Tendon Fenestration

What is Ultrasound Guided Tendon Fenestration?

Tendon Fenestration involves passing a needle through the abnormal tendon multiple times (20-25 times) to change a chronic degenerative process into an acute condition that is more likely to heal.

In the Foot and Ankle this is beneficial for Achilles Tendinopathy and Plantar fasciitis.

It is very important that the region is numb for this procedure with the use of local anaesthesia.

Ultrasound guidance ensures that the needle is passing through the areas of tendon degeneration.

Ultrasound image above shows a thick insertion of the plantar fascia

The needle is passed through the plantar fascia around 20 – 25 times to change the chronic degeneration of the tendon into a more active acute response.

How does Ultrasound Guided Tendon Fenestration Help?

  • Tendon Fenestration is thought to stimulate tendon healing (1)
  • Disrupts area of tendinosis this is achieved by making multiple passes through the damaged tendon (1)
  • Injecting the damaged tendon causes bleeding which results in the release of growth factors (1)



  1. Chiavaras, M.M. and J.A. Jacobson, Ultrasound-guided tendon fenestration. Seminars in Musculoskeletal Radiology, 2013. 17(1): p. 85-90.