An Overview of Achilles Bursitis

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There are 2 bursae that surround the Achilles tendon to protect it from friction - the retrocalcaneal bursa and the subcutaneous calcaneal bursa.

The retrocalcaneal bursa lies between the tendon and the back, or posterior surface, of the heel bone (calcaneus). This is a "true" bursa that is present from birth. It acts as a cushion between these two structures to protect the tendon from friction against the heel bone.

The larger subcutaneous calcaneal bursa lies over top of the tendon at the lower part of the heel where the tendon joins to the heel bone. This bursa develops as you age with the intent of protecting the tendon from friction at the back of the heel. It is not found in everyone and for this reason is termed an "adventitious" bursa.

The most common bursa to be inflamed in the foot is the retrocalcaneal bursa (also referred to as the subtendinous calcaneal bursa). Located between the Achilles tendon and the heel bone (calcaneus), it acts as a cushion to protect the Achilles tendon from friction against the heel bone. Also commonly affected, the subcutaneous calcaneal bursa (also referred to as the Achilles bursa), located between the Achilles tendon and the skin, sits a little lower down the ankle towards the heel than the retrocalcaneal bursa.

Due to the proximity to the area on the Achilles tendon, Achilles bursitis is often mistaken for midpoint insertional tendinitis. Achilles bursitis is a common overuse injury in runners, ice skaters and other athletes.

Causes of Achilles Bursitis

Inflammation of the achilles bursae and/or the achilles tendon usually develops due to overuse, trauma, or degeneration of the protective tissue in the heel and lower leg. Specific causes include:

Acute Trauma - A direct blow to the back of the heel can cause injury to the retrocalcaneal bursa. In such cases, blood may leak into the bursa causing irritation, inflammation, swelling and pain.

Excess Stress - Without exercise or activity, muscles can weaken and your heel no longer has the muscle support it needs to move correctly. This can cause excess load on the lower leg and heel or your weight may be distributed unevenly within your ankle joint. Uneven distribution of weight will put extra stress on some areas compared to others leading to abnormal wear and tear on the stressed areas.

Athletes Who Overtrain or runners that increase their distance to quickly are at greater risk of experiencing Achilles bursitis. With over use, the Achilles bursae and tendon can become irritated and inflamed leading to thickening of the bursae lining and wearing of the tendon. Fluid builds in the bursa when it becomes irritated causing swelling of the Achilles bursa and pain at the back of the heel.

Overuse Injury (Chronic) - Excessive friction, or rubbing, on the retrocalcaneal bursa can aggravate it over time. If your run, walk or hike often, you may be at higher risk of achilles bursitis due to frequent stress and friction on the achilles bursa. This risk increases if there is anything that many cause abnormal wear and tear within the joint.

Improper foot wear, tight shoes or shoes that do not fit properly can cause extra pressure and friction on the back of the heel. Over time, this pressure causes irritation of the bursae that protects the Achilles tendon causing one or both to swell and become inflamed.

Pressure on the Bursa - Work and frequent activities that place repetitive pressure on the infrapatellar bursa can cause achilles bursitis. Although the bursae in your heel function as cushions to protect the tendons and other soft tissue, frequent walking or stair climbing during your work or activities often creates more stress than they can handle. The excess pressure causes the bursa to become irritated and inflamed, leading to swelling and thickening of the bursa lining.

Infection (Septic Bursitis) - The closer the bursa is to the surface of the skin, the more likely the chance of infection from specific bacteria that are commonly found on the surface of the skin. This infection is known as septic bursitis and common bacteria that create this infection are known as Staphylococcus Epidermis (or Staphylococcus Aureus). This bacteria can affect the bursa if the heel is cut or scraped, allowing it to get under the skin.

Symptoms of Achilles Bursitis

Symptoms of Achilles bursitis are often mistaken for Achilles tendinitis because of the location of the pain at the back of the heel. When you suffer from Achilles bursitis you will experience some or all of the following symptoms which are most noticeable when you begin activity after resting.

• Pain at the back of the heel, especially with jumping, hopping, tip-toeing, walking or running uphill or on soft surfaces. If tendonitis is also present, the pain can radiate away from the bursa. Pain description is often "sharp"
• Lump at the back of the heel
• Direct pressure on the bursa will exacerbate the pain and should be avoided if possible.
• Swelling, Tenderness, Warmth, and Redness might make it difficult to wear certain shoes on the feet. In severe cases, the bursa will appear as a bump, called a "pump bump", and is usually red, and extremely tender. Swelling can cause difficulties moving as the range of motion in the ankle can be affected. This swelling may appear immediately following trauma, over a couple of hours, or up to 7-10 days after the event that caused the irritation.
• Limping due to the pain and/or limited range of motion
• If you press on both sides of the inflamed heel, there may be a firm spongy feeling.
• Weakness in the tendons and muscles surrounding the bursa can develop as the pain worsens and the inflammation in the area spreads.
• Possibly a fever if you are suffering from septic bursitis (You will need to see a doctor for medication to get rid of the infection).
• Individuals that wear high-heeled shoes frequently may feel an increase in pain when they are wearing flat shoes When wearing high-heels, the calf muscles and Achilles tendon remain in a shortened position. When flat shoes are worn it causes the calf muscles and Achilles tendon to stretch more than usual causing the tendon to tighten around the heel bone causing irritation.
• Limited Range of Motion and Weakness - Pain often limits your stride as you stop performing motions that make the pain worse. If bursitis is left untreated the inflammation can increase, causing more pain, limiting movement even more. Eventually, weakness in the leg muscles and and tendons around the heel and lower leg can set in.

If any of those statements are true for you or you're suffering from on-going pain in your heel then you might have an injury called "retrocalcaneal bursitis".

A bursa is a sac of synovial fluid, rich in protein and collagen. These fluid-filled sacs form in areas where 2 surfaces in your body - most often where a bone and tendon or a bone and muscle - rub together during movement. When pressure or friction is too high, excess fluid can build up in the bursa sac and/or the the lining of the sac can thicken, causing inflammation. When an achilles bursa becomes inflamed, moving your heel becomes painful and difficult. Any actions that put pressure on the inflamed bursa can increase irritation and cause further inflammation and pain.

Bursitis occurs when a bursa is irritated from frequent pressure and it becomes inflamed. When one or both of the bursae (outlined at the top of this page) become inflamed, it is generally referred to as Achilles bursitis because of the bursa's proximity to the Achilles tendon. In some cases, an inflamed bursa can become infected with bacteria (referred to as septic bursitis) and can quickly become life threatening. It is important to see a doctor quickly if you have an infected bursa.

Achilles bursitis can happen to anyone - seriously. The achilles tendon handles extreme forces everyday, and the achilles bursae handle the friction from these forces. Achilles bursitis can happen from acute trauma (direct hit on the bursa), but often results from stress due to repetitive movements (running, walking, jogging) as part of your job or from sports related activities. Achilles bursitis becomes more prevalent due to aging as soft tissue around the ankle and bursae become weakened as we grow older.

Achilles bursitis is one of those injuries that can really bring down the quality of your life. Anyone - young or old - can suffer from this injury, and if you're active this condition will keep you from doing the things you love to do. It will definitely interrupting any of your normal daily tasks and make living life harder than it really needs to be.

How Do I Diagnose Achilles Bursitis?

When you are experiencing heel pain and suspect you have bursitis, the best way to diagnose this condition is with a quick visit to your doctor for a physical examination of your heel. Getting a proper diagnosis is important so you can treat your condition correctly. Untreated chronic inflammation of bursitis can lead to calcification of the bursa. Calcification of the bursa will mean that it will become even more painful than before.

To begin with, your doctor will gather a medical history about you and your current condition and symptoms. He/she will ask about the amount pain you are having with your lower leg and heel. How long you have had your symptoms and if you are experiencing a range of motion loss or limp when walking/running. Details about what caused the pain in the heel, when it started, and whether or not you have ever had treatments for this or a similar condition in the past, are very helpful in assessing your injury.

Range of motion movements / tests will be done to see how much movement has been lost in your heel. Your heel might hurt from the doctor poking and prodding at it, but by doing this the doctor will better understand the source of your pain, the level of tenderness in the area and how well you can move with this condition.

Your doctor may also consider any previous foot/knee injuries or joint stiffness that you may have had in the past. This will help the doctor to determine if you have a more complex injury in your heel and rule out any other foot injuries that may be present.

If a soft tissue injury is suspected, an MRI may be undertaken to view where and how extensive the damage in the ankle is. An x-ray may be recommended to rule out a bone spur or other foreign body as the cause of your ankle pain. Possible causes of pain that an x-ray can identify include instability, abnormal bone shapes (bone spurs or bone cysts), wear and tear on the joints, avulsion fractures (when a fragment of bone tears away from the main bone along with the muscle, tendon, or ligament as a result of trauma), dislocations, arthritis, calcium deposits in the bursa or joint, and/or other problems.

As the bursae in the heel are close to the surface of the skin, they significantly susceptible to septic bursitis (caused by a cut or scrape) than most other bursae. Your doctor may aspirate (use a needle) to remove fluid from the bursa to check for possible staphylococcus epidermis (or staphylococcus aureus) bacterial infection. Your doctor will be able to determine whether there is an infection or not by drawing a small sample of the bursa fluid with a needle. If it is determined that your bursitis is septic, you will be prescribed antibiotics to get rid of the infection.

A physical examination will be performed to determine if you have any signs of Achilles Bursitis or other ankle injury. He/she will look and feel the soft tissue and bones in your ankles to note any differences between the two of them. This will identify any abnormalities, such as swelling, bone deformities, atrophied muscles, redness and/or warmth on the skin. In many cases, the first sign that you have Achilles bursitis is swelling in the back of the foot and ankle pain.

As the subcutaneous bursa is close to the surface of the skin, it is more susceptible to septic, or infectious, bursitis caused by a cut or scrape at the back of the heel. Septic bursitis requires antibiotics to get rid of the infection. Your doctor will be able to determine whether there is an infection or not by drawing a small sample of the bursa fluid with a needle.

Are You Sure It Is Achilles Bursitis?

Pain, swelling and inflammation at the back of your heel could mean that you have achilles bursitis, but it's also important to consider that there are other conditions that might cause pain and swelling in the area too. Visiting your doctor when you have achilles pain is always recommended, as there are many possible issues that can happen within the Achilles and ankle. Sometimes, one set of symptoms can result in multiple diagnoses.

Haglund's Deformity (also known as Haglund's Syndrome) refers to an enlarged boney protrusion on the upper, back part of the heel bone. It is caused by calcification of the heel bone due to the inflammation of Haglund's Syndrome, a combination of Achilles tendinitis and Achilles bursitis. The boney protrusion causes further irritation to the retrocalcaneal bursa and Achilles tendon as it presses them between the protrusion and your shoes. This increased irritation then causes Haglund's Syndrome to become worse. Due to similar symptoms and the location in the Achilles tendon area, Haglund's Syndrome is frequently misdiagnosed as Achilles tendonitis.

Achilles Tendon Strain If you have a strained achilles tendon, you will experience pain along the back of your foot and above your heel, especially when stretching your ankle or standing on your toes. Most strains are mild, though this condition can persist and worsen if conservative treatment methods are not undertaken. The seriousness of the strain will most like affect the way you walk, forcing you to limp due to pain. A sudden increase in your activity or improper warm ups before activity can cause an Achilles tendon strain. Trying to go fast, jumping (hurdles), cutting (football) or twisting in the air are just some of the scenarios with an advanced risk of developing achilles tendon strain.

Achilles Tendonitis Achilles tendons carry our entire body weight so it makes sense that the achilles tendon is the thickest, strongest and most powerful tendon in the body. The achilles tendon responsible for many things, allowing you to walk, run, jump, or stand on your toes. Due to the major stresses taken on by this tendon, it is often injured either. Injury can also be attributed to overuse or as a result from excessive strain (even a traumatic accident or sudden pop). If you have tendinitis of the achilles, you will be suffering from irritation and inflammation in the back of the foot - just above the heel. Tendonitis is a result of degenerative tears within the tendon itself, and these microscopic tears are much akin to a rope that is starting to fray from excessive load.

Achilles Movement and the Re-Injury Cycle

Every time you flex your ankle, those ligaments and muscle tissue move; when they are inflamed, every movement hurts. Once this tissue is injured it's painful and becomes very difficult to recover 100% without proper treatment.

Re-Injury of the Achilles Tendon Must Be Avoided At All Costs

Constant re-injury needs to be avoided at all costs! Please excuse the obvious statement, but I really need to drive this point home. Re-Injury is very common... why? Everyone wants to get back to their regular lifestyle once the pain has reduced. Here is where you have to be careful - often, much of the pain is due to inflammation - so, once you iced the area and the swelling dropped, a lot of the pain probably disappeared too. So then you start back at your regular lifestyle and then all of a sudden the old injury starts flaring up again - this is re-injury!

The Pain May Have Dropped But It Does Not Mean The Underlying Injury Has Healed

Re-Injury is bad because sure, it delays the healing process, but what's worse is that every re-injury and additional healing cycle increases the amount of scar tissue that builds up in the area of your original achilles injury. This applies to muscle, tendons, ligaments and other connective tissue as well.

Scar tissue is a weak form of collagen - hard, inflexible, and tough to get rid of once it begins to take hold. The more scar tissue that develops, the more you lose the range of motion in your ankle. With excess scar tissue build up, the injured tissues and the achilles in general will remain weak and very prone to re-straining and re-tearing.

While you can go a number of days and even a few weeks without any major setbacks during the injury.. inevitably, a certain movement or motion will happen that causes your injured soft tissue to strain and even tear once again. This is attributed to the scar tissue build up and will result in the buildup of yet more scar tissue and a further reduced range of motion (ROM).

The more scar tissue that develops, the greater the risk of winding up permanently injured with chronic pain or arthritis. Scar tissue means that your achilles will not perform as well as it once did and it makes it much more prone to injury later on. The longer the injury remains, the risk of atrophy increases and the risk of more scar tissue increases. This is why it is critical to treat your achilles injury now rather than later.

An Achilles Injury Does Not Have to Persist For Months Or Longer. Here is Why It Does For Many

Recovery from an achilles injury can take a long time, especially when some of the less effective, traditional methods are utilized. This is simply because many treatments either focus on masking of pain or are too inconsistent to provide sustainable improvement.

1: Bursitis Sufferers Continue to Aggravate & Re-Injure Their Bursa

It goes without saying that anyone suffering from bursitis should want to minimize their chance of worsening the injury, or re-injuring the bursa once it has started to get better. Obviously, a worsening injury will delay the healing process, but what's worse is that every re-injury and additional healing cycle increases the amount of time that your joint is immobilized. Time is not kind to an immobilized joint - you lose strength in the joint but worse than that, you lose the range of motion in your joint via atrophy (your flexible tendons, muscles and ligaments slowly shrink, decreasing joint elasticity). The more time that goes by with an immobile joint, the more likely you will wind up with a chronic joint problem (long term injury such as tendonitis or persistent bursitis pain). Basically it means that your joint will not perform as well as it once did and it becomes more prone to injury again later on.

If you have an inflamed bursa in one of your joints, it's very important to heal it quickly and completely. Minimizing the healing time of your bursitis should be an obvious goal, as bursitis typically limits your ability to go about your daily routine. As stated here (MedicineNet.com), if your long-term (chronic) bursitis is left untreated, calcium deposits can form within the bursae. These calcium deposits can lead to permanent stiffness in the affected joint.

2: Visits to Physio (PT) Help - We Always Recommend It - But It Can Be Costly And Inconvenient

While the benefits of PT are very real and we believe it to be integral for recovery from soft tissue injuries, the problem is that people only attend sessions a few times a week.

To truly provide a long term solution to combat bursitis induced soft tissue damage, you need to be receiving multiple treatments on a daily basis and get rid of your bursitis asap. Not just any type of treatments, but ones that focus on generation of new healthy tissue - along with proper synthesis of that tissue as well.

Treatments for soft tissue injuries are cumulative in nature...meaning the more the treatments are administered, the faster the benefits can be experienced.

Who these days has time to visit a clinic on a daily basis? Not only is your time limited, but the cost of daily PT sessions is out of reach for most people.

Therefore, the focus needs to be on adding treatment options that can be done frequently, from the comfort of your own home (and even the workplace if the opportunity presents itself). We will discuss these options later on down the page.

3: People Tend To Focus Too Much On Cold Treatments

This is the final reason for extended bursitis and soft tissue injuries. We see it all the time - people for weeks and even months only focus on using cold.

Doing too much cold will actually inhibit the recovery because you are starving the injured tissues of the blood flow they need to repair and rebuild the collagen. Cold restricts the vessels - reducing the blood flow to the tissues that truly need it most.

The truth is, there will always some mild inflammation associated with tissue injuries. However, some of that inflammation will remain UNTIL you begin to focus on healing the soft tissue (muscle). Once this begins to heal, the inflammation will then subside more permanently - not just temporarily like with cold treatments.

As an analogy, think of a home with a leaky roof. You can place a bucket on the floor of the attic whenever it rains - and this will help temporarily, but does it truly address the situation? Obviously the answer is no. Not until you focus on repairing the structural issues with the roof - will the problem be actually solved.

The same concept applies to injured soft tissue - you need to focus on reinforcing growth of flexible, strong tissue. To do this, you need more blood flow reaching them, not less.

4: Injections Can Cause Harm If You Are Not Careful

This can be VERY helpful in alleviating pain and when it comes to bursitis, pain relief alone can make a huge difference. However, some people get a false sense that their injury is healed because they are not experiencing the pain they once did. Some individuals even engage in activities they should not be doing because they "no longer feel pain". Once the effects wear off, people often find their bursitis persists . This of course, results in a prolonged recovery. Be very careful about your activity after the injection because there is little, if any, pain feedback to tell you that you're overdoing it.

Merely masking the pain can be very helpful temporarily, but it is not a solution; it is just a temporary fix.

Achilles Injuries Not Only Affect the Achilles - But Can Lead to Other Conditions and Injuries.

Every time we use our injured heel, damaged and swollen tendons and muscle tissue move; when they are inflamed, every movement hurts. With injured tissue, pain happens - sometimes a LOT of pain, so we try not to move it. So, when doing something we need to use our heel for (getting dressed, driving, talking on the phone), we start to use the knee and even the hips more. If we can, we use our other foot instead, even though it is inconvenient and usually the non-dominant foot.

A couple days later (after purposefully avoiding movement of our achilles), the pain has gone down (as well as the swelling) and this is where the trouble begins! The pain disappeared with the swelling but we still aren't fully healed! Not knowing this, we start using our achilles normally again and then the pain shows up again like it did before - all because the injury wasn't fully healed in the first place.

Eventually, we use the other joints more and more, instead of having to put the injured achilles under strain again. This is why these other areas start to hurt - they are being overused now. Soon, aches and pain can become commonplace in other areas of the lower body - all as a result of the original injury and the body's instinctive nature to "protect" the original achilles tendon injury - all because the injury wasn't fully healed in the first place!

Muscle imbalances result, placing tension on bone and softer tissues - leading to a misalignment within the lower body. The extra stress on the opposite side of the body will also result in weakness and fatigue of the tissues - increasing the chances they can eventually be injured or gradually degenerate. This is a textbook example of how you get an overcompensation injury. In some cases, physical therapists warn that overcompensation can be very dangerous as it will eventually affect gait or alignment on a permanent basis.

An injury to one achilles can easily lead to straining in other areas, making an overall recovery hard to initiate. The longer the injury (and corresponding pain) persists, the greater the chance that you will sustain more strain from overcompensation, eventually leading to issues in those areas as well. To minimize potential secondary injuries, know that it is important to deal with your achilles heel tendon injury quickly and completely.

Truly, chronic achilles/calcaneal tendon and bursa injuries can become a vicious cycle - which is why it is absolutely critical to focus on methods that improve and strengthen injured soft tissue in a timely manner. The faster you truly heal, the less chance you have of sinking into a downward spiral of re-injury, scar tissue growth and overcompensation injuries.

Okay, So I Have Achilles Bursitis...What Should I Do Now?

If you want to dig deeper into home treatment options, view our Bursitis Treatment Page Here

Surgery, Post-Surgery Rehabilitation and Achilles Tendon Exercises

If you have undergone surgery or your achilles (reattachment, repair or graft) and are looking for rehabilitation information, click here.

Increasing flexibility and strength in the ankle is a key component to speed healing and avoid re-injury. For this reason, we have created ebooks that outline specific exercises / stretches for our clients undergoing achilles injury recovery.

Even when you're injured and in pain you need to keep moving to break-up scar tissue that's forming in your tendons and ligaments in your ankle and calf.

Moving when you're injured is hard. Since moving while injured can be painful most people think it's better to stop moving, rest their foot and hope that their achilles injury will heal all on its' own. Even though rest is important to recovery, too much rest during the recovery process will increase the amount of scar tissue in your lower leg.

Circulatory Boost treatments combined with a proper stretching regimen will help decrease scar tissue growth while increasing elasticity and strength in the lower leg and ankle joint.

During the healing process your body will fill in soft tissue tears with dense, brittle tissue called "scar tissue". The human body will use scar tissue as a temporary solution and will try to build the scar tissue as fast as possible to heal a tears in the soft tissue. Scar tissue can form fast to bring together the edges of a tear, but working fast doesn't mean that the job's done right. When scar tissue forms it doesn't come together as neatly as regular (healthy) tendon/ligament tissue would. Scar tissue fibers will lay down over top of your tear in a cluttered, messy and jumbled up way.

Ankle Joint Atrophy is arguably a bigger issue than scar tissue. Whether you have a ankle/lower leg injury or have recently had an operation in that area, you will find that the joint has a more limited range of motion than you had before. In most cases, this is due to atrophy - the shortening of connective tissue in the lower leg, knee and ankle due to inactivity. In cases where atrophy exists, it is very important to stretch and do gentle exercise to nip this problem in the bud before it becomes a chronic (long-lasting) issue. If you are currently recovering from a Achilles injury speak with your physician about stretches and exercise.

When done properly under recommendation of a physician, stretches have a proven track record of assisting in the speedy recovery of many patients. This is without doubt, the final essential tool for complete achilles/ankle injury recovery. Once a patient deals with the swelling and inflammation through use of a Cold Compress or Ice Pack, then begins the Circulatory Boost process by using home treatment with the TShellz Wrap, all the while keeping rested to keep stress off the injury. Once the injury has healed, it is time to take the third and final step to recovery by beginning a rehabilitation stretching regimen.

Before making the transition to crutches, PTs prescribe gentle stretching of an injured achilles, especially if your are recovering from achilles reattachment surgery. They don't prescribe this to annoy you - it is in fact the most important part of injury recovery. You probably know of someone that chose not to do these stretches as it is common - and they paid a high price for it. By choosing to ignore recovery recommendations (ie. not stretching), there is a substantial risk of re-injury or even sustaining an injury greater than the original injury ever was.

Consistent stretching (as prescribed by your physician or PT) not only helps minimize the growth of scar tissue, but it also increases the elasticity and strength of the achilles tendon and interconnected soft tissue. Stretching, when used in conjunction with the Achilles TShellz Wrap will allow you to be better prepared to handle higher and higher loads. Eventually you will reach a stage where your tendon can handle standing or walking for longer and longer periods of time. This is the final stage of recovery and depending on age, the nature of the injury, your weight and many other factors, it can take the longest time to complete. But remember, for achilles injuries, it pays to be patient! Rushing your tendon injury recovery almost never pays.

If you do wind up getting surgery, know that rehabilitation at-home while attending regular PT or doctor appointments is vital for your overall recovery.

Consistent exercise and conservative treatment on a daily basis during your rehabilitation while working with your doctor or physical therapist is key. This is why you should seriously consider maximizing your recovery by using the TShellz Wrap^® at home once you are approved for PT.

The more consistent you work at enhancing blood flow to surgically repaired soft tissue, the more consistent the healing process will be. Nourishing the tissues will more oxygen and nutrients (which are carried through the blood stream) will give the body a better ability to produce new, healthy collagen. In effect, you will help the body produce stronger tissues while potentially reducing the number of setbacks that can occur following surgical procedures.

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Conservative treatment tools just like these have been used successfully by thousands of soft tissue injury sufferers - just like you.

We believe the use of TShellz Wraps^® for boosting blood flow to soft tissue in the area of application is one of the most under-utilized home treatment options available on the market today. We have client after client that have tried many options out there and have been amazed at how effective and fast the TShellz Wrap treatment can relieve pain and increase blood flow in the treatment area.

With regular use of the TShellz Wrap:

• Your pain will be reduced*.
• Due to increased blood flow, soft tissue in the treatment area will be expected to recover at an accelerated rate with reduced potential for re-injury*.
• Tissue in the treated area should experience a larger range of motion and increased extensibility of collagen tissue* due to the heat effect on soft tissue. This should translate into a reduced rate of re-injury occurrence as soft tissue is known to lengthen and become more flexible when exposed to warm temperature. (*Chapter 9 of "Therapeutic Heat and Cold", 4th edition. (amazon.com link - Ed. Justus F. Lehmann, M.D., Williams, and Wilkin)

A TShellz Wrap^® application is intended to produce the following results:

This, in turn, improves function of the immune system which increases the body's ability to eliminate toxins and other waste by-products resulting from damaged tissue at the injury location. This allows the body to more easily stimulate the self healing process.

Many soft tissue injuries are the result of trauma to a tendon or muscle, usually causing the tissue to tear. As a result of the tear, your body triggers a natural healing process resulting in pain, inflammation, and the creation of scar tissue, then eventually reinforcing that band-aid solution with flexible tissue (proliferation). Increased blood flow will make this process more quick and efficient in the majority of cases.

It is generally accepted that heat will enhance both the flexibility and the extensibility of soft tissue. This is an important point. Many people with achilles, knee and back conditions (to name a few of many) often experience re-injury due to the fact the damaged muscle or soft tissue is tight and the range of motion is restricted. Even the most minor of activities can cause recovering tissue to strain, sprain, or even tear. Every time this happens, your recovery is delayed. This is why using the TShellz Wrap^® not only now, but also into the future, is wise. The TShellz Wrap^® warms tissue, and thereby increases it's elasticity...all without risk of causing further harm - greatly reducing your chances of re-injury.

TShellz Wraps^® applied to muscles and soft tissue that surround the nerves should help them become more loose, as heat is known to increase the flexibility and extensibility of soft tissue. You may find this will alleviate tightness which may have led to nerve compression and the subsequent pain it produces.

Osteoarthritis occurs when cartilage and meniscii degenerate. Over time, two bones in the joint rub together with little or no protection from cartilage. This leads to pain and inflammation in the joint as the space within the joint starts to decrease without the cushioning, and stiffness starts to become a bigger and bigger problem. The TShellz Wrap^® is intended to generate warmth and an increase in blood flow - resulting in less stiffness and better range-of-motion.

Increased blood flow should result in a stronger immune system and an ability for you body to recover from soft tissue injuries more quickly.

Believe me when I say this; words alone cannot accurately describe what the TShellz Wrap^® can do for you. It truly is something you need to experience first-hand.

The Key Points To Keep in Mind When Treating Your Injury

Make Sure That Complete Healing is Your #1 Goal

We all know that if the injury was healed, the pain would go away but what about the opposite situation? If the pain is gone, does that mean the injury is better? Unfortunately, this is not always true.

Too many people only focus on suppressing pain symptoms while providing less attention to the true healing aspects of the body. Experiencing less pain, while obviously a good short-term goal, does not equate to underlying healing. Scar tissue can remain for months after one gets to a point of being relatively pain-free. However, as long the weak and brittle scar tissue remains, you are susceptible to re-injury or re-aggravation. Certain motions or movements can cause the weaker tissue to easily tear - resulting in some reversal of the recovery up until that point.

This is why we recommend for people to continue with their doctor recommended exercises and to continue with mild treatments of the TShellz Wrap^® for a period of time - to better ensure complete recovery.

Ongoing treatments to enhance circulation are intended to soothe, relax and promote healing of damaged soft tissue in the application area. T•Shellz treatment also results in the ability of soft tissue to extend further due to the effect of heat on soft tissue. The more extensible your tissues are, the less likely they are to strain or sprain.

People tell us all the time, "I was told that if I stay off my feet for a few weeks, my pain will disappear for good."

The truth is, tendonitis pain is usually a culmination of numerous factors, such as repetitive stress, poor posture, acute injuries, and overcompensation issues resulting from other muscle and soft tissue ailments.

To really deal with a injury, you have to know what the injury is - so get to the doctor and find out the source of the problem.

Soft tissue damage in the lower leg and ankle is typically a result of a tear or strain in your muscle, tendon or ligament. Tendonitis, tendinopathy, tendinosis, tenosynovitis, nerve impingement, general ankle instability, calf muscle spasms, heel bursitis, capsulitis, pain associated with trigger points, scar tissue, and arthritis are not uncommon issues in the lower leg and foot, perhaps especially due to the enormous stresses caused by support the body's weight day in and day out. When dealing with arthritis and/or gout, soft tissue damage would be considered a secondary effect due to the underlying disease; in such cases, soft tissue pain and inflammation can be temporarily alleviated, but until the underlying cause is dealt with, the soft tissue damage will most likely return.

It may take weeks or months for these pain triggers to surface. When they , however, merely resting will solve the underlying issues. You need to utilize actions and options that actually treat the source of the pain and help reverse the damage that has been done.

Resting has a role to play, but it is only one small factor in a recovery plan.

Let me tell you, we appreciate all the feedback we have received over the years. We have had many medical professionals, athletes and everyday people call and write to tell us about their positive experiences with our devices and the company in general. It never gets old hearing about the successes and it provides us with the motivation to continue doing what we do best - provide individuals with options to heal from the comfort of their own home.

Below is a small sample of some of the Customer Service comments we have received from customers...

If you're tired of being told that resting, drugs and surgery are the only answers to your soft tissue injury.... Be optimistic, because there are effective alternatives for you.

We will never claim our products will work for everyone. That is simply impossible to achieve. Everyone has a different capacity for recovery and different circumstances behind their injuries and/or conditions.

In addition, some people may have a hard time sticking with recommended protocol in order to achieve benefits from our devices. Quite simply, our clients that have had successful outcomes have made a small effort to invest 60 minutes a day into the program. If you do the same, chances are you will be very happy with the outcome. The fact that our very low return rate speaks volumes as to the confidence we have that our products will be effective for you! I mean with a full 60 day money back guarantee on our wraps, there really is no risk in trying.

Right after you place an order, email us and we will have a plan developed immediately so you will be able to get started upon arrival of your parcel. We can't promise you miraculous results, however, we do promise to do everything we can to help you with your condition.

Everything you have read up to now has hopefully given you some hope.

However, words are meaningless unless a company stands strongly behind the products they sell. This is what sets us apart from others...we offer people a comprehensive, 60 day, full 100% money back guarantee. We take on all of the risk because we know our products work well for the overwhelming majority of people who purchase them.

We Will Support You Every Step of the Way

You are never alone when making a purchase from us. When we say we stand behind our products, we truly mean it!

If any question or concern arises, simply send us an email at any time (we check our emails constantly all throughout the day and night - even on holidays!). We will respond as soon as possible.

Click HERE to Go To Our Online Store We take all major credit cards and Paypal. If you are on your mobile phone, Click to Call Our Office (toll free continental NA).

Simply call toll free 1-866-237-9608 to place an order with one of our knowledgeable Product Advisers. They have the ability to answer all your questions...ensuring you only receive the products you need.

Product Advisors are available 9:00 am to 5:00 pm Eastern Standard Time Monday to Friday.

North America Toll Free 1-866-237-9608

Outside North America +1-705-532-1671

We Stand Behind All Our Promises With An Iron-Clad Guarantee

• Guarantee #1 - Use your products diligently for up to 60 days and you will experience a significant reduction in pain. If not, I encourage you to call us to send back the items for a 100% refund.
• Guarantee #2 - You will not be left in the dark after purchasing any product form us. AidMyBursa Advisers and Product Specialists are available Mon - Fri by toll free phone 1.866.237.9608 or email to answer your questions or concerns.
• Guarantee #3 - Your order is guaranteed to be shipped within 24 hours on every business day.
• Guarantee #4 - All purchases receive a one year, full replacement warranty with guaranteed, prompt service.
• Guarantee #5 - You could save hundreds of dollars and possibly more, by utilizing our products, and getting back to work sooner.

Overall, we are able to be cost effective and value oriented due to two major reasons:

1. Word is spreading and as a result, our sales are increasing. With this increase, we can achieve economies of scale...meaning we receive the best component pricing because our volume is high.


2. We keep our overhead costs low by selling only on-line versus setting up costly distribution channels offline.

Think about it – you can now have the ability to treat your pain from the comfort of your own home while saving money in the process. Best of all, you are fully protected when making a purchase from us as we offer a 60 day, full money back guarantee.

Living with pain is never easy as it affects your entire lifestyle. Nothing is more important than making the proper decision when it comes to treating your muscle injury. Most methods only mask the problems or provide temporary relief; they do not treat the pain at its source.

AidMyBursa stands out in this regard as our goal is to help you heal for the longer-term.

The bottom line is, you are welcome to try our products for a full 2 months. If you do not receive the benefits that others have experienced, call us to let us know you will return your purchase back to us and we will issue a prompt & full refund. There will be no hard feelings.

The fastest option you have to get our product into your hands as soon as possible is by placing your order online - at this very moment..

Or, Call Our Office. We are open Monday to Friday to allow you place an order over the phone. Simply call toll free 1-866-237-9608 to place an order with one of our knowledgeable Product Advisors. They have the ability to answer all your questions...ensuring you only receive the products you need.

If you choose to order through our online shop, know that we keep no credit card data on file. Once the transaction is completed, the credit information disappears from our internal systems.

As you can see, ordering from us is a very easy and safe process, no matter if choosing to order on-line or over the phone.

Are you still unsure about placing an order? let me address some questions that may causing some hesitation...

What is the success rate of the TShellz Wraps^®? Do they really work?

We try and keep in touch with a large percentage of our customers, and we encourage them to do the same. In doing so, we have received a lot of feedback as we have been in the business since 2008.

We can say that the return rate on our products is only around 5 to 10% any given month. That is exceptional by anyone's standards. Therefore, we can safely indicate that the overwhelming majority of people who purchase from us do achieve benefits with our products.

How much time do I need to dedicate for treatments? Are the products easy to use?

The TShellz Wraps^® are very easy devices to use. After one or two uses, you will engage in the treatments with ease. Very detailed instructions are included and you are always welcome to contact us by phone or email if the need for help arises.

In regards to the TShellz Wrap^®, it is ideal to use the device two or three times a day on average. Each treatment session is a maximum of 20 minutes in duration and the device will turn off automatically at that time. Typically, people use the TShellz Wrap^® before bed, upon awakening (or not long after) and one other time during the day when the opportunity presents itself. For people in an office setting, many will use the device at work (as it can be worn over clothing). For others, they will use the device an our or two after work.

A Cold Compress or Ice Pack is primarily used following activity that stresses the injured tissues (following work, after a sports activity, or just suffering a general re-injury). This is done to reduce inflammation and to minimize tissue damage. Treatments are 15 to 20 minutes in duration.

How long has MendMeShop been in business

We established our firm in December of 2005. Our track record in this field continues to grow and we plan on being around for many decades to come.

What is your return policy? Is it the standard 30 days?

We go above and beyond what other companies offer - we offer a full 60 day money back guarantee with no restocking fees.

AidMyBursa advisors do not work on commission, so be assured you will only receive fair and objective information.

Product Advisors are available 9:00 am to 5:00 pm Eastern Standard Time Monday to Friday.

I want to learn more about Post-Surgery Recovery

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I want to learn more about Ice & Heat: Which Is Better For Treatment?

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I want to learn more about Bursitis Surgery

During your recovery, you will probably have to modify and/or eliminate any activities that cause pain or discomfort at the location of your soft tissue injury until the pain and inflammation settle. The more diligent you are with your treatment and rehabilitation, the faster you will see successful results!