Victorian Orthopaedic Foot & Ankle Clinic
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Achilles Tendinosis

The Achilles tendon is the largest and strongest tendon in the human body. It is a very important tendon in normal gait (walking). Over time the tendon can wear out, in particular with frequent running/jumping activities, weight gain or increasing age. Degeneration of the Achilles tendon can occur close to the middle of the tendon or at its insertion into the heel bone. Non-operative management is often very effective at reducing or eliminating symptoms and this comprises of Achilles stretching exercises and a heel lift orthotic.

Surgical management is reserved for patients who have tried the non-operative management without success. Surgery can comprise of tendon debridement, tendon transfer and debridement of bony prominences, which irritate the tendon close to its insertion.

Case - 1  

Achilles Tendinosis - Victorian Orthopaedic Foot & Ankle Clinic

This photo illustrates the typical location of a (Haglund's) bony prominence related to insertional Achilles tendinosis. This bump can rub in shoes and can occasionally be painful.

Achilles Tendinosis - X-ray - Victorian Orthopaedic Foot & Ankle Clinic

X-ray demonstrating the bony prominence as well calcium deposits in the Achilles tendon indicating some inflammation

Intra Pre Operative - Achilles Tendinosis - Victorian Orthopaedic Foot & Ankle Clinic

Picture of a degenerate and partially ruptured Achilles tendon. Note the swollen tendon which indicates longstanding tendon pathology

Intra Post Operative - Achilles Tendinosis - Victorian Orthopaedic Foot & Ankle Clinic

Repair and reconstruction of the worn Achilles tendon. Incorporation of another (strong) tendon into the repair is sometimes required to augment a severely diseased Achilles.

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