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.

Achilles Tendinitis

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 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.

Achilles Tendinosis

The term tendinosis refers to the 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 accumulation of damage on the Achilles tendon is not able to heal properly. The collagen fibers deteriorate 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.

Achilles Tenosynovitis

Tenosynovitis, also called paratendonitis (or peritendinitis), is a term used to describe inflammation and degeneration of the tendon's outer layer or sheath. Depending on the tendon, the sheath is also called the synovium or paratenon. 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, Achilles tendinosis. In either case, as your body tries to heal, scar tissue forms inside the sheath attaching the inner tissues of the Achilles tendon to its outer covering, the paratenon. This scar tissue limits the gliding movement of the tendon in the paratenon, reducing the range of motion and causing pain, tenderness, redness and swelling.

Achilles Tendinopathy Treatments

The trick with any Achilles tendon injury is getting it to heal with minimal scar tissue formation and with as much realignment of the tendon fibres as possible - something ultrasound therapy is 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.

Allowing your Achilles tendon to rest is always recommended following injury. During your recovery, you will probably have to modify and/or eliminate any activities that cause pain or discomfort in your Achilles tendon until your pain and inflammation settle. Avoid all activities that may have caused the injury or irritation and begin cold compression treatments as soon as possible.

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. Therapeutic ultrasound treats inflammation and scar tissue while Blood Flow Stimulation Therapy (BFST^®) promotes blood flow to heal your Achilles tendon faster and more completely than any other methods available.

Cold Compression Therapy

Doctors recommend using cold compression as soon as possible following an acute Achilles injury and/or re-injury. This will reduce pain and swelling and minimize tissue damage that occurs with soft tissue injuries like Achilles tendon tears.

The Ankle/Achilles Freezie Wrap^® allows you to treat your Achilles tendon in an effective and convenient way.

Cold Compression Therapy works by interrupting and slowing nerve and cell function in the injured area and reducing swelling that can block blood vessels. This is important because once blood vessels are blocked or damaged, they can no longer carry oxygenated blood through the Achilles tendon and tissue cells begin to break-down. Without cold compression therapy cellular break-down and tissue damage continues as the cells do not get the oxygen they need to survive. By limiting the amount of damage done to your tendon, you also limit the amount of healing that needs to occur. This is a very important step to heal your tendon faster and with less pain!

The deep cooling effect provided by the Ankle/Achilles Freezie Wrap^® slows cell metabolism thereby reducing cellular break-down and tissue damage. Furthermore, because the cold wraps serve to numb the nerves, the wrap also reduces pain! Only the Freezie Wrap^® gel pack is charged in the fridge. This means the cooling temperature of the gel pack will not cause cold burns, or cryoburn, on your skin like ice or freezie charged gel packs can. You can also treat yourself for longer periods of time so you get lasting pain relief.

Ultrasound Therapy

Ultrasound Therapy increases tissue elasticity while promoting the flow of blood (filled with vital oxygen and nutrients) to your injured Achilles tendon. This cleans the injured area by getting rid of damaged tissue and reducing inflammation in the Achilles tendon while opening up the blood vessels to begin healing.

During the healing process, scar tissue builds on the Achilles tendon and can attach the inner layers of the tendon to the surrounding paratenon that it glides through, limiting the flexibility and movement of the Achilles tendon, gastrocnemius and soleus muscles in the calf, the subtalar joint (also known as the talocalcaneal joint) in the ankle, and even the plantar fascia. Fortunately, you can treat your Achilles tendon with therapeutic ultrasound to soften scar tissue and improve the gliding motion and flexibility of your ankle.

Not only does ultrasound aid in the duration of healing, but it helps to prevent long term complications. Pain, lack of mobility, tendinosis, or a complete Achilles tendon rupture are some of the more common long term complications that can occur when Achilles injuries and tendinitis go untreated. By treating your Achilles tendon with ultrasound, scar tissue becomes softer and the tissue becomes stronger reducing the risk of chronic problems in the future.

For those who suffer from long term Achilles injuries (chronic tendonitis, tendinosis, tenosynovitis, Achilles bursitis or Haglund's Syndrome), ultrasound can help. Ultrasound therapy will break up the tough and fibrous scar tissue that has built up over time on the tendon and restore flexibility in your ankle, calf muscles, and foot.

Ultrasound can also be used to administer therapeutic medicines into the body. This is a process known as phonophoresis. Ultrasound with phonophoresis is rapidly becoming more popular than ultrasound therapy alone.

Using the MendMeShop^® Lavender Infusion Gel during your ultrasound therapy gives you 2 therapies in 1. You get the benefit of the regenerating sound waves from the ultrasound device itself AND the added bonus of the therapeutic ingredients inside the gel being delivered into the tissue where it is most effective.

Lavender Infusion Ultrasound Gel contains the natural essential oils of Bulgarian lavender, peppermint, eucalyptus, and menthol and is exclusively available from MendMeShop^®. These ingredients reduce inflammation, relieve pain and improve blood circulation to your Achilles tendon. 1 bottle of MendMeShop^® Lavender Infusion Ultrasound Gel comes FREE with every MendMeShop^® Ultrasound System so you get unbeatable ultrasound therapy for your injured Achilles tendon.

MendMeShop^® ultrasound therapy with phonophoresis is safe, convenient, and easy and generally requires between 5 - 10 minutes per treatment. It is based on a form of deep tissue therapy, which is generated through high frequency sound waves (that we can not hear). These waves send vibrations deep into your Achilles tendon and slightly increase the temperature of your soft tissue cells. The waves are delivered through a hand held transducer and conductive gel that are used together in a slow, circular motion on your skin over the injured area.

Blood Flow Stimulation Therapy

Once the inflammation in your Achilles tendon has been reduced, nourishing and strengthening the tissue in the Achilles tendon and surrounding area is recommended.

Using Blood Flow Stimulation Therapy, or BFST^®, will speed your recovery and heal your Achilles tendon more completely preparing it for strengthening exercises.

BFST^® increases the amount of blood that flows naturally to your ankle to nourish your tendons, ligaments and muscles, improving elasticity and accelerating the healing process.

The Achilles tendon receives a limited blood supply compared to other tendons in the body and this greatly reduces its natural ability to heal itself. By treating your Achilles tendon with Blood Flow Stimulation Therapy you can increase your body's blood supply to the Achilles tendon and increase your body's natural healing power. In addition, the fresh blood flow whisks away dead cells and toxins that have built up from the injury leaving the area clean and able to heal faster. Our Ankle/Achilles Inferno Wrap^® provides effective, non-invasive, non-addictive pain relief and healing with no side effects.

With these 3 easy therapies you will notice incredible improvement in your tendon. The more diligent you are with your treatment and rehabilitation, the faster you will see successful results!

Learn More About These SUPERIOR Achilles Treatments

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Although steroid injections may provide temporary relief of the pain of Achilles tendinitis, they should generally be avoided as they weaken the tendon and may lead to a rupture of the tendon. 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.

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.

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