Achilles Tendinitis, Tendinosis, or Tenosynovitis
What's the Difference?
Any injury to your Achilles tendon can be referred to as Achilles tendinopathy. The suffix "pathy" means suffering or disease, therefore tendinopathy is a general term that can describe any condition of a tendon. To be more specific about the type of injury that has occurred in a tendon, the terms tendinitis (also spelled tendonitis), tendinosis, and tenosynovitis are used.
The suffix "itis" means something is inflamed, therefore, the term Achilles tendinitis (tendonitis) is used when the Achilles tendon is inflamed. Inflammation in the Achilles tendon is often due to irritation and/or micro-tearing of the tissue (collagen fibers). When the fibers tear, they become weaker, inflamed and swollen causing pain and tenderness in the area.
There are 2 types of tendonitis, acute and chronic. Acute tendonitis refers to inflammation that comes on suddenly, usually from a tendon strain or overloading it during exercise. Chronic tendonitis occurs over time and generally results from long term repetitive use of the Achilles tendon.
With both types of tendinitis, scar tissue develops on the Achilles tendon as the tears begin to heal. This scar tissue mends the tears in an abnormal way leaving the collagen fibers weaker and more prone to further injury. In the case of chronic tendinitis a node of scar tissue may form and/or the Achilles tendon may actually become thicker with a build up of scar tissue over a long period of time.
People with Achilles tendon pain often call their injury tendonitis however, in reality, Achilles tendinitis is a rare occurrence. Tendinosis is a more common Achilles injury.
The term tendinosis refers to a non-inflammatory, degeneration of the collagen fibers in a tendon.
This tissue break down is often caused by repetitive stress on the tendon fibers and the failure for the fibers to heal. In fact, the rate of tissue damage exceeds the healing process and eventually the build-up of damage on the Achilles tendon is not able to heal properly. The tissue (collagen fibers) degrade to a point where the once straight, strong, flexible bundle is weakened by abnormally formed fibers that look more like a mess of strands.
Since there is no inflammation with tendinosis you will not experience swelling, heat or redness. However, you will experience pain, tenderness and stiffness at the back of the ankle where the tissue degeneration has occurred. This is the most common among Achilles tendon injuries.
Tenosynovitis, (also called paratendonitis), is a term used to describe inflammation and degeneration of the tendon's outer layer or sheath. The Achilles tendon sheath is called the paratenon, which explains why the term paratenonitis has become a popular term for this condition as well.
It is possible to suffer from tenosynovitis alone or in conjunction with the degeneration of the Achilles tendon (called Achilles tendinosis). As your body tries to heal, scar tissue forms inside the sheath attaching the inner tissues of the Achilles tendon to its outer covering (paratenon). This scar tissue limits the gliding movement of the tendon, reducing the range of motion and causing pain, tenderness, redness, and swelling.
How Do You Treat an Achilles Tendon Injury?
Your doctor will assess your particular case and determine a course of action. In most cases, a conservative treatment protocol will be enough to heal the injury, though in cases such as significant tearing or a fully ruptured tendon, you will most probably require surgery. It is generally understood by doctors and surgeons, that surgery will introduce more scar tissue into the any already damaged tissue. This added scar tissue will be problematic, requiring more physical therapy and conservative treatment options post-surgery. If not dealt with properly, your Achilles tendon injury could end up in worse condition than before the surgery! This is why surgery is only performed as a last resort.
Some conservative treatment methods recommended include:
- Rest - This is important for initial recovery for both Midpoint and Insertional Achilles Tendonitis. This can be difficult when you have to carry on with daily activities, but resting and elevating your foot whenever you can is recommended. During your recovery you will probably have to modify or avoid the activities that put stress on your Achilles tendon until your pain and inflammation settles. Too much rest can also be harmful to achilles injuries because ankle joint immobility can actually cause stiffening in the joint. This is why rest should be used when reducing initial pain and swelling, but should not be considered for more long-term conservative treatment.
- Avoid Activities that Caused Your Injury - While resting your injury it's also important to avoid all activities that may have caused your tissue damage (especially any repetitive movement). Continuing on with regular activities will not only make your injury worse.
- Use a Cold Compress or Ice Pack - Cold is very effective at reducing pain and inflammation - use at the onset of the injury and during flareups.
- Use Deep Tissue Regeneration Therapy (DTR Therapy) - You can use your own blood flow to maximize your rehabilitation, maintain healthy blood flow to your achilles and heel, decrease recovery time, and boost the bodys healing rate. Promoting blood flow to your achilles will help to minimize the growth of scar tissue, increase flexibility and help prevent atrophy.
- Physical Therapy - Surgery is usually the last resort. This means doctors or surgeons typically won't perform a surgery until they feel that their patient has put effort into treating their injury with conservative treatment methods. This may include up to 4 to 6 months of physical therapy. If you haven't experienced any improvement in your condition during that time then surgery may be considered. Agressive physical therapy approaches will focus on forced or manual manipulation of the achilles - this means your physical therapists will be trying to move your achilles past the point of comfort as they strive to increase range of motion and prevent further atrophy. This can be painful and end up making your injury worse if not done correctly. (reference: 1)
- Stretching - Stretching your ankle in physical therapy and at home will help you to regain your range of motion much faster than not stretching at all. Stretching in many ways is key to maintaining good Range of Motion (ROM) in the ankle, and stretching can be made much easier with use of a TShellz Wrap before to warm up soft tissue, and a Cold Compress or Ice Pack treatment after to prevent any return of swelling and inflammation.
Stage 1: If the injury is very recent - use a good quality cold pack and Arnica Pain Relief Cream. If the injury has been going on for awhile, then skip to Stage 2 below.
An injured Achilles tendon will receive very little blood flow; this occurs because swelling and inflammatory symptoms restrict that blood flow. Couple that with the fact that your Achilles tendon receives very little blood flow to begin with, and you can start to see why this can be a major problem. In most tendonosis cases, however, the tendon is not inflamed - in such cases the use of cold therapy is relatively ineffective as there is little or no swelling to be dealt with.
If you are experiencing pain and swelling in the very early stages of the injury (first 48 to 72 hours), the first step in a conservative treatment protocol would be to focus on reducing the discomfort by applying a quality cold pack to the injured achilles along with a high quality pain relief cream such as our Arnica Infusion Cream.
If you are experiencing pain and swelling, not only will you use your cold pack for the first 48 to 72 hours after the injury, but you should also use it during other stages of the healing process. Some examples include...
- after any activity that stresses the achilles in a moderate way. It is wise to quickly apply cold therapy to not only reduce the pain, but to also minimize tissue damage that may have occurred during the prior event.
- If you have a job that requires you to place some demands on your injured ankle. If that is the case, use cold therapy immediately following work and if the opportunity allows - use it for 15 to 20 minutes during lunch or another break time.
- If you are in a post-operative situation where cold compression therapy would be utilized heavily for at least the first few weeks following the procedure. Similarly, if you are scheduled for upcoming surgery, then you will find a Cold Compress or Ice Pack helpful as well.
Having a Cold Compress or Ice Pack available at home to use if and when the need arises is helpful. Many of you already do so. If not, here are samples of wraps that might interest you via amazon. (they open in new tab) Please note, we are not condoning specific brands, nor do we make any claim about their efficacy - they are just examples.
Often, too many people over-focus on cold therapy while ignoring the most critical aspect to healing - nourishing the injured tissues with a healthy supply of blood flow needed to repair and rebuild injured soft tissue.
This leads to the most important recommendation - Stage 2.
Stage 2: Focus on Increasing Blood Flow To The Injured Tissue - As This is The ONLY Way Soft Tissue Heals For the Long-Term
Even though the concept is simple, improving blood flow to injured tissues can be difficult. When the injury is achilles related, the challenges are even greater. Traditional methods require your muscles and tendons to move to promote blood flow (exercise), but that same motion that promotes blood flow can at times lead to making your pain and condition worse.
- Have you reinjured your achilles by getting back on your feet too quickly?
- How many times in the past have you aggravated your achilles just trying to perform basic tasks around the home?
- Is your debilitated achilles preventing you from work or activities you love to do?
Most people we deal with tell us these scenarios have happened to them many times in the past. Perhaps it has already happened to you.
Promoting blood flow within a muscle or soft tissue injury to help the body heal itself is a concept that has been utilized for centuries. This is where the focus has to be if you are seeking long-term improvement.
Oxygen and nutrients, carried within the blood, are critical for the body to heal itself. Without proper blood flow, recovering from an injury or condition will be delayed...sometimes for a very long period of time.
The real challenge is how do you promote blood flow to the achilles injury site without causing further injury? This goal is further complicated by the fact the achilles (and muscles controlling the ankle joint) are involved every physical movement we perform each day if we are on our feet.
When people think blood flow beyond exercise, they instantly think "heating pad". Unfortunately, many individuals make the mistake in believing that a simple heating pad or microwavable gel packs will provide the blood flow needed to heal injured tissues. Nothing could be further from the truth.
To begin with, heating pads and warmed gel packs work on conduction. The heat they generate has to be forced through multiple layers of skin and fatty tissues. With each layer of skin the heat passes through, there is a corresponding energy loss because that heat is absorbing into each layer it passes through- the skin is an excellent insulator! Your body responds to this heat by increasing the blood flow near your skins surface (not in your injured tissue) to dissipate the heat and it does so quite effectively.
By the time what little heat reaches below the skin, sub-dermal layer and fat layer into the targeted area (the dense, injured tissues), very little energy remains and this does not effectively enhance blood flow. With little blood flow reaching these injured tissues - healing just doesn't happen.
The heating pad may feel comforting when on the body, but that is because the warmth is absorbing into the skin. Moist heat has been believed to be more effective at warming internal tissues versus dry heat, because it is believed that water transfers heat more quickly than through air. Clinical studies do not support that popular belief.
When you are using a heating pad, all that you are really accomplishing is warming of the skin. The unintended consequence is that you draw blood flow AWAY from the targeted tissues (the injured ones deeper in the body) and direct the blood flow to the surface of the body.
Warming the skin will not significantly contribute to healing of muscles, tendons, ligaments, cartilage, or any other tissues.
So If A Heating Pad Is Not The Answer, What Is?
In order to effectively stimulate blood flow to the dense tissue deep within the body, an energy based on an electromagnetic principle (diathermy) is needed. In essence, this is a conversion energy vs a conductive heat (like the heating pad example above - that is conductive heat).
Electromagnetic energy waves are not conductive heat waves - they are a much longer wavelength and hence, penetrate deep into the body. They are very safe and very effective as research over decades has shown. The F.D.A recognizes this as fact.
When these energy waves are emitted,they penetrate right through your skin and fat layers until they are absorbed by tissue high in protein. This means ligaments, muscles, cartilage, tendons and bone. Once they reach the targeted areas, they are absorbed and quickly converted into thermal energy... right at the location of the injury.
This results in relaxation of the vessel walls. The vessels then gently expand, allowing for more nutrient rich blood flow along with extra oxygen and antibodies to reach the damaged tissues. Plus, the enhanced blood flow helps in flushing cell waste and fluid build-up from the injury site - further enhancing the ability of the body to heal.
As mentioned above, standard heating pads and heated gel packs accomplish the exact opposite of your goals. They direct blood flow to the skin, not to the injured muscles and soft tissues you are trying to heal.
Electromagnetic energy is a form of energy will easily penetrate through clothing, skin, and fatty tissues... directly into your injured muscles and soft tissues within the achilles and ankle. After the energy absorbs into the achilles, the metabolic response then kick starts the repair and rebuilding process.
More blood now begins to flow effectively to the injured tissues deep within the body. The injured tissue needs the extra blood flow to heal as it is through the blood the body carries the oxygen, nutrients, and antibodies needed for proper and long-term healing.
While the concept of electromagnetic energy is slowly catching on in North America, the truth is, it is a technology that has been utilized in other societies for decades. Over the past 30 years, researchers in Japan and China have completed extensive studies on the use of the modality and their findings have been impressive. In addition, success has been reported in studies from countries such as Sweden and Germany.
Research is continuing and soon, much of North America will know what the Far East and Europe has known for a long time; electromagnetic energy provides a wide range of health benefits for those not only suffering from achilles injuries, but for many other soft tissue ailments (plantar fasciitis, bursitis, tendinitis, Tenosynovitis, frozen shoulder, golfer's elbow, tennis elbow, hamstring strain etc.) as well.
Now, on to recommendation number two in the journey to heal your injured achilles...
The Achilles T•Shellz Wrap® - Heal Your Achilles For The Long Term
The best option we came across in our research to accomplish true healing of achilles injuries is the Achilles T•Shellz Wrap®. Use of this device results in a dramatic increase in blood flow to the injured tissues located deeper within the body - all in a non-invasive manner.
Have you seen what happens when you add water to a flower wilted from drought? In essence, your injured achilles is much like a "wilted" flower; your body wants to heal its injury, but needs lots of nutrients to do it. Blood brings new life to your cells by delivering healing nutrients and oxygen that are vital to your tissue. In addition, the blood carries away toxins and cellular waste cleaning the area and healing it faster. Without a good supply of blood, your achilles simply won't heal properly.
Using a T•Shellz Wrap® will not expose you to the risk of causing further harm to soft tissue like you can when using rigorous exercise. The Achilles T•Shellz Wrap® accomplishes the goal of enhanced blood flow without the need for intensive exercise and as such reduces your risk of re-injury.
T•Shellz Wrap® = Accelerated Healing Power for Your Achilles Injury
The Achilles T•Shellz Wrap® is based on the scientifically validated principle of Electromagnetic energy as we discussed previously. This form of treatment is safe and effective as shown in numerous studies which can be referenced through the National Library of Medicine. Professional athletes and those in the medical field have been users of the technology for decades - it really hasn't been until recently that companies like ours introduced these devices to the home user.
Electromagnetic energy from the T•Shellz Wrap® does not absorb into the skin - it absorbs directly into the damaged muscle and soft tissue (as a result, you will not feel the same level of heat on the skin versus a heating pad). The longer wavelength provides the electromagnetic energy wrap with the capability of penetrating deep into the body (well over two and a half inches).
EM energy emitted from the T•Shellz Wrap® is absorbed by high protein tissue (muscle, tendon, ligament, cartilage) and is converted into Kinetic energy - much of this energy being released as heat. Overall, EM energy will warm soft tissues, improve blood circulation, and boost metabolism and enzyme activity. In stimulating localized blood flow to damaged soft tissue, you provide needed oxygen, nutrients, and antibodies to regenerate new, healthy collagen. In addition, you will experience a clearing of toxins and excess fluid build up from the injury site. Over the intermediate term, this helps to reduce incidents of swelling as trapped fluids will be whisked away - reducing pressure on blood vessels.
Using the T-Shell Wrap is truly a unique experience. Within moments of applying a treatment to your injured achilles, you can feel the sensation due to the increase in blood flow deep within the area. During a treatment, and for quite some time after you finish, the treated area will feel relaxed and warm. It's a very soothing sensation and extremely effective. This is especially important because the insertion point of the Achilles tendon receives very little blood flow to begin with.
Who Should Use the T•Shellz Wrap®
We recommend the use of a T•Shellz Wrap®:
- If you have injured your achilles, lower leg or other soft tissue in the back of your ankle, then you would find the Achilles T•Shellz Wrap® to be a great home treatment tool.
- If you are dealing with conditions affecting your range of motion such as impingement or even arthritis.
- If you have a chronic achilles condition that has lasted for years- this device will help start the rebuilding process and help strengthen the surrounding and supporting tissues. Many of our past clients had suffered for years, then were completely amazed at the results only after a few months of treatments.
- If you are still working with an injured achilles, the T•Shellz Wrap® will help relax injured soft tissue prior to work and after a day at the job.
- If you are still trying to enjoy your favorite activities such as gardening, tennis, golf, etc - use the T•Shellz Wrap® prior to activity to help reduce chances of re-injuring or re-aggravating those targeted tissues.
- If you are suffering from bursitis and want to treat the major source of it (secondary damage to the muscle and tendon surrounding the bursa sac). Through overuse or degenerative changes in the lower leg, the muscle and tendons surrounding the bursa sacs will tighten and constrict. When they do, they place pressure on the bursa, causing it to become irritated. Applying a soothing and deep penetrating energy to the achilles relaxes soft tissue and takes pressure off the bursa.
- If you are experiencing atrophy in your lower leg and want to reduce the chance of re-injury - this is a perfect treatment to use on a regular basis.
- If you have had stem cell, PRP or prolotherapy treatments and your physician told you to get a radiant energy wrap, then this is exactly what you need.
- If you have injured your achilles and need surgery, then this is exactly what you need after your surgery to help the surgically repaired tissues rebuild for long-term health. (once the surgery wound has healed)
Increased Blood Circulation = Increased Healing Rate
T•Shellz Wraps contain a unique Carbon Fiber Energy Pad which is flexible and will shape to conform to your body. This Energy Pad emits a uniform wave of perfectly safe electromagnetic energy over its entire surface. This energy travels deep inside to the soft tissue within your ankle, heel and lower leg, stimulating blood flow your own body needs to heal your injury. It is the electromagnetic energy that is crucial to the healing process.
What Else Makes the Achilles T•Shellz Wrap® So Special?
We believe the T•Shellz Wrap® to be one of the most effective treatments to increase localized blood flow to dense, injured tissues such as muscles, tendons, ligaments, and other similar tissues.
We can promise that you will receive a product that is designed to be safe and does what it is supposed to do...quickly relieve pain and aid in the recovery from tendon, muscle and other soft tissue injuries.
The unit plugs into a standard wall outlet to get its power. The nice thing about the power supply is that the same unit can be used in North America and overseas as well. It has the capability to operate between 110v and 230v.
The T•Shellz Wrap® has a special signal controller that can be set for 3 different power levels of application (3=High, 2=Medium, 1=Low). The cord is long enough that you can sit or lie comfortably and watch TV, read or surf the net while you're using it.
Treatments are max 30 minutes in duration and the device can be worn over clothing. This allows you to use the device at work, at home, or really anywhere you have access to an electrical outlet.
A Recap of the Benefits of the T•Shellz Wrap®..
- Targeted treatment of Muscle Strain, Tendonitis, tendonosis, Bursitis, Impingement, Arthritis, etc
- It can be used before exercise to warm up your achilles to reduce the risk of injury
- FDA Registered medical device for use in the home - very high quality
- Greatly enhances healing of tendons, ligaments, and muscles
- Increases flexibility of tissues (reducing the re-injury factor)
- Carbon fiber Energy Pad is strong, lightweight, and flexible - contours very easily
- It provides an accelerated healing rate that will save time and money when associated with missed work or extended therapist visits
- it is an outstanding tool for post-surgery rehabilitation, getting you back to work faster
When Should I Use My TShellz Wrap During the Day?
The most common question we receive from individuals prior to purchasing is - how many times a day should I be using my T•Shellz Wraps and when should I be using them? While treatment plans will differ for each individual and their specific injury, there are general guidelines that should be adhered to.
- Use a Cold Compress or Ice Pack when you are experiencing inflammation (usually after exertion or movement of the injury area).
The Achilles T•Shellz Wrap® would then be used:
- Right after rising from bed in the morning (as this is when it is most stiff)
- Prior to going to bed at night (to relax the achilles, allowing for better sleep)
- Before you know you will be using your injured joint (going to work, driving, running, walking, etc).
Stage 3 - In Between Treatments With T•Shellz Wrap®, Apply Our New Fast Acting Pain Relief Cream Called ARNICA INFUSION
Dealing with aches and pains affecting the foot, ankle, leg, knee, hamstring, hip, back, arm, shoulder, elbow, wrist, or hand? If so, then applying the Arnica Infusion to any of these targeted areas will bring about fast relief from the pain and sore tissues. Simply apply a small amount of cream to the body and moments later, you will experience a soothing and comforting sensation over the area.
Arnica Infusion is specially designed to relieve pain due to sore muscles and joints associated with arthritis, backaches, sprains, strains, and bruises. No matter if you are dealing with an acute injury, chronic pain, or a general "flare-up" - you will experience fast relief from pain and inflammation.
This is a product that many of our current MendMeShop customers asked us to develop. So we focused our time and resources over the past few years and came up, with we believe, will be one of more effective, fast acting, topical pain relief creams on the market.
You are likely familiar with some of the standard topical agents on the market as most of our customers use them. The are mass marketed and even found in most department stores now.
Well, we are here to say that Arnica Infusion goes many steps beyond what they offer.
Made in the USA at an FDA registered manufacturing facility, you can be assured that Arnica Infusion is both safe and effective. We only source top grade ingredients while implementing strict quality control checks during every step of the production process. Expect the same high quality that MendMeShop customers have been accustomed to since we started the company in 2005.
The "Cool Blue" formula is the perfect balance between the smooth application of a cream and the effective absorbing factor of a gel. It is not too thick and not too thin - just the right texture. Best of all, it feels very nice on the skin!
Each application of Arnica Infusion feels so comforting and soothing, we are certain it will become an item you will not want to live without.
Arnica Infusion Ingredients
The Arnica Infusion formula is based on a combination of scientific research and the use of high quality ingredients. The properties within the formula were chosen for their pain relief, anti-inflammatory, and soothing qualities.
The acting ingredients within the formula include ones many of us are familiar with; along with ones that have not received a lot of publicity (only in research circles). Extensive testing resulted in a blending of ingredients that provides the most synergistic of benefits.
The notable ingredients in the Arnica Infusion formula include:
- Arnica - powerful anti-inflammatory, speeds recovery, enhances circulation
- Menthol - provides deep penetrating pain relief with a nice cooling sensation
- Vitamin B6 - promotes normal nerve function
- MSM - supports healthy connective tissues, anti-inflammatory
- Ilex Leaf Extract - increases circulation, skin conditioner
- Vitamin E - anti-inflammatory, enhances circulation, hydrates the skin
- Aloe - anti-inflammatory properties, soothes the skin
- Tea Tree - enhances penetration of ingredients
Extensive quality control procedures during the manufacturing process ensure the ingredients and final product are both safe and effective. We would not stake our reputation on anything but the best.
When Do I Apply the Arnica Infusion?
While At Work
Apply Arnica Infusion at work to help reduce acute discomfort associated with overuse of muscles and joints. No matter if you are in a physical demanding job or work within an office environment, you will be placing stress on different parts of the body and aches and pains will result.
Before Or After Work, Sports, & Activity
If you suffer from a sprained ligament, pulled muscle, strained tendon, or even bruising - apply Arnica Infusion for quick relief of the pain.
Chronic Pain Suffering
Application of Arnica Infusion can be done up to a maximum of 4 times per day on a consistent basis to help bring about relief from various pains and aches.
In-between Treatments With the T•Shellz Wraps
Follow up your T•Shellz and Cold treatments with an application of Arnica Infusion. Combine the pain relieving benefits of Arnica Infusion along with the healing benefits of the wraps to make your recovery go much more smoothly.
Do not apply Arnica Infusion within a 2 hour timespan before a T•Shellz Wrap® treatment.
Whether you decide to use the Arnica Infusion in conjunction with the T•Shellz Wrap® and other treatments - or if you decide to use the cream as a stand-alone product - you will not be disappointed with the results. We guarantee it.
Learn More About Leg Injuries & Treatments
I want to learn more about Surgery & Post-Surgery Recovery
I want to learn more about Deep Tissue Regeneration Therapy
I want to learn more about Ice & Heat: Which Is Better For Treatment?
I want to learn more about Stretching for the Hamstring
I want to learn more about Soft Tissue Injury Treatments
During your recovery, you will probably have to modify and/or eliminate any activities that cause pain or discomfort at the location of your soft tissue injury until the pain and inflammation settle. Always consult your doctor and/or Physical Therapist before using any of our outstanding products, to make sure they are right for you and your condition. The more diligent you are with your treatment and rehabilitation, the faster you will see successful results!
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