SHOCKWAVE THERAPY for Tenoperiostitis/ Calcaneal spur/ Heel Bone Spur elite physiotherapy


Introduction to Tenoperiostitis:

Tenoperiostitis, also known as tendon periostitis or traction periostitis, is a condition characterized by inflammation and irritation of the tendon and its attachment to the periosteum, the thin layer of connective tissue covering the bones. This condition primarily affects individuals engaged in repetitive activities or sports that place excessive strain on the tendons. In this article, we will delve into the definition, causes, risk factors, signs and symptoms, diagnosis methods, and medical treatment, and emphasize the significance of physiotherapy in the management of tenoperiostitis.


Tenoperiostitis refers to the inflammation of the tendon and its attachment to the periosteum. It commonly occurs in areas such as the elbow (tennis elbow), knee (jumper’s knee), and ankle (Achilles tendinitis).

Causes and Risk Factors of Tenoperiostitis:

Tenoperiostitis typically arises due to repetitive or excessive strain on a specific tendon. Some common causes include:

  1. Overuse: Engaging in repetitive activities that strain the tendon without adequate rest or recovery can lead to tenoperiostitis.
  2. Poor technique: Incorrect or improper technique during sports or exercise can increase the risk of tendon irritation.
  3. Biomechanical factors: Abnormalities in foot posture, limb alignment, or muscle imbalances may predispose individuals to develop tenoperiostitis.
  4. Age and gender: Middle-aged individuals and males are more susceptible to tenoperiostitis.
  5. Medical conditions: Certain medical conditions such as rheumatoid arthritis or diabetes can increase the risk of developing tenoperiostitis.

Signs and Symptoms:

The following signs and symptoms are commonly associated with tenoperiostitis:

  1. Pain: Persistent or intermittent pain in the affected tendon region, often exacerbated during movement or activity.
  2. Tenderness: Tenderness upon palpation or touching of the tendon.
  3. Swelling: Localized swelling around the tendon area.
  4. Stiffness: Restricted range of motion and stiffness in the affected joint.
  5. Weakness: Decreased strength and grip in the affected limb.


To diagnose tenoperiostitis, a healthcare professional will typically perform a thorough physical examination and review the individual’s medical history. Diagnostic methods may include:

  1. Medical history assessment: Evaluating the onset, duration, and aggravating factors of the symptoms.
  2. Physical examination: Palpation of the affected area to identify pain, tenderness, swelling, and range of motion limitations.
  3. Imaging tests: X-rays, ultrasound, or MRI scans may be used to assess the severity and rule out other underlying conditions.

Medical Treatment:

Medical treatment options for tenoperiostitis may include:

  1. Rest and activity modification: Avoid activities that exacerbate the symptoms and allow the tendon to heal.
  2. Pain management: Non-steroidal anti-inflammatory drugs (NSAIDs) or corticosteroid injections may be prescribed to reduce pain and inflammation.
  3. Physiotherapy: A structured exercise program designed to strengthen the affected tendon and improve flexibility may be recommended.
  4. Orthotics: The use of shoe inserts or braces can help correct biomechanical abnormalities and reduce strain on the tendon.
  5. Surgery: In severe cases where conservative treatments fail, surgical intervention may be considered to remove damaged tissue or repair the tendon.

Physiotherapy Treatment:

Physiotherapy plays a crucial role in the management of tenoperiostitis. A skilled physiotherapist will develop an individualized treatment plan tailored to the patient’s specific needs. The physiotherapy treatment may involve the following components:

Therapeutic exercises:

The physiotherapy treatment for tenoperiostitis involves a progressive exercise program that focuses on strengthening the affected tendon, improving flexibility, and restoring normal movement patterns. These exercises are designed to promote healing, reduce pain, and prevent future recurrences. The physiotherapist will guide the individual through a range of exercises targeting the specific tendon involved. This may include eccentric exercises, isometric exercises, stretching exercises, and functional movements that simulate real-life activities. The exercise program will be tailored to the individual’s pain levels, stage of healing, and overall fitness.

Manual therapy techniques:

Physiotherapists may employ various manual therapy techniques to address soft tissue restrictions, improve joint mobility, and alleviate pain. These techniques may include soft tissue massage, myofascial release, joint mobilization, and trigger point therapy. Manual therapy helps reduce inflammation, promote circulation, and enhance tissue healing.


Certain physical modalities may be utilized as part of the physiotherapy treatment. These modalities aim to reduce pain, and inflammation, and promote tissue healing. Commonly used modalities for tenoperiostitis include

  1. Ultrasound therapy,
  2. High-intensity class 4 laser therapy,
  3. Electrical stimulation,
  4. Cryotherapy (cold therapy), and
  5. Extracorporeal Shock Wave Therapy (ESWT).

Biomechanical assessment and correction:

A thorough assessment of the individual’s movement patterns, posture, and biomechanics is conducted by the physiotherapist. Any abnormalities or imbalances that contribute to the development of tenoperiostitis are identified. The physiotherapist then develops a plan to correct these issues through specific exercises, orthotic prescriptions, or recommendations for ergonomic modifications.

Education and self-management strategies:

Physiotherapy treatment for tenoperiostitis includes educating the individual about the condition, its causes, and strategies to manage symptoms. This may involve educating on proper body mechanics, techniques for activity modification, and self-care measures to prevent future flare-ups. The physiotherapist will provide guidance on appropriate warm-up and cool-down exercises, as well as tips for the gradual progression of activity levels.

Gradual return to activity:

As the individual progresses through the physiotherapy treatment and experiences reduced pain and improved function, the physiotherapist will guide them in gradually returning to their desired activities or sports. This includes implementing a structured plan for progressive loading and monitoring the response of the tendon to ensure a safe and successful return to full activity.

It is important to note that the physiotherapy treatment for tenoperiostitis is highly individualized, and the duration of treatment may vary depending on the severity of the condition and the individual’s response to therapy. Compliance with the prescribed exercise program and active participation in the rehabilitation process are key factors for achieving optimal outcomes.


In conclusion, physiotherapy plays a vital role in the comprehensive management of tenoperiostitis. Through a combination of therapeutic exercises, manual therapy techniques, modalities, and education, physiotherapy aims to alleviate pain, promote healing, restore function, and prevent future occurrences. If you are experiencing symptoms of tenoperiostitis, consulting a qualified physiotherapist is recommended to receive an accurate diagnosis and tailored treatment plan.

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