Your Achilles tendon is the largest tendon in your body, and it needs to be in order to handle all the stress that is put on it during regular and more intense movements. Despite its size and strength, it’s not immune from the effects of acute or chronic trauma, and oftentimes this manifests in the form of tendonitis.

In the Achilles tendon, tendonitis is typically classified as insertional or non-insertional. In today’s blog, we take a closer look at the causes, symptoms and treatment options for insertional and non-insertional Achilles tendonitis.

The Difference Between Insertional And Non-Insertional Achilles Tendonitis

The mechanism of injury is the same in both insertional and non-insertional Achilles tendonitis. Repetitive trauma on the Achilles leads to the development of microtearing and inflammation within the tendon, which can lead to symptoms like pain, stiffness, tightness and swelling on the backside of our heel area. The difference between the two conditions is where within the tendon the tearing and inflammation develops.

• Insertional Achilles Tendonitis – This type of tendonitis develops where the tendon connects (or inserts) into the back of your heel bone. This is the less common version of the condition, and it also tends to be a little more difficult to effectively treat.
• Non-Insertional Achilles Tendonitis – This type of Achilles tendonitis typically develops about 2-8 centimeters above where the tendon attaches to your heel bone. This is the most common form of Achilles tendonitis.

Both forms of tendonitis tend to be the result of repetitive trauma on the tendon that overstresses it. A significant increase in activity, like failing to adequately train prior to the upcoming sports season or increasing your running distance too quickly, can oftentimes lead to tendonitis onset. You’re also more likely to develop Achilles tendonitis if your increase in activity is coupled with any of the following risk factors:

• Obesity
• Diabetes
• Older age
• Poor-fitting footwear
• Smoking
• Related inflammatory health conditions

Treating Achilles Tendonitis

The treatment for insertional and non-insertional Achilles tendonitis is largely similar, but treatment courses are not identical. The main difference is how treatment focuses on a specific area of the tendon. Physical therapy exercises to strengthen a particular part of the tendon will differ based on your specific type of tendonitis. How you help protect the tendon from additional trauma during the healing phase may also differ. While rest plays a big role in helping the inflamed tendon heal, patients with insertional Achilles tendonitis may find more benefit in specific shoe modifications. Switching to a more supportive shoe will be beneficial for patients with either type of tendonitis, but patients with insertional tendonitis may better be able to protect their heel from additional strain with the help of a heel lift or a custom orthopedic shoe insert.

Both forms of Achilles tendonitis tend to respond well to:

• Rest
• Footwear changes
• Anti-inflammatory medications
• Physical therapy
• Orthopedic inserts
• Gradual reintroduction to strenuous physical activity

Dr. McDonald and his team have a wealth of experience pinpointing the location of Achilles tendonitis and developing an individualized recovery program that helps you put an end to your symptoms once and for all.

So if you want to figure out what’s causing discomfort in the backside of your heel, or you need assistance managing another foot or ankle condition, reach out to Dr. McDonald and his team today at (860) 244-8889.