The problem

Rigours of a football season throw up scenarios influenced by load. Success brings increased fixtures and intensity to playing squads.

Former pro player Chris Hackett (16-year career) had an injury-ravaged season because of an Achilles tendon problem. After facing the prospect of Achilles surgery, he was struggling to reach the end of the season. 

Tendinopathies have the uncanny knack of disrupting the best-laid plans for players and their clubs. At the top of the game, fatigue can be managed. Bigger pools of playing staff mean squad rotation can provide rest & proper injury recovery. Lower down the leagues this luxury isn't afforded to all.

GLORY: Chris Hackett scores for Millwall

Unlike breaks or tears, Achilles injuries tend to be gradual. Prolonged periods of putting the foot on and then off the gas can last throughout a season. Granted, players can keep being 'available' for selection but generally with reduced performance levels. 

Physiological constraints influence emotional well-being. Players carrying an injury will normally play within themselves. 

The location of the Achilles tendon means it's vital for the majority of movements on the pitch. Success at managing problems when they occur there can come down to position and playing type. Anything that requires explosive movement, jumping or stabilisation will be limited.

The research

Football club medical teams face dilemma's when combatting Achilles tendon conditions in affected players. Platelet-rich plasma (PRP) therapy or Dry Needling 'are' procedures that can include invasive surgery with lengthy recovery times. TRB Chemidica's Ostenil Tendon has been clinically tested against conventional short-term options of corticosteroid treatment as well as shock wave therapy with positive results. 

EXAMINE: Initial 'hands-on' consultation highlights Achilles problem

For players suffering from tendinopathies, the outcomes of Ostenil Tendon presented a preferred pathway to staying on the pitch.

Advancements in Hyaluronic Acid utilisation by orthopaedic surgeons for ankle and knee injuries has promoted its potential for other inflammatory conditions. Having previously shown benefits for joint injuries with Ostenil Plus, TRB Chemica identified the opportunity to help treat problematic tendons.

Having spoken to injured players, Hackett was directed to the injury team at football4football. He and the club physio were presented with a series of potential solutions to get Chris pain free and able to play.  Their chosen route saw them in consultation with a leading sports orthopaedic, Prof Sanjiv Jari. With an Ostenil Tendon injection the chosen procedure. 

The procedure

Ostenil Tendon is a non-invasive treatment. Avoiding the need for lengthy surgery, it's injected into the tendon sheath (intrasheath injection) or around the affected tendon (peritendinous injection). Done under ultrasound precise placement can be ensured. 

LOCATE: Injection under ultrasound for accurate administration

Once injected, distribution along the entire tendon happens through natural movement. Several tendons can be treated at the same time. Yes, injections aren't always liked by footballers, but the procedure is considered less problematic than 'slice & dice'.

The result

Engaging with numerous footballers about on-field performance and concerns over being sidelined, we found one common school of thought. Getting back on to the pitch as quickly as possible was paramount. Competition for places is fierce. Extended dialogue with senior pro players & medical teams, saw long-term health and playing longevity the real driver. The balancing act is achieving a speedy, safe, and longlasting solution for all injuries. 

As on-pitch performance is enhanced by research, data, and realtime metrics the medical field is moving at an even faster rate to become the safety net for athletes. 

STEADY: Pain management meant Chris Hackett adapted his game

Financial & personal rewards in the pro game mean there can be a disconnect between what a footballer thinks and what their body feels. Club physiotherapists & medics have to be ready to identify this and offer solutions to facilitate it.