Achilles Tendinopathy and Rupture

The Achilles tendon begins near the mid-calf and inserts into the posterior of the calcaneus, connecting the gastrocnemius and soleus muscles to the ankle. It is surrounded by a connective tissue sheath (paratenon, or 'paratendon'), rather than a true synovial sheath. The paratenon, which is very vascular and highly innervated, stretches with movement, allowing maximum gliding action. Near the insertion of the tendon are two bursae the subcutaneous calcaneal and the sub-tendinous calcaneal bursae as well as Kager's fat pad, all of which can be a source of heel pain.