Condition Guide · Atlanta, GA

When the Achilles never fully recovers

A tweaked Achilles usually calms down with rest. But for a lot of runners, walkers, and people who are simply on their feet all day, the ache in the back of the ankle keeps returning — thicker, stiffer, and slower to warm up each time. That pattern points to tendinopathy: a tendon that has been quietly breaking down faster than the body rebuilds it.

Rx
Six Atlanta specialists
Sports medicine, PM&R & interventional pain
Each office below evaluates chronic Achilles tendinopathy and can tell you whether an in-office procedure like TenJet is a fit for your case — or whether a more conservative path makes sense first.

Firsthand Account

One Achilles Tendon, Years of Pain

A patient describes chronic Achilles tendon degeneration, the treatments that failed first, and the outcome after TenJet.

TenJet - Achilles Tendon Pain Case Experience and Patient Testimonial

Video courtesy of HydroCision, Inc., the maker of TenJet®. Individual results vary; this patient's experience is not a guarantee of outcome. Talk with a specialist about whether the procedure is appropriate for you.

Understanding The Condition

Not all Achilles pain is the same

Where the pain sits tells the specialist a great deal. Some tendon breakdown occurs a few centimeters above the heel, in the mid-portion of the tendon; some sits right where the tendon meets the heel bone. They can behave differently and respond to different treatments, which is one reason a hands-on evaluation with imaging matters more than guessing from symptoms alone.

Stiffness and pain that are worst on the first steps of the morning
A tender, sometimes visibly thickened section of the tendon
Symptoms that flare with hills, stairs, or a jump back into training
A degenerative process — which is why rest alone often only pauses it

Where TenJet Fits

Treating the tendon without opening it

Loading programs and physical therapy resolve many cases of Achilles tendinopathy and are almost always the starting point. When they don't, TenJet — a HydroCision, Inc. device — lets a specialist address the degenerated portion of the tendon directly, in the office, and skip the extended downtime of open tendon surgery.

Continuous ultrasound shows the specialist exactly where the breakdown is
A fine saline jet emulsifies the diseased tissue while sparing healthy fibers
Built-in suction clears the debris as the procedure goes
Entry is through a small incision, under local anesthesia only
About 15 minutes in-office, then home the same day
Reimbursed by Medicare and most private insurers
Read the technical details at hydrocision.com →

See The Procedure

TenJet® in Action

Official demonstration video from HydroCision, plus a simple visual of how a healthy tendon differs from one in chronic degeneration — the state TenJet is designed to address.

TenJet Achilles & Plantar Fascia Tendinopathy — Procedure Technique

Healthy tendon fiber structure diagram
Healthy Tendon
Tendinitis inflamed tendon diagram
Tendinitis
Tendinosis degenerated tendon fiber diagram
Tendinosis (Chronic Degeneration)

Diagrams and video courtesy of HydroCision, Inc.

Common Questions

Frequently Asked Questions

Why does the Achilles degenerate?

It carries very high loads with a relatively modest blood supply, so accumulated micro-damage can outpace repair — particularly with a sudden increase in training or standing time.

What is dorsiflexion and why is it measured?

It is how far the foot can flex upward. Restriction is common in Achilles problems, and published examinations record it as an objective marker alongside symptoms.

Can insertional and mid-tendon problems both be treated?

Both regions can be addressed. One published case treated calcifications at the mid-Achilles and then the distal insertion within the same session.

How much improvement is realistic?

In that case pain fell from 7 out of 10 before the procedure to 3 out of 10 at four weeks, with continued improvement afterwards. Results vary between patients.

This information is general and is not medical advice. Whether any procedure is appropriate for you can only be determined by a physician who has examined you and reviewed your imaging.

Speak Directly With Each Physician's Office
Call the office below that matches the specialist you'd like to see about Achilles pain.
CC
Sports Medicine & PM&R
Northside Hospital Orthopedic Institute
(770) 795-5620
MS
Non-Operative Orthopedics
Northside Hospital Orthopedic Institute
(770) 758-5059
KK
Dr. Kamal Kabakibou, MD
Interventional Pain Medicine
Center for Pain Management, Atlanta
(404) 882-9778
EO
Interventional Pain Medicine
OlympusMD Pain & Wellness
(770) 629-9023
OH
Interventional Pain Medicine
OlympusMD Pain & Wellness
(770) 629-9023
UN
PM&R & Spine
Resurgens Orthopaedics, Covington & Decatur
(404) 856-3706