16/10/2024
Understanding Achilles Tendinopathy: Insertional vs. Mid-Portion 🦶
Achilles tendinopathy is a common condition that causes pain, stiffness, and discomfort in the Achilles tendon, the large tendon at the back of the ankle. While this condition can affect anyone, it’s especially common in athletes, runners, and active individuals. What many don’t realise is that there are two types of Achilles tendinopathy: Insertional and Mid-Portion—and they require slightly different treatment approaches.
Insertional Achilles Tendinopathy occurs where the Achilles tendon attaches to the heel bone. It often results in pain and swelling directly at the back of the heel, and patients may experience stiffness in the morning or after periods of rest. This type of tendinopathy can also involve bone spurs or calcifications near the insertion point, adding to the discomfort. Insertional tendinopathy often occurs in individuals who are less active but may also affect those who have overused the tendon without proper conditioning.
Mid-Portion Achilles Tendinopathy, on the other hand, affects the middle section of the tendon, about 2-6 cm above the heel. This type is usually linked to overuse and repetitive strain, making it more common in runners and athletes. Symptoms include a thickened or lumpy tendon, pain during or after activity, and tenderness to touch along the middle of the tendon. In some cases, you may notice a slight bulge in the affected region of the tendon.
Diagnosis of both conditions involves a thorough examination, often including tests to assess tendon strength and pain during movement. In some cases, imaging such as ultrasound may be used to determine the severity of the tendinopathy and rule out other potential issues, such as ruptures. Early diagnosis is key to managing the condition effectively and avoiding chronic symptoms.
Treatment for Achilles tendinopathy can vary depending on whether it’s insertional or mid-portion. In most cases, conservative treatment is recommended first. Your clinician is likely to want to look at your footwear to check it is suitable. You may be advised to modify your activity levels (but rarely take complete rest) and start an exercise programme to help build up the capacity of the tendon. In some cases, treatments like shockwave therapy, heel raises or insoles may be recommended in the short term. It can take several weeks and sometimes months to fully recover however so don’t be in too much of hurry with your rehab!
If you're experiencing Achilles pain, don’t wait to seek professional help! Our podiatry team is experienced in diagnosing and treating both types of Achilles tendinopathy. We’ll work with you to develop a treatment plan tailored to your needs, helping you get back on your feet and back to the activities you love. 💪
📞 Call us at 01933 594444 or book online at https://rushdenpodiatry.co.uk/booking/ to schedule a consultation today!