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What is meant by enthespoathic change in the distal achilles tendon insertion?

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Orthopaedic Surgeon
Practicing since : 1994
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I, 51 years old, have some bony irregulaities and possible calcification of enthespoathic change in the distal Achilles tendon insertion. What does this mean in plain English and what cause it?What is the treatment?
thank you
Posted Mon, 3 Dec 2012 in Bones, Muscles and Joints
Answered by Dr. Praveen Tayal 11 minutes later
Thanks for posting your query.
You have inflammatory changes at the junction of bone and achilles tendon. Calcification of the inflammatory area is an age related degenerative change.
Recurrent trauma in the area often causes the inflammation.
Treatment involves pain killers, local steroid injections, hot fomentation and application of a local analgesic gel.
You should use as many of these treatments as possible concurrently:
1. Wear shoes with a heel ½” to 1” higher than the ball of the forefoot and are somewhat flexible through the ball of the foot.
2. Add a heel lift in your shoe. (You may also use arch support inserts or orthoses, such as Superfeet orthotics)
3. Avoid standing or walking barefoot. Avoid flat footwear like slippers or sandals. Avoid stiff shoes.
4. Perform calf stretching exercises for 30-60 seconds on each leg at least two times per day. (Stand an arm’s length away from the wall, facing the wall. Lean into the wall, stepping forward with one leg, leaving the other leg planted back. The leg remaining back is the one being stretched. The leg being stretched should have the knee straight (locked) and the toes pointed straight at the wall. Stretch forward until tightness is felt in the calf. Hold this position without bouncing for a count of 30-60 seconds. Repeat the stretch for the opposite leg.)
4. Perform eccentric calf rehab exercises under guidance of a physiotherapist.
I hope this answers your query.
In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.
Please accept my answer in case you do not have further queries.
Wishing you good health.
Dr. Praveen Tayal.
Above answer was peer-reviewed by
Follow-up: What is meant by enthespoathic change in the distal achilles tendon insertion? 2 hours later
Thank you for that information. Should I give it complete rest, apart from stretching, or is it okay to keep exercising while their is still pain or will it cause more damage?
regards, XXXXXXX
Answered by Dr. Praveen Tayal 2 hours later
Thanks for writing again.
Avoid exercising while there is pain. After the pain subsides with appropriate medicines, you can start with physiotherapy exercises. Avoid weight bearing and give it a complete rest till pain subsides. You can use a brace of appropriate size too.
Hope my answer is helpful.
Do accept my answer in case there are no further queries.
Above answer was peer-reviewed by
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