Insertional Tendinopathy of the Achilles Tendon

Heel pain is a common complaint and is often poorly managed. Non-operative treatments are highly effective for the vast majority of patients, and surgery is reserved for recalcitrant cases. The first distinction to make clinically is between plantar heel pain and posterior heel pain. The former is commonly caused by plantar fasciitis. Posterior heel pain: Baxter [1] classified Achilles pain as arising from the insertional portion of the tendon or from the noninsertional region. This distinction is helpful clinically. Noninsertional Achilles tendon pathology is more common than insertional tendinopathy and is due to degeneration within the substance of the tendon, thickening of the paratenon, or a combination of the two.