Key points
- Long-standing tendon pain is mostly a degeneration problem, not an inflammation problem, which is why rest, anti-inflammatory pills, and steroid shots often fail to fix it for good.
- Through a small skin nick, under live ultrasound, a fine high-pressure stream of sterile saline cuts away the damaged tissue and leaves healthy tendon in place.
- Improvement is gradual, not instant: most people notice change over 6 to 12 weeks, with full benefit taking 3 to 6 months.
- The single biggest factor you control is protecting the tendon: 1 week of limited activity and 6 to 8 weeks of no strenuous activity.
Understanding your diagnosis
When a tendon is overloaded again and again, damage can outpace the body's ability to repair it, and healthy tendon fibers are slowly replaced by weak, disorganized scar-like tissue. This is called tendinopathy, or tendinosis. Despite the common name "tendinitis," long-standing tendon pain is mostly a degeneration problem, not an inflammation problem, which is why rest, anti-inflammatory pills, and steroid shots often fail to fix it for good.
The treatment
TenJet is a minimally invasive procedure performed through a small skin nick, without open surgery.
Under live ultrasound guidance, a thin instrument uses a fine, high-pressure stream of sterile saline to cut away and remove the damaged tissue while leaving healthy tendon in place. The goal is to clear out tissue that is not healing and restart the tendon's repair, which is why the recovery that follows matters as much as the procedure.
Strengthening exercise remains the foundation of tendon treatment, before and after TenJet. Steroid injections calm pain for a short time but do not repair the tendon, and repeated injections can weaken it. TenJet is an option when good rehab has not been enough, before considering open surgery. Insurance coverage for this procedure varies and some plans do not cover it; we verify your benefits and discuss any cost with you before scheduling.
| Area | Often called | Where it hurts |
|---|---|---|
| Hip, gluteal tendons | "Hip bursitis" | Outside of the hip; lying on that side, stairs, standing on one leg |
| Shoulder, rotator cuff | Rotator cuff tendinitis | Front and side of the shoulder; reaching overhead or behind, sleeping on it |
| Knee, patellar and quadriceps tendons | "Jumper's knee" | Just below or above the kneecap; stairs, squatting, kneeling, jumping |
| Heel, Achilles tendon | Achilles tendinitis | Back of the heel or lower calf; first steps, walking uphill, running |
| Foot, plantar fascia | Plantar fasciitis | Bottom of the heel; first steps in the morning or after sitting |
| Elbow, forearm tendons | Tennis or golfer's elbow | Outside or inside of the elbow; gripping, lifting, turning a doorknob |
Usually a good fit
- Tendon pain lasting 3 months or longer
- Damaged tendon tissue confirmed on ultrasound or MRI
- Not enough improvement after a real trial of physical therapy
- Willing and able to follow the 6 to 8 week recovery plan
Usually not a fit
- A complete or large tear, which needs a surgical evaluation
- New pain, or no trial of therapy yet
- Infection in or near the area
- Pain from another source, such as arthritis or a nerve
Before your procedure
- Tell us about blood thinners. Most can be continued, but we will give you specific instructions.
- Avoid a steroid injection in the area being treated in the weeks before your procedure.
- Plan your week. Arrange time off work, help at home, or lighter duty for the first week.
- If you receive sedation, you must have a driver and should not drive the rest of the day.
- Wear loose clothing that easily exposes the treatment area.
- Bring your boot, sling, brace, or crutches if you were asked to get them in advance.
Procedure day
- We locate the damaged tendon with ultrasound, clean the skin, and numb the area well; some patients also receive light sedation.
- The treatment itself usually takes 10 to 20 minutes. You may feel pressure but should not feel sharp pain.
- The small skin opening is closed with an adhesive strip, usually no stitches, and you go home the same day.
- Expect soreness once the numbing wears off. It is common for the area to feel worse for the first several days before it starts to improve.
Afterward: what to expect
Protect the tendon for 6 to 8 weeks
After TenJet, the tendon is rebuilding and is temporarily weaker than it feels. Many people feel much better within a few weeks and are tempted to resume their usual workouts, sports, or heavy work. Doing too much too soon is a common cause of setbacks and raises the risk of a tear. Following the 1 week of limited activity and 6 to 8 weeks of no strenuous activity gives the treatment its best chance to work.
- The first days. Soreness once the numbing wears off, and the area commonly feels worse for the first several days before it starts to improve.
- Improvement. Gradual, not instant. Most people notice change over 6 to 12 weeks, with full benefit taking 3 to 6 months. The repaired tendon continues to strengthen during that time, so keep up your exercises.
- Coverage. Insurance coverage for this procedure varies and some plans do not cover it. We verify your benefits and discuss any cost with you before scheduling.
Possible risks
- Soreness, bruising, or swelling for several days to two weeks
- Infection, bleeding, or nerve irritation: uncommon
- Tendon weakening or tear: rare, most often with early overuse
- Not enough improvement; some patients need a repeat procedure or surgery
Activity
Wound care and comfort
Your procedure in one paragraph
Many patients have meaningful, lasting improvement after TenJet, though no procedure works for everyone. Improvement is gradual, not instant: most people notice change over 6 to 12 weeks, with full benefit taking 3 to 6 months. The single biggest factor you control is protecting the tendon during recovery.
Follow-up schedule
- 1
6 to 8 weeks
Follow-up visit. Once cleared, gradually build back to exercise, sports, and heavy work over several weeks.
- 2
3 to 6 months
Full benefit. Keep up your exercises as the repaired tendon continues to strengthen.
Call us right away if you notice
- Fever, spreading redness, warmth, or drainage from the site
- Pain that keeps getting worse after the first several days
- A sudden "pop" with new weakness, or new numbness
- Calf swelling or pain, especially while wearing a boot
This guide is the same information as the printed handout from Abilene Pain. It is general information and does not replace the instructions your care team gives you at your visit. Your care team: Nicolas Pugh, MD · Adrianne Anders, NP · Ted Chaka, PA.