Updated: Jul 29, 2020
The Tenex procedure is a cutting edge new technique for treating Achilles Tendinitis and stubborn Plantar Fasciitis. The Tenex system utilizes a small ultrasonic probe that breaks up damaged abnormal tissue and removed it from the site. The entire procedure is performed through 1 or 2 small incisions.
Long standing tendinitis causes physical changes to the tendon resulting in chronic pain and weakness. While the term tendinitis is more widely used, patients with chronic tendon pain usually have a condition called tendinosis. Tendinitis is simply inflammation of the tendon, tendinosis is a more chronic condition that involves a physical change to the tendon.
Tendinosis results in the development of an amorphous, jelly-like “goop” called Myxoid tissue to develop in and around tendon fibers. Scarring, thickening and fibrosis also occurs in the tendon. These changes are neither healthy nor supportive to the tendon and greatly increases the chances of a tendon rupture. The Tenex probe isolates and pulverizes the diseased tissues. It then suctions the debris away to stimulate new blood vesicles and healthy tissue to develop.
Diseased tendon can easily be identified with an MRI. Normal tendon should be solid dark black on MRI (colored blue in below images). Tendon should also have a fairly consistent diameter from side to side. Tendons that are diseased or damaged are be more lobular with thick portions and thin portions. Damaged tendon will also not be solid in color. The lighter areas are where normal collagen fibers have torn or have been replace by damaged diseased tissue.
The Tenex procedure is also referred to as Focused Aspiration of Scar Tissue (F.A.S.T.). It is revolutionary because it involved only a small incision. Historically surgical repair of the Achilles tendon and plantar fascia involved a large incision with extensive dissection of the tissues. Damaged tissues are manually visualized and cut out with a scalpel using conventional methods. The Tenex procedure is performed through a small incision through which the Tenex wand is inserted. The tip of the Tenex wand has a jet of water along with ultrasonic waves that come out of its tip. These ultrasound waves are set at just the right frequency to loosen and break apart the diseased tissue. The ultrasound along with the mechanical movement of the probe break up the damaged tissues that cause pain in a process called emulsification. A small sheath around the tip of the probe then suctions the particles of damaged tissue from the body.
Using ultrasound, damaged tendon and painful bursas are pulverized with the ultrasound and essentially turned into a liquid which is then removed from the site with a suction system attached to the probe.
Prior to the development of the Tenex procedure there was not much that could be done for bursitis and tendonitis besides an extensive open surgery with prolonged recovery time. The Tenex procedure is minimally invasive and more accurate than the open procedure because the ultrasonic frequency is set to a frequency that only removed damaged and diseased tissues. The technique spares living healthy tissue. While this procedure is “new” to podiatry and orthopedics, the technology has been used for over 30 years by optometrists to removed cataracts. So the technique itself has been tested tried and true.
With chronic tendonitis physical therapy, anti-inflammatories and even cortisone injections are often unsuccessful because they do not remove damaged scared tissues.
Dr. Beau Willis at has extensive experience with the procedure and states, “The Tenex procedure has revolutionized how we treat plantar fasciitis and Achilles tendinopathy”. Dr Willis performs several procedures a week and has become one of the leaders with the Tenex procedure.
Conventional “open” surgery requires extensive dissection to expose and access the damaged tissues. Even once exposed, the abnormal tissues being removed are somewhat arbitrary because the abnormal tissues are mixed with viable normal tissues. Recovery with the Tenex procedure is much quicker. Athletes are back to sports within 6-8 weeks vs 3-6 months or longer with open surgery.