Medically reviewed by Dr. Tom Biernacki, DPM
Board-certified podiatric surgeon | Balance Foot & Ankle, Howell & Bloomfield Hills, MI
Last reviewed: May 2026
Achilles tendinitis near Auburn Hills has two distinct locations — insertional (at the heel bone) and mid-portion (2–6cm above it) — and the treatment that resolves 80% of mid-portion cases actively worsens insertional cases. Identifying which type you have takes 10 seconds on exam and changes the entire rehab approach. Call (810) 206-1402 for Achilles tendon evaluation.
Medically Reviewed by: Dr. Tom Biernacki DPM · Board-Certified Podiatrist · Balance Foot & Ankle PLLC · Updated 2026
Achilles Tendinitis Treatment Near Auburn Hills, MI
Achilles tendinitis (tendinopathy) treatment near Auburn Hills, MI is available at Balance Foot & Ankle in Bloomfield Hills. Dr. Biernacki DPM distinguishes non-insertional (midportion) from insertional tendinopathy — which require different treatments — and manages both with evidence-based eccentric loading protocols, shockwave therapy, and PRP when indicated. Corticosteroid injections directly into the tendon are never used. Call (810) 206-1402.
Non-Insertional vs Insertional Achilles Tendinopathy
Achilles tendinopathy is the most common overuse injury of the lower extremity in runners, affecting both competitive athletes and recreational exercisers. The most important distinction: non-insertional (midportion, 2-6cm above the insertion) vs insertional (at the calcaneal insertion itself) — these are different conditions requiring different treatments. Non-insertional tendinopathy: Pain and thickening at the midportion 2-6cm above the heel. Responds excellently to the Alfredson eccentric loading protocol — 80%+ success at 12 weeks. Insertional tendinopathy: Pain at the posterior heel at the tendon insertion. Associated with Haglund deformity — a prominent posterior superior calcaneal tuberosity causing retrocalcaneal bursitis and direct tendon impingement against the bony prominence. The Alfredson eccentric protocol (heel drops below the step) is counterproductive for insertional cases — it compresses the tendon against the Haglund prominence and worsens pain. In our Auburn Hills-area practice, the most common error is applying the full eccentric below-step protocol to an insertional case, which inevitably fails and discourages patients from the highly effective exercises that would work for their actual condition.
Key Takeaway: Non-insertional: Alfredson eccentric protocol (heel drops below step) 12 weeks = 80%+ success. Insertional: eccentric below-step protocol WORSENS it — use heel lift, concentric/isometric loading, shockwave. NEVER inject corticosteroid directly into the Achilles tendon (rupture risk). PRP reasonable for chronic refractory non-insertional cases. Haglund + insertional = surgical consultation if conservative fails 6+ months.
Evidence-Based Treatment Protocol
Non-insertional — Alfredson eccentric protocol: Eccentric heel drops off a step (knee straight = gastrocnemius, knee bent = soleus), 3×15 reps twice daily, 12 weeks. Initial pain expected — do not stop. 12-week completion: 80%+ success rate. Heel lift (1cm) reduces Achilles tension during activity. Insertional tendinopathy: Heel lift in all footwear to reduce tendon compression. Soft heel counter shoes. Concentric and isometric loading instead of eccentric below-step exercises. Extracorporeal shockwave therapy (ESWT) — particularly effective for insertional cases. Adjunct treatments: PRP injection (ultrasound-guided into the tendon body) for non-insertional cases refractory to eccentric training — moderate evidence. Topaz/radiofrequency ablation for chronic tendinosis. Surgical: Tendon debridement and reconstruction for >50% cross-section involvement. Posterior calcaneal exostectomy + retrocalcaneal bursectomy for Haglund deformity. Absolute contraindication: Corticosteroid injection directly into the Achilles tendon body — associated with spontaneous rupture.
⚠️ See a Podiatrist If:
- Achilles pain not responding to stretching after 4-6 weeks — clinical diagnosis needed
- Palpable tender nodule or thickening of the Achilles — degenerative tendinosis on ultrasound
- Recent fluoroquinolone antibiotic course with Achilles pain — high tendon rupture risk
- Posterior heel “pump bump” with Achilles pain — Haglund deformity evaluation
- Sudden pop in the Achilles — rupture evaluation urgently needed
Recommended Products for Achilles Tendinitis Recovery
Achilles tendinopathy is one of the most common conditions we treat — and one of the most responsive to the right combination of load management and support. Dr. Biernacki recommends these products for patients managing Achilles tendinitis between appointments.
Tuli’s Heavy Duty Heel Cups — Achilles Offloading
A heel lift is one of the fastest ways to reduce Achilles tendon load. By raising the heel, you shorten the tendon’s working length and decrease the stretch placed on it with each step. Tuli’s waffle-cup design provides both the lift (3/8 inch) and shock absorption that Achilles tendinopathy patients need. We use these in our clinic as a first-line intervention before prescribing orthotics. Fits most shoes; inexpensive enough to put in every pair.
Strassburg Sock — Achilles & Plantar Fascia Night Splint
Many Achilles tendinopathy patients experience the worst pain with their first steps in the morning — a sign of nocturnal tendon shortening. The Strassburg Sock gently maintains the ankle in a neutral or slightly dorsiflexed position overnight, keeping the Achilles tendon elongated while you sleep. This prevents the microadhesions that cause morning pain and promotes collagen remodeling. Far more comfortable than rigid night splints; most patients adapt within 2–3 nights.
OrthoInfo – AAOS: Achilles Tendinitis
Getting to Our Office From Auburn Hills
Our Bloomfield Hills office at 43494 Woodward Ave #208 is about 20 minutes from Auburn Hills via I-75 S to Woodward Ave. We accept most major insurance. Call (810) 206-1402 or book online.
Achilles Pain? Get Expert Tendinopathy Treatment
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📋 Dr. Tom Biernacki, DPM, FACFAS answers:
Achilles tendinitis near Auburn Hills is treated with an eccentric heel drop exercise program, heel lifts, custom orthotics correcting overpronation, and activity modification. Anti-inflammatory medications and ice manage acute pain. Extracorporeal shockwave therapy (ESWT) has strong clinical evidence for chronic insertional Achilles tendinopathy. PRP injections accelerate healing for mid-portion tendinopathy. Our clinic serving Auburn Hills offers same-week appointments and accepts most major insurance plans.
Dr. Tom Biernacki, DPM is a board-certified foot & ankle surgeon (ABFAS & ABPM) at Balance Foot & Ankle Specialists in Southeast Michigan. With over a decade of clinical experience, he specializes in heel pain, bunions, diabetic foot care, sports injuries, and minimally invasive surgery. Dr. Biernacki is a member of the APMA and ACFAS, and his patient education content on MichiganFootDoctors.com and YouTube has made him one of the most-followed foot & ankle educators on YouTube.