The Achilles tendon becomes prone to injury & pain in middle-aged people due to reduced tissue quality and blood supply. This can come on as a result of a specific injury or more chronic overuse, and often presents with a painful swelling. This can be located near the insertion into the heel bone (insertional) or some distance away (non-insertional tendinopathy) but invariably causes difficulty with mobility and participating in sports. Most patients respond to anti-inflammatory medication, splintage & stretching exercises, but occasionally surgery to remove abnormal tissue from the tendon is required. Usually the normal tendon can be preserved in this procedure, but in longstanding cases with extensive tissue damage a tendon reconstruction or transfer is necessary prolonging the postoperative rehabilitation.

Insertional Heel Lump
(Haglund’s Node)

Acute tears of the Achilles tendon often occur as a result of sport activities and can be treated successfully both with and without an operation. In many cases the injury is not immediately recognized leading to a delay in diagnosis. In this situation surgical repair can lead to a better outcome especially in a patient keen to return to sport activities.

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