Tenex Procedure

What can cause fascia discomfort or tendon pain? 

Tendons can be considered rubber bands that help hold your joints in place and connect your bones to your muscles. They’re found alongside ligaments — fibrous soft tissues that connect bone to bone.

Overuse through repetitive motion can cause the build-up of scar tissue in the tendons. Hence, some forms of chronic tendon pain are given names such as golfer’s elbow, jumper’s knee, or tennis elbow.

When scar tissue builds up on the Achilles tendon (the tendon that connects your calf muscles to your heel) due to damage to its insertional point, it is known as Achilles tendinopathy.

Similarly, the thick band of tissue that connects the heel bone to the toes, the plantar fascia, can become inflamed. This is known as plantar fasciitis. In some cases, it is not sports activities or repetitive movement that cause tendon pain, but rather trauma, such as a trip, fall, or sudden twist of the foot.

Regardless of the culprit of scar tissue build-up, if left untreated, it can cause pain and a limited range of motion. Achilles tendinopathy and plantar fasciitis are commonly characterized by heel pain or foot pain, particularly when walking or running. Other symptoms include stiffness, swelling in the affected area, skin that feels warm to the touch, and trouble lifting the toes.

How are Achilles tendinopathy and plantar fasciitis traditionally treated? 

Traditional methods for treating tendon or ligament pain usually begin conservatively. Dr. Bob Baravarian’s podiatrists often start with rest to see if the tendon will heal on its own. After a period of limited activity, you may begin physical therapy to help strengthen the muscles surrounding the tendon. To assist with pain, we may suggest custom orthotics or anti-inflammatory medication. If the pain is severe, cortisone injections can help temporarily alleviate discomfort.

Persistent pain from tendinosis (chronic damage to the tendon) or tendinitis (a swollen tendon) can signal the need for a more thorough evaluation and treatment. Historically, this would have meant pursuing surgical options, such as Achilles tendon repair surgery. Surgical Achilles tendon repair may involve open surgery, debridement of damaged tissue, suture repair of any tears, a tendon transfer, and possibly a fasciotomy to relieve pressure from swelling.

Similar methods are used to relieve swelling of the plantar fascia. In some cases, repair surgery could even involve detaching the plantar fascia from the heel bone.

However, these surgical procedures typically involve a larger incision and longer recovery downtime.

What is the Tenex procedure? 

The Tenex Procedure is an ultrasound-guided percutaneous needle tenotomy (PCNT). We’re able to surgically cut the damaged tendon through the skin, without the need for an open incision. During the Tenex treatment, our doctor will use diagnostic ultrasound to pinpoint the exact area(s) of damage. Ultrasound imaging utilizes a real-time, specific frequency that, with the guidance of our specially trained doctors and technicians, can distinguish between healthy tissue and scar tissue without the need for open surgery.

Then, they use local anesthesia to numb the target area and use an ultrasonic needle to target the scar tissue. Ultrasonic energy is transmitted through the needle, helping to break down the scar tissue on your tendon. The needle also removes the damaged scar tissue after it is broken down. Healthy tendon tissue remains unaffected.

In most cases, the treatment takes approximately an hour, with the actual Tenex procedure lasting only about 15 minutes. General anesthesia isn’t required, and only a very small incision is necessary. Afterward, there can be minor swelling.

However, recovery time is significantly reduced from several months (with traditional surgery) to one to two weeks with Tenex. You can usually begin light weight-bearing exercise within two weeks after your follow-up appointment. Most patients experience significant pain relief within four to six weeks and achieve full recovery by six months. During recovery, we may suggest wearing a walking boot for the first week or so and starting physical therapy to maximize Tenex results and help prevent future injury.

The TenJet System: a new and better alternative to Tenex? 

Although the Tenex surgery is excellent, the TenJet minimally invasive procedure is considered an improved version. Instead of the larger needle probe of the Tenex, which could theoretically cause scar tissue as a result of the procedure itself, the Tenjet Hydrocision system uses water jet technology. While Dr. Bob Baravarian’s surgeons are trained in Tenex, we prefer the TenJet.

What is the TenJet procedure? 

This outpatient procedure begins in the same way as the Tenex procedure: with ultrasound imaging to identify areas of concern. Then, after applying local anesthetic, we cut a minute hole, the size of a needle, allowing a tiny probe to be inserted into the target area. Once at the scar tissue site, a high-strength water jet breaks up the damaged tissue.

However, the jet is not strong enough to destroy healthy tissue, so it remains intact. The TenJet enables better precision in breaking up scar tissue, and the attached suction machine allows scar tissue to be effortlessly removed from the body.

There is even less downtime following TenJet Hydrocision Therapy. Patients can bear weight on the foot immediately after the procedure. However, our doctors often provide crutches and a walking boot for optimal healing. After a week, you’ll be able to return to light, everyday activities. At this time, we recommend starting physical therapy to rebuild strength and flexibility.

While both Tenex and TenJet can be used to treat foot and ankle pain caused by conditions such as Achilles tendinitis or plantar fasciitis, Dr. Bob Bavarian recommends the TenJet treatment as the best option. They can also combine the procedure with additional therapy options such as platelet-rich plasma (PRP) or amniotic cell injection to boost healing and get you back to a pain-free life.

Why Turn to Dr. Bavarian for your TenJet or Tenex procedure

Dr. Bob Bavarian stands at the forefront of these exciting new podiatry procedures. He utilizes every traditional and advanced technological modality to address your foot and ankle concerns safely.

For a consultation, please call (855) 557-5400 or make an appointment online now.

Dr. Bob Baravarian is conveniently located in Los Angeles, near Cedars-Sinai Medical Center, providing expert foot and ankle care for patients throughout Southern California.