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  • Writer's pictureLuke Nelson

Achilles paratenon involvement: what is it & how to fix it

Updated: Mar 12

The paratenon can be a cause of tendon pain, but what is it & how can it be fixed?

The paratenon is a sheath that covers the Achilles’ tendon which can get irritated & cause tendon pain. Its' function is to protect the Achilles tendon & reduce the friction between the tendon & adjacent structures.

What are the telltale signs of paratenon irritation?

🔑Diffuse pain up & down the tendon vs more specific pain in tendinopathy

🔑Pain is worse on slower movements i.e. calf raise rather than quicker movements such as hopping (tendinopathy will be worse with hopping)

🔑Crepitus (noise) that can be felt or heard (with the naked ear or stethoscope).

🔑Puffiness & swelling around the tendon

The solution?

🎯Applying a mix of topical anti-inflammatory & hirudoid cream twice per day for 7-10 days, wrapping in cling wrap overnight (only apply if directed by a health professional)

🎯Appropriate loading progressions: those suffering paratenon irritation may better tolerate isometrics or more dynamic exercises such as hopping (rather than slow calf raises), as there tends to be LESS sliding of the tendon inside the sheath with these movements.

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