widely publicized, PRP success stories have caused the popularity of the procedure to far outpace the research behind it, experts say.”

1 Ryan M, Wong A, Taunton J. Favorable outcomes after sonographically guided intratendinous injection of hyperosmolar dextrose for chronic insertional and midportion achilles tendinosis. Am J Roentgenol. 2010 Apr;194(4):1047-53.

2 Yelland MJ, Sweeting KR, Lyftogt JA, Ng SK, Scuffham PA, Evans KA. Prolotherapy injections and eccentric loading exercises for painful Achilles tendinosis: a randomised trial [epub ahead of print] Br J Sports Med (England), Jun 22 2009, pages pending.

3 Achilles Tendonopathy DEX: Maxwell et al 2007 Dextrose 25% injection in chronic Achilles strain resulted in ultrasound documented healing. Maxwell NJ, Ryan MB, Taunton JE, Gillies JH, Wong AD. Sonographically guided intratendinous injection of hyperosmolar dextrose to treat chronic tendinosis of the Achilles tendon: a pilot study. JR Am J Roentgenol. 2007 Oct;189(4):W215-20.