Achilles Tenosynovitis (Paratenonitis) Treatment

[@TreatMyAchilles]

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[@slackwear81]

Love your information and videos. Didn’t realize this popping sensation had a name.

[@TreatMyAchilles]

So glad!

[@novicetheaf]

Marake your information is very helpful thanks 🙏

[@TreatMyAchilles]

Glad it was helpful!

[@DonaldGaron]

If there are adhesions you need to remove them (or most of the bulk of the adhesions)! In my case, a quad tear wasn't getting better for almost a year and when I finally got it treated with shockwave therapy (radial SWT), I went from about 72% range of motion to about 93%. And the pain got much better. Same thing for my forearms except that the mobility was barely limited and I never had an injury to begin with (probably micro tears from using my arms too much and instead of healing properly, they healed with adhesions). I'm still getting treatment for both of my forearms. Pin and stretch techniques and other techniques like using cross fibre massage with a muscle scraper helped A LOT my forearms muscles/tendons pain and did have durable effects on 1) how the muscles and tendons felt when touching them (they felt/feel much less fibrous or had/have less of a weird shape when touching them) and 2) their mobility. But it wasn't enough to remove the amount of adhesions required to get rid of most or all of the pain. Systemic enzymes like nattokinase and serrapeptase also helped a lot but once they've done their job, they can only help inflammation. I am really not a fan of surgery or injections if all you have is pain and or adhesions. I would never recommend PRP or surgery unless you had a tear or have degeneration. Surgery probably if your scar healed really poorly.

[@TreatMyAchilles]

I think it is important to make advice injury specific. The treatment that works for muscle injuries and the type of stuff you are describing are very different from what applies to tendons and sheaths. So I don't agree with your advice about not considering surgery for chronic paratendinopathy.

[@DonaldGaron]

@@TreatMyAchilles I don't understand what you mean by '' The treatment that works for muscle injuries and the type of stuff you are describing are very different from what applies to tendons and sheaths '' - I'm gonna need you to be more specific so I can understand what you mean. I didn't mention paratendinopathy because I have never heard of it. Unless you mean a tendon with adhesions. In that case, my opinion is well described in my comment.

[@user-kv4eg7pu8w]

Great video, thanks for this. In the acute phase following a marathon, so was glad to see you uploaded this your videos are the best. You mention anti-inflamms, is icing generally ok to help manage the inflammation?

[@TreatMyAchilles]

Yes, icing can also help - just limit it to about 7 or 10 in as it is quite exposed. If it doesn't respond to icing over a few days, then I would still consider anti-inflamms.

[@savtajoyce2622]

I am an 85 year old woman. Developed paratenonitis from pickleball. Had a cortical steroid injection, which was good for a year. Symptoms have returned and have been present for four months, although I no longer play pickleball. I now take Eliquis, an anticoagulant, so I cannot take NSAIDS. MY doc does not want to do another injection. What options are available now?

[@TreatMyAchilles]

I would start by trying to understand why you are getting this - if you can identify the cause it often allows you to understand what is the best treatment. One thing that might help is looking at your shoes and if they provide enough support (if you need arch support) and also if they perhaps need to have a slight heel e.g. like running shoes (for daily walking) or if they are pressing on your tendon and irritating it. This is also something that our team of physios can help you with via video call. You can read more about how the online consultations work here: www.treatmyachilles.com

[@lynetteqian7621]

Great video, thank you! have had a small local oedema and thickening of the paratendon for 3 months now- although the small lump has become much less noticeable (I guess it may no longer be acute?), the thickening won’t seem to go away and stop causing pain despite limiting my activities significantly to prevent flareups. How do I know it has entered the chronic phase and does the remaining thickening usually stay forever or will it eventually return to normal thickness?

[@TreatMyAchilles]

That's not really a simple thing to answer - the small lump you are describing makes me wonder if you don't perhaps have Achilles tendonitis in combination with the paratenon being irritated because the paratenon usually don't produce a small lump but rather more spread out swelling. So perhaps you need to get a review with your physio or a second opinion on your treatment and see if you should be doing exercises to actually help strengthen the tendon and get the paratenon used to moving more normally. If you want help with figuring it out and with getting back to your normal activities, this is something that our team of physios can assess and help you with via video call. You can read more about how the online consultations work here: www.treatmyachilles.com

[@tylerreyes543]

I recently had a powerlifting meet and going in I had Achilles tendonopathy, but for the first day after the meet, my pain completely went away but then started to creep back up on me, what would cause this?

[@TreatMyAchilles]

I can't really make a guess with such limited info - there are loads of different factors that could impact it to act that way.

[@TheEdition100]

I have no pain just a popping feeling, i have been walking 8 to 10k steps each day, should I slow day a little bit for a while?

[@therea1_ndo]

yeah me too have you found out what to do yet?

[@TheEdition100]

@@therea1_ndo nope. It comes and goes. I notice it in the morning when going down the steps, but by the end of the day, it's gone. not sure if its bad or not lol

[@therea1_ndo]

@@TheEdition100 have u tried doing the achilles rehab

[@TreatMyAchilles]

Yes, you likely just need to dial down your speed and perhaps the amount (if possible) a bit. Also, check that your shoes are optimal (slight heel e.g. running shoes rather than flat)

[@therea1_ndo]

@@TreatMyAchilles it doesn’t hurt when it pops but i can still feel it.should i also do achilles tendon rehab excises and in turn will the popping go? i have already not trained for around 5 days.