Treatment for insertional achilles tendinopathy Case Presentation A 45 year old female who participates in triathalons presents to your clinic with stiffness and pain over the right heel.
Treatment for insertional achilles tendinopathy Case Presentation A 45 year old female who participates in triathalons presents to your clinic with stiffness and pain over the right heel. The patient describes pain with activity that localizes to the calcaneus. She is exquisitely tender over the Achilles insertion over the lateral portion and nontender over the midportion.
A plain radiograph shows a small Achilles enthesophyte over the insertion. Which of the following initial treatment options is most appropriate for this patient? Cast and non weight bearing for 6 weeks C.
Physical therapy with exercise program D. Extracorporeal shock wave therapy (ESWT) Insertional Achilles tendinopathy (IAT) is difficult to manage, and there is no definite consensus on which nonoperative treatment is superior over the others. Sports medicine providers will undoubtedly be involved in challenging cases involving IAT.
Treatments for tendinopathies are wide ranging, and include but are not limited to orthotics, physiotherapy, laser treatment, ultrasound, extracorporeal shock wave therapy, NSAIDs, peritendinous corticosteroid injections, platelet rich plasma injections, high volume saline injection, eccentric loading, sclerosant injection and surgery. This wide range of treatments reflects the limited consensus among clinicians on how this pathology is best managed. Insertional Achilles tendinopathy (IAT) is located at the insertion of the Achilles tendon onto the calcaneus , possibly with the formation of bone spurs and calcifications in the tendon proper at the insertion site.
Patients can complain of pain, stiffness, and sometimes swelling that can be firm or solid. On physical examination, the tendon insertion is painful. A swelling may be visible and a bony spur may be palpable.
If you are experiencing symptoms that may be related to treatment for insertional achilles teninopathy, it is important to see a sports medicine physician. Early evaluation and treatment typically lead to better outcomes. Do not ignore pain or symptoms that are limiting your activity.
*This article is for educational purposes only and does not substitute for professional medical advice. Always consult a qualified healthcare provider.*
Connect with a doctor, physical therapist, or imaging center near you.
Find a Provider Near You โ