Insertional Achilles Tendinopathy: The Central Approach
Insertional Achilles tendinopathy is a painful, frequently disabling condition of the posterior foot and ankle. Discomfort and irritation typically arise along the posterior aspect of the heel. As with most tendinopathies, pain begins intermittently and gradually becomes constant as the disease progresses. A common sign of this insertional tendon disease is the patient’s difficulty in wearing closed-back shoes. Athletically inclined patients may report more pain after exercise.
Despite advances in basic science tendon research, the pathophysiology of insertional Achilles tendinopathy is still not well understood. Traditionally, the disease has been viewed as an overuse phenomenon. Shear forces between collagen fascicles as well as biomechanical problems at the osseotendinous junction have been cited as causative factors in the disease. Recently, molecular collagen studies have hinted at the role of tenocytic chondral metaplasia as a causative factor.1Other studies have focused on the...
KeywordsAchilles Tendon Diffuse Idiopathic Skeletal Hyperostosis Flexor Hallucis Longus Nonoperative Side Calcific Tendinopathy