For years, I despised treating the insertional Achilles tendon pain patient. I tried everything I was told by different gurus. One well-established ankle and foot orthopedist swore by heel lifts and prolonged stretching off a step: 3 minutes, 3x/day and you would get better. The next told me to place patients in a walking boot to unload the insertion. Another podiatrist requested I ultrasound and ice massage them. My PT Mentors told me to exercise them.
At this point, my head was spinning and I begged not to see these patients anymore. Finally, I began to see the light. For some reason, this condition is poorly understood, causing it to not be treated properly. To effectively treat it, we really need to understand why it is happening.
Understanding the MOI
It is not that the Achilles or calf is too tight as many had suggested to me. It’s certainly not that we only need a modality-based treatment plan. A...