Many people complain about their tendinitis, and many times they’re mistaken. The source of their pain is really tendinosis.
“That’s from chronic tears or chronic minimal or partial thickness tears of the tendon where it hasn't ruptured all the way, but the internal fibers have stretched,” says Dr. Andrew Belis, foot and ankle surgeon on Lee Memorial Health System’s medical staff.
Tendinitis refers to inflammation of the tendon, while tendinosis is the name used for microtears in the tissue in and around the tendon. An actual injury, it is responsible for most Achilles tendon trouble.
“Most commonly pain occurs when they’re pushing off; in that phase of gait. So it’s not really standing that bothers them, it’s that push off on that one leg that can give them trouble,” says Dr. Belis.
While an Achilles rupture results from a sudden, forceful movement. These microtears occur over time, and can weaken the tendon making it more susceptible to rupturing. Several techniques are available to fix the pain before it escalates.
“Fixing that can involve de-bulking the tendon. Another would be to actually cut out the damaged portion of the tendon, that’s more of a chronic situation. But lengthening the tendon can help to take the stress off,” says Dr. Belis.
Repeated microtears cause the tendon to thicken, similar to scar tissue. So notching the tendon with tiny cuts, also called lengthening the tendon, allows it to stretch and often brings relief.
“That really does prove to be very successful,” says Dr. Belis.