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.
Achilles Tendinopathy Treatments
If you have an achilles tendon injury, rest is recommended, however, some careful movement is required to prevent the joint from freezing and losing range of motion. See your doctor or physical therapist for stretches that will not cause further injury to your achilles. Avoid activities that cause pain or may have caused the injury and begin cold compression treatments as soon as possible.
The trick with any Achilles tendon injury is getting your achilles back in the best possible condition you can is getting it to heal quick to minimize scar tissue growth - something our T•Shellz Wraps are great at! Even with optimum healing, there is always less elasticity in a previously injured tendon. This will cause your Achilles tendon to hurt during regular movement and exercise. However, if you heal your injury efficiently and quickly, your chance of re-injury later on is much lower than average.
The Achilles tendon is a difficult tendon to rest completely as it is an essential tendon for walking and daily activities. Fortunately, there are healing tools that can help treat your Achilles tendon and speed up the healing process so you can get back to a life without pain and risk of further injury. The use of a T•Shellz Wrap® (Deep Tissue Therapy) increases elasticity of soft tissue while promoting blood flow at the treatment site.
Although steroid injections may provide temporary relief from the pain of an achilles injury they should generally be undertaken with caution as they weaken the tendon and may lead to a complete rupture. If you do opt for an injection, doctors usually recommend that you do not participate in strenuous activities for several weeks to reduce the risk of a rupture.
Conservative Treatment Step 1: Reduce The Initial Inflammation
Inflammation is the body's natural response to an immediate achilles injury and is a normal part of the healing process - helping to reduce tissue infection in the early stages of injury. Swelling, pain, heat sensation, redness, and loss of function are the main symptoms experienced.
The combination of rest, topical pain relief cream and minor amounts of cold therapy is the gold standard in medicine for minimizing tissue damage and reducing inflammation after injury or activity. It serves as a critical bridge into the next phase of the healing process.
Conservative Treatment Step 2: Enhance Blood Flow to the Injured Soft Tissue
Once the inflammation in your Achilles tendon has been reduced, nourishing and strengthening the tissue in the Achilles tendon and surrounding area is recommended.
It is through the blood that the body carries nutrients, oxygen, and antibodies that injured tissue needs to repair and rebuild. Research shows that electromagnetic energy is a very effective treatment for stimulating blood flow to dense tissues such as tendons, ligaments, muscles, and even vascular portions of cartilage. This dramatically improves the healing process.
Electromagnetic energy is an energy waveform that is absorbed by dense tissue (muscles, tendons, ligaments) and not absorbed much by less dense tissue (fat cells, skin). Absorption of this energy translates to thermal heat, and the body increases blood flow to the area as a response to this heat. This increased blood flow speeds up the healing process, clearing the area of toxins and excess fluid build up, thereby reducing inflammation. More details on this are found further down the page.
Electromagnetic Energy is recognized in scientific circles as a legitimate treatment for many forms of muscle and soft tissue injuries.
Conservative Treatment Step 3: Recognize That Healing is a Process
With dedication, the right tools, and the right information - you will achieve your goal of a sustainable recovery. A combination approach of cold therapy, deep heat treatments, and functional movements will make it happen much more quickly. Healing takes a comprehensive approach and will differ from person to person.
If you have questions, we welcome you to call our office toll-free at 1-866-237-9608 (Continental US), or Internationally at +1-705-532-1671.
The Achilles T•Shellz Wrap® - Heal Your Achilles For The Long Term
The best option we came across in our research to accomplish faster healing of soft tissue injuries in the achilles is the AchillesT•Shellz Wrap®. Use of this device results in a significant 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 ankle/heel 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.
Learn More About Achilles Injuries & Treatments
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Remember: Always consult your doctor and/or physiotherapist before using any of our outstanding products, to make sure they're right for you and your condition.