Ultrasound Exam Results Show Thickening of Achilles Tendon

by F

Ultrasound exam results showed up " thickening " of Achilles tendon sheath ? Is this tenosynovitis

And is the treatment the same ?


Joshua Answers:

Hi F.

Does the achilles have a tendon sheath?

Technically the achilles tendon does not have a tendon sheath, or 'synovial sheath'. But does have 'paratenon'...which is a sheath...

For our purposes, let's go with that yes, there is a tendon sheath around the achilles.

But even that is splitting hairs a little, as the achilles tendon is the achilles tendon, with some inner/outer structural variation.

So...thickening. Yes that happens.

The body is always changing, and depending on how one does or doesn't use their body, age, overall health, bodyweight and composition, etc.

A thickening of the tendon sheath isn't necessarily a bad thing.

If you have pain with it, that's a different story, and then it could certainly be, essentially, Tenosynovitis.

Ultimately, the treatment is the same as for Tendonitis:

1. Relax the muscles, open up the connective tissue.

2. Ice Dip and Ice Massage.

3. Cover bases with Vitamin D level up where it's supposed to be, Magnesium for Tendonitis to help relax muscles/stop spastic tightness.

See: What Is Tendonitis?

See: Achilles Tendonitis

Tenosynovitis is a variation of tendonitis that is more stubborn, more acutely painful, and a bit tougher to get the inflammation out.

Please reply using the comment link below. Do not submit a new submission to answer/reply, it's too hard for me to find where it's supposed to go.

And, comments have a 3,000 character limit so you may have to comment twice.

Joshua Tucker, B.A., C.M.T.
The Tendonitis Expert

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Comments for Ultrasound Exam Results Show Thickening of Achilles Tendon

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Jan 22, 2010
by: Anonymous

thanks joshua

Mar 21, 2017
Thickening and recurring flare ups of achilles tendon
by: Stuart D

Hi there, thanks for the opportunity you're offering here.

My achillies was injured in a silly moment of pride by chasing my cat who had stolen some cooling chicken on the bench, I chased him inside then outside then back inside and around and around like a bad Wylie Coyote vs Roadrunner cartoon.

At the height of the chase I took the decision to leap and try to trap his tail beneath my foot as he jumped up the door step......unfortunately he flinched ever so slightly and I altered my trajectory slightly to compensate and landed my left foot on the very front part of the step leaving the back of my foot to stretch badly at the tendon unsupported.

There was immense pain and very bad swelling and may have partially ruptured.

I did not seek medical advice and just took a few days off work and did the normal ice treatment and rest.

Over the next seven years I have perhaps three to four flare ups of this injury and each time the small lump on the tendon I had grows in size and pain. It's never gone away and is now at the point that the whole length of the tendon is markedly thickened and very tender and painful to touch and now it has in the last few weeks made me limp badly without any reprise from pain or inflammation.

I'm currently following a protocol of using nitro glycerin patches and trinitrate sprays on the area in what my medical professional is hoping will regenerate a good blood supply promoting healing.

However this route seems very slow if there is any relief at all. I'm told this may take eight months to complete this course of action but I can't see any immediate benefit.

I'd be very grateful if you could offer an opinion or set me on a course of different way of looking at this injury, at the moment it is affecting my performance at work and is a troublesome injury to carry around plus I find the act of having to limp from morning to night both physically and mentally tiring.

Any help or thoughts on this would be great, thanks.


Joshua Comments:

Hi Stuart.

1. Did your doc ever do an MRI to see if you had a tear? The conversation is potentially a little/a lot different if A. had/have a tear or B. don't have a tear.

You can get the thickening with A or B, but it's good to know what we're working with.

Just because it hurt really bad when you hit that step doesn't necessarily mean that there was an 'injury' (by which I mean rip/tear).

2. Personally, I wouldn't stick with that strategy for 8 months, as you'll be (probably) unhappy if you aren't any better in 8 months.

3. How are the nitro glycerin patches and trinitrate sprays going to fix/help the thickening?

4. What is causing the thickening? It's kind of important to understand that when picking a treatment method.

Thickening doesn't just happen for no reason.

If you need 'healing', why exactly do you need healing and what exactly needs to heal?

If you don't need 'healing', why the thickening?

Answer those, and we'll go from there.

See Related: Acutely Painful Small Lump On Achilles Tendon

Jul 17, 2018
Get it checked properly
by: Anonymous

I've been in a vacoped boot for 8 wks with a partial tear before that I had a cast for 9 days ! I've just had a scan and I was told imy Achilles is now intact she then told me she could see thickening on my Achilles ! She also asked who diagnosed the tear ! I immediately asked why have I been wearing this contraption for all these weeks for nothing she then said no it had healed or was healing was intact but there was thickening there . I told my physio weeks ago it felt like thickening and she said it would do because of injury ! I'm very concerned someone's got it wrong here have I actually had a tear ??? Make sure u get a scan asap after injury I've still got boot on and see physio Friday hopefully I'll get rid of boot.


Joshua Comments:

If you had a tear, you'll have thickening.

If you didn't have an MRI or equivalent, then nobody knows if you had a tear or not (I guess maybe an xray could see if the tear was big enough).

How big was the tear?

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