Overview of Insertional Achilles Tendinopathy

  • James A. Nunley

Overuse injury of the Achilles tendon is becoming a more common problem in the United States as the younger population becomes more athletic and as elderly patients assume ever-increasing levels of physical activity. Thus, it is not surprising that the Achilles tendon, one of the largest tendons in the body, would be subjected to repetitive overuse injuries in both patient populations. This overuse phenomenon can ultimately lead to different forms of Achilles tendinopathy. It is important at the onset to emphasize that Achilles tendinopathy is not a single entity, but rather is made up of a large variety of pathophysiologic processes, all of which can result in pain production at the posterior heel and calf areas. It is useful, I believe, to divide Achilles tendinopathy into noninsertional and insertional disease processes since the location of the pain and the pathophysiology is so distinctly different. This chapter concentrates on the evaluation and diagnostic characteristics of...


Achilles Tendon Achilles Tendinopathy Calcium Pyrophosphate Calcify Tendon Plantar Heel Pain 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    Clain M,Baxter D,1992; Foot fellows reviewer: Achilles tendonitis. Foot Ankle 13:482–7.PubMedGoogle Scholar
  2. 2.
    Schepsis AA, Leach RE. 1987; Surgical management of Achilles tendonitis. Am J Sports Medicine 15:308–15.CrossRefGoogle Scholar
  3. 3.
    Kolodziej P, Glisson RR, Nunley JA. 1999; Risk of avulsion of the Achilles tendon after partial excision for treatment of insertional tendonitis and Haglund’s deformity: a biomechanical study. Foot Ankle Int 7:433–7.Google Scholar
  4. 4.
    Frye C, Rosenberg Z, Shereff MJ. 1992; The retrocalcaneal bursa: anatomy and veinography. Foot Ankle 13:203–7.Google Scholar
  5. 5.
    dePalma L, Marinelli M, Meme L,. et al. 2004; Immunohistochemistry of the enthesis organ of the human Achilles tendon. Foot Ankle Int 6:414–8.Google Scholar
  6. 6.
    Baxter DE, Zingas C. 1995; The foot in running. J Am Acad Orthop Surg 3:136–45.PubMedGoogle Scholar
  7. 7.
    Dickinson PH, Coutts MB, Woodward EP, et al. 1966; Tendo Achillis bursitis. J Bone Joint Surg 48A:77–81.Google Scholar
  8. 8.
    Jones D, James S. 1984; Partial calcaneal ostectomy for retrocalcaneal bursitis. Am J Sports Med 12:72–3.PubMedCrossRefGoogle Scholar
  9. 9.
    McGarvey WC, Palumbo RC, Baxter D. Insertional Achilles tendinosis: surgical treatment through a central tendon splitting approach. Foot Ankle Int 2002;23:19–25 PubMedGoogle Scholar
  10. 10.
    Gerster JG, Baud CA, Lagier R,. et al. 1977; Tendon calcifications in chondrocalcinosis. Arthritis Rheum 20:717–21.PubMedCrossRefGoogle Scholar
  11. 11.
    Gerster JG, Lagier R, Boivin G. 1980; Achilles tendinitis associated with chondrocalcinosis. J Rheumatol 7:82–7.PubMedGoogle Scholar
  12. 12.
    Gerster JG, Saudan Y, Fallet GH. 1978; Talagie: a review of 30 severe cases. J Rheumatol 5:210–6.PubMedGoogle Scholar
  13. 13.
    Lotke P. 1970; Ossification of the Achilles tendon. J Bone Joint Surg 52A:157–60.Google Scholar
  14. 14.
    Pavlov H, Henerghan MA, Hersh A,. et al. 1982; The Haglund syndrome: initial and differential diagnosis. Radiology 144:83–8.PubMedGoogle Scholar
  15. 15.
    Ruch JA. 1974; Haglund’s disease. J Am Podiatr Assoc 64:1000–3.Google Scholar
  16. 16.
    Holmes G, Lin J. 2006; Etiologic factors associated with symptomatic Achilles tendinopathy. Foot Ankle Int 11:1952–9.Google Scholar
  17. 17.
    Angermann P. 1990; Chronic retrocalcaneal bursitis, treated by resection of the calcaneus. Foot Ankle 10:285–7.PubMedGoogle Scholar
  18. 18.
    Leitze Z, Sella EJ, Aversar M. 2003; Endoscopic compression of the retrocalcaneal space. J Bone Joint Surg 8:1483–96.Google Scholar
  19. 19.
    Sayana M, Maffuli N. Insertional tendinopathy of the Achilles tendon: debridement and reattachment of the Achilles tendon using bone anchors. Tech Foot Ankle Surg;4:209–13.Google Scholar
  20. 20.
    Kennedy J, Willis B. 1976; The effects of local steroid injections on tendons: a biomechanical and microscopic correlative study. Am J Sports Med 4:11–21.</Ref>PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • James A. Nunley

There are no affiliations available

Personalised recommendations