Insertional Achilles Tendonitis

Insertional Achilles Tendonitis is an inflammatory reaction to the tendon where it inserts into the heelbone. This can be either acute or chronic and is associated with pain and sometimes swelling.
The tendon is encased in a sheath and the space in between this is called the paratenon, which becomes inflamed when there is insertional Achilles tendonitis especially where it attaches into the calcaneum (heel).


Pain on palpation (touch) at the back of the ankle where the Achilles inserts. The pain can be sharp or and ache. There maybe redness or swelling present. Insertional Achilles tendonitis may have a lump associated with it on the calcaneum especially if an overuse or chronic injury.

Acute insertional tendonitis can be through repeated friction of the area and is common in athletes. Where there is irritation and inflammation at the apohysis or enthesis (site of insertion of bone and tendon) at the Achilles from the calf muscles the condition is called apophysitis. This can be associated with an acute episode whilst growing but also adults can also get the issue from activity such as running and the tendon insertion becomes inflamed and can cause an avulsion injury to the tendon if enough force is applied.

Chronic insertional Achilles tendonitis in teens is usually due to an issue like sever’s disease where traction occurs at the site of insertion. This is due to growth where the tendon or muscles become tight and can be painful on activity or touch. This condition can leave a lump on the heel if chronic but was to help to take tension off the Achilles tendon.


Exercises and treatments are well documented and researched in the Achilles tendonitis section of and are similar.
The most important intervention for insertional Achilles tendonitis is in the acute phase to stop a chronic issue and is usually treated by reducing the inflammation with rest, ice, stopping the irritation or loading issue, gentle stretches, NSAIDs (non-steroidal anti-inflammatory drugs), isometric or eccentric exercises and it is important to not poke or rub the area. In chronic and acute Achilles tendonitis reducing or rescheduling the load to stop overuse is essential. Also making sure the calf muscle can take any load and endurance of the activity with full mobility and tonicity of the muscle group when required will both help treat but also stop insertional Achilles Tendonitis from occurring.