The Achilles tendon is often injured in sports like running, gymnastics and dancing. As the body heals the tendon, it sometimes heals abnormally which weakens the tendon and makes it susceptible to even more damage down the road. This is called tendinopathy.
Tendinopathy is usually treated with special exercises that target its cause and disrupt the abnormal healing. If an athlete doesn't respond to these exercises after six weeks, a procedural intervention is often recommended. One procedure aimed at breaking up the abnormal healing is called percutaneous scraping.
As always, please consult with your physician to see if the percutaneous scraping procedure is the best option for you.
About The Procedure
Using ultrasound and power Doppler, the abnormal regions with high blood flow inside and outside the under surface of the Achilles is marked on the skin by a physician using a skin pen. After cleaning the skin, a local anesthetic is injected on the medial and under side of the Achilles.
Using ultrasound guidance, the physician inserts a needle from the medial side, avoiding contact with the nerve. Keeping the needle close to the under surface of the tendon, the region with tendon changes and high blood flow is released from the soft tissue by scraping with the sharp side of the needle, staying close to the under surface of the tendon.
After Procedure Protocol
- Day 1: rest, elevated foot.
- Day 2: range of motion (ROM) exercises, light stretching and short walks.
- Day 3–7: gradually increased walking activity.
- Day 8–14 or follow up: light bicycling.
- After your follow up visit: gradually increased load up to free activity based on pain and discomfort.
Please refrain from any heavy loading activity during the week after the procedure (like jumping). Do not take any aspirin or other anti-inflammatory agents to relieve any discomfort. Please use acetaminophen-based pain medication.