TenJet for plantar fasciitis: how the procedure works, what the evidence shows, and recovery

If your heel still hurts after months of stretching, inserts and maybe a cortisone shot, you may have read about TenJet. This guide covers TenJet plantar fasciitis treatment in depth: how the saline jet works, how it differs from Tenex, who is a good candidate, what happens on the day, and what recovery looks like week by week. For the bigger picture of heel pain care, start with our plantar fasciitis treatment guide.

Why consider a procedure for plantar fasciitis at all?

Because stubborn heel pain can last for years. In a Danish study of 174 people, half still had plantar fasciitis five years after it began, and 44% still had it at 15 years. On average, those who got better took about two years.^[7]

The American College of Foot and Ankle Surgeons calls heel pain that hasn’t improved after more than six months of proper care “refractory.” That’s the point where it says surgery can be considered.^[4] And a procedure can beat staying the course. In a randomized trial of 30 people, those who had an endoscopic (camera-guided) release had better foot function at one year and less activity pain at two years than those who kept up injections and strength training. More of them got back to running and jumping.^[8]

The question is how small that procedure can be. Ultrasound can show the thickened fascia near the heel,^[7] and small-incision procedures aim straight at the damaged area. In the heel, they have reported large, lasting drops in pain:

Study	Patients	Follow-up	Result
Mayo Clinic 2025[6]	58 procedures	6.6 years	Pain 6.8 to 0.7 out of 10; 91% satisfied; no complications
Kruse 2024[9]	67	1 year	Pain improved 5.87 points; 94% satisfied; no complications
Encinas 2025[10]	56	27 months	Better pain, function and mobility scores

None of these is described as a TenJet study. Encinas used Tenex, Kruse an ultrasonic device, and the Mayo abstract names no device. They show what this kind of targeted procedure can do in the heel. TenJet uses the same idea with a different tool.

What is TenJet and how does it work?

TenJet is made by HydroCision. The FDA cleared a TenJet device in 2019 through its 510(k) process, which checks that a device is substantially equivalent to ones already on the market.^[1] It’s not a shot and it’s not a laser. It is a cutting tool that uses water.

• The needle. A 12-gauge needle, about 2.8 mm wide, carries two channels.^[11]
• The jet. Sterile saline races across a small window at the tip at up to 14,000 pounds per square inch. The flow creates suction, so the jet cuts the damaged tissue and pulls it out in one step.^[11,2]
• The target. The doctor watches the needle on the ultrasound screen the whole time. Treatment stops when the dark, damaged area on the screen shrinks and the needle meets less resistance.^[2]
• What it spares. In a lab study on cow tendon with chemically created damage, the jet removed the damaged tissue with negligible disruption of the healthy tissue around it.^[12]

The maker lists plantar fasciitis among its uses.^[13]

How is TenJet different from Tenex?

Both remove damaged tissue through a small cut, under ultrasound, with numbing medicine. The difference is the cutting tool. Tenex uses an ultrasonic cutting tip.^[14] TenJet uses the saline jet described above.^[11]

The other real difference is the research. Tenex has published heel results; TenJet does not yet.^[10,5] No study has compared the two devices, so no one can say one works better. Dr. Ozturk offers both and chooses with you based on your ultrasound and history. Our Tenex and TenJet overview puts them side by side.

What does the TenJet evidence show so far?

Here is everything we found as of November 2026, after searching PubMed, the ClinicalTrials.gov registry and the wider web.

Study	Where	Patients	Result
Strauser-Curtis 2022[2]	Elbow	29 (32 elbows)	Pain 5.1 to 0.5 out of 10 at 1 year; no procedure complications; 2 later had open surgery
Dakkak 2023[15]	Elbow	100	Elbow scores improved at 1 year; no complications; none needed open surgery
Dakkak 2026[11]	Hip (gluteal tendons)	46	Pain 5.8 to 2.1 at 6 months; one adhesive rash
Dakkak 2024[16]	Knee ligament calcium	1	Case report of calcium removal
Lieu 2026[17]	Knee ligament calcium	1	Calcium removed; a small open incision was needed to finish
Wong 2018[12]	Cow tendon (lab)	None	Damaged tissue removed, healthy tissue spared

For the plantar fascia, there is one published case description from Cleveland Clinic, not a study. It describes hydroresection, the saline-jet method TenJet uses, though its text doesn’t name the device. A 29-year-old woman with a year of heel pain, who had failed anti-inflammatories, therapy, cortisone and night splints, was back to normal activities without pain three weeks later.^[3] The two Cleveland Clinic doctors who describe this case, Dr. Vikas Patel and Dr. Jason Genin, co-authored TenJet elbow and hip studies, and Dr. Genin consults for HydroCision, TenJet’s maker.^[3,15,11] The only TenJet patient registry listed on ClinicalTrials.gov covers the elbow, hip and shoulder, not the foot.^[18]

So the honest case for TenJet in the heel rests on four things: how the device works, its results in other tendons, the lab study, and the strong heel results of related small-incision procedures.

Who is a good candidate for TenJet for plantar fasciitis?

You may be a candidate if:

• heel pain has lasted six months or more despite good care, such as stretching, supportive shoes, inserts and shockwave,^[4]
• ultrasound shows a thickened, damaged area of fascia that can be targeted, and
• you want to treat the damaged tissue without a larger release.

The TenJet registry left out people with a full tear of the tendon, an active infection, or blood thinners they couldn’t pause. It also excluded anyone who’d had a cortisone, PRP or other biologic injection in the prior three months.^[18]

It may not be the right first choice if your calf is very tight, where calf lengthening may address the cause,^[19] or if burning and tingling point to a pinched nerve such as Baxter’s nerve entrapment (external site).

What happens on the day of a TenJet procedure?

This is how the published TenJet studies describe it:

1. Numbing. Local anesthetic goes into the skin and down to the damaged tissue, under ultrasound.^[2,3] In the hip study, 45 of 46 people had local anesthetic only.^[11]
2. A small nick. The doctor makes a small cut with the tip of a scalpel.^[15]
3. The jet. The needle goes in under live ultrasound. In the elbow study, the jet itself ran for about 3.65 minutes, and the time from the first nick to the finish averaged 12 minutes.^[2]
4. Closing. Adhesive strips close the skin, with no stitches.^[2]
5. Home. Patients went home the same day.^[11]

TenJet plantar fasciitis recovery: week by week

No TenJet heel study has published a recovery timeline. Below is what the Cleveland Clinic heel case, TenJet studies in other tendons, and a Tenex heel protocol report. Your own plan may differ.

Time	What the sources report
Weeks 0 to 2	Walking boot. The Cleveland Clinic heel patient wore one for two weeks.[3] A Tenex protocol allowed walking as tolerated in a boot for one to two weeks.[20]
Week 2	Wound check, then exercise can begin.[11] In the hip study, most incisions had healed by two weeks.[11]
Week 3	The Cleveland Clinic heel patient was back to her regular activities without pain.[3]
Weeks 2 to 6	No running or jumping in the Tenex protocol.[20]
Week 6	The soonest anyone in the Tenex series returned to full activity.[20]
Week 12	Most people returning to sports or manual work needed about 12 weeks.[20] The maker says significant relief is expected within three months.[13]

How does TenJet compare with surgery, shockwave, PRP and cortisone?

No study has compared TenJet with any other heel treatment. Here is what each option has shown on its own.

• Open or endoscopic release. The surgeon partly cuts the fascia where it meets the heel bone, either through a larger opening or with a small camera.^[19] Both work well. In a 2026 review of 19 studies, complications were 5% after endoscopic release and 11% after open release.^[21] Another review found 8.9% after endoscopic release, most often pain that came back.^[22]
• Shockwave. In a large review, shockwave therapy was the only treatment that improved pain in the medium and long term.^[23] In a randomized trial for stubborn heel pain, shockwave and endoscopic release did not differ significantly at one year.^[24] It’s non-invasive, and we offer it.
• PRP (platelet-rich plasma). Across six trials, PRP lowered pain slightly more than shockwave, but not by an amount patients would notice.^[25]
• Cortisone. A Cochrane review found shots may slightly ease heel pain for up to a month, but not after that. Two plantar fascia ruptures were reported among 699 people who had them.^[26]

Many people try shockwave or PRP first. In our view, when they haven’t worked, a procedure that removes the damaged tissue is a reasonable next step.

What are the risks of TenJet?

In the elbow studies, no procedure complications were reported.^[2,15] In the hip study, one person in 46 had a rash from the adhesive.^[11] Small-incision tenotomy with Tenex had a 0.7% complication rate across 289 procedures at several body sites, including the plantar fascia: one superficial wound infection and one sensitive wound.^[20] As with any procedure that cuts tissue, some people don’t get enough relief. Two of 29 people in one elbow study went on to open surgery.^[2]

The limits. No TenJet study in the plantar fascia has been published, so any heel results above come from other devices or other tendons.^[5] The TenJet studies have no comparison group, the hip study was sponsored by the maker, and several authors consult for it.^[11,15] In the hip, the gain in function did not reach the size researchers call clinically important.^[11] In 2018, the American College of Foot and Ankle Surgeons rated ultrasonic debridement for heel pain “uncertain.”^[4] A 2026 network review found endoscopic surgery improved scores more than open or percutaneous techniques, though its studies carried moderate to high risk of bias.^[27] Please call our office at 908-215-5953 to inquire about your insurance.

How we decide

Dr. Efe Ozturk is a Foot and Ankle Surgeon and podiatrist who offers both TenJet and Tenex. We confirm the diagnosis with an exam and in-office ultrasound, check your calf, and make sure the first steps had a fair trial. Then we lay out the options side by side: TenJet, Tenex, calf lengthening, or a release through our Center for Lower Extremity Surgery (external site). See our heel pain page. We see patients in Lyndhurst, Paramus and Millburn, NJ.

Common questions

Is TenJet the same as Tenex?

No. Both remove damaged tissue through a small cut under ultrasound, but Tenex uses an ultrasonic tip and TenJet uses a high-pressure saline jet.^[14,11] They haven’t been compared head to head.

Is TenJet considered surgery?

Yes, it is a minimally invasive surgical procedure: it removes tissue through an incision. The FDA lists TenJet under the same regulation as arthroscopes, the small cameras used in joint surgery.^[1] In the hip study, 45 of 46 people had numbing medicine alone; in one elbow study, most also had sedation.^[11,2]

How does TenJet compare with shockwave for plantar fasciitis?

No study has compared them. Shockwave has the larger evidence base for heel pain and needs no incision.^[23] TenJet removes damaged tissue directly. Many people try shockwave first and consider a procedure if it hasn’t helped.

What is the TenJet success rate for plantar fasciitis?

There isn’t a published figure for the heel yet. In the elbow, 2 of 29 people went on to open surgery in one study, and none of 100 in another.^[2,15]

When to see a Foot and Ankle Surgeon or podiatrist