Medically reviewed by Dr. Tom Biernacki, DPM
Board-certified podiatric surgeon | Balance Foot & Ankle, Howell & Bloomfield Township, MI
Last reviewed: May 2026
Achilles tendonitis near Novi splits into two completely different conditions — insertional and non-insertional — and the eccentric exercise protocol that cures one type increases pain in the other. Identifying which type you have on day one determines the treatment path. Call (810) 206-1402 — Achilles tendon evaluation in Novi.
Achilles Tendonitis Treatment close to Novi
Novi’s large running and fitness community means we see a significant volume of Achilles tendinopathy patients at our Bloomfield Township office — 15 minutes east via Haggerty to M-5. Achilles tendinopathy is degenerative change in the Achilles tendon from repetitive overloading. It causes morning stiffness at the back of the ankle, pain that warms up during activity but returns worse afterward, and a tendon that’s progressively thickening. Left unaddressed, it can progress to partial or complete tear.
In our Bloomfield Township clinic, we distinguish between insertional tendinopathy (pain right at the heel bone — often with Haglund’s deformity, requiring modified protocols and potentially earlier surgery) and mid-substance tendinopathy (pain 2–6 cm above the heel — the classic runners’ form, responds best to eccentric loading). The treatment is different, and treating the wrong type with the wrong protocol explains many treatment failures we see referred to us. See our complete Achilles guide.
Key takeaway: For Novi runners: Achilles tendinopathy doesn’t resolve with rest — it resolves with structured progressive loading. Rest reduces symptoms temporarily, but the underlying tendon degeneration remains. Eccentric heel drops done correctly over 6–12 weeks are the best evidence-based intervention to remodel the tendon and restore full function.
What to expect at your appointment
Your evaluation: tendon palpation (localize pain), Thompson test (rule out rupture), calf flexibility and strength assessment, in-office X-rays when bony contribution suspected. We determine insertional vs. mid-substance and prescribe the appropriate eccentric loading protocol for your type.
Treatment: eccentric heel drop protocol (taught in-office, individualized), heel lifts, custom orthotics for underlying mechanics, load management. For non-responders: PRP, surgical debridement, or Haglund’s resection. Novi patients: appointments. Call (810) 206-1402.
⚠️ When to see a podiatrist promptly:
- Sudden ‘pop’ + inability to push off — Achilles rupture, call today
- Significant tendon swelling
- Complete loss of plantarflexion strength
- Rest or night pain beyond morning stiffness
Why Balance Foot & Ankle for Novi patients
Dr. Tom Biernacki, DPM treats Achilles conditions at our Bloomfield Township office — 15 minutes from Novi. Conservative protocols, PRP, and Achilles surgery all available.
We accept most major insurance. 4.9★ | 1,200+ reviews.
OrthoInfo – AAOS: Achilles Tendinitis
Insurance & scheduling for Novi patients
We accept Blue Cross Blue Shield, Aetna, Cigna, United Healthcare, Priority Health, and Medicare. From Novi: Haggerty Rd north to M-5 east to Woodward south — 43494 Woodward Ave #208, Bloomfield Township MI 48302.
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📋 Dr. Tom Biernacki, DPM, FACFAS answers:
Achilles tendonitis near Novi is inflammation of the Achilles tendon typically caused by overuse, training errors, or tight calf musculature. Our podiatrist serving Novi differentiates insertional tendonitis (at the heel bone attachment) from mid-portion tendonitis, as treatment approaches differ. Conservative treatment includes a structured eccentric heel-drop exercise program, which has the strongest evidence base for mid-portion tendonitis. Custom orthotics with a heel lift reduce tendon strain. Extracorporeal shockwave therapy (ESWT) is highly effective for chronic insertional tendonitis that has not responded to exercise and orthotics. PRP injections are used for significant tendon degeneration visible on ultrasound. Surgical debridement of degenerative tendon tissue and reattachment for insertional cases provides lasting relief when all conservative options have been exhausted. Most patients near Novi respond well to a structured non-surgical program within eight to twelve weeks.
What is Achilles tendonitis and what causes it?
Achilles tendonitis is inflammation and degeneration of the Achilles tendon caused by repetitive overloading that exceeds the tendon’s recovery capacity. Runners increasing mileage too quickly, sudden return to activity, and tight calf muscles are common precipitants. Our podiatrists in Novi differentiate mid-portion from insertional Achilles tendinopathy on ultrasound or MRI, as the treatment protocols for each differ significantly.
How is Achilles tendonitis treated conservatively?
Eccentric heel-drop exercises (Alfredson protocol) performed daily over 12 weeks are the gold standard — they remodel degenerative tendon tissue and restore load capacity. Heavy slow resistance training is an effective alternative. Custom orthotics with heel lifts reduce tendon strain, and extracorporeal shockwave therapy (ESWT) accelerates healing in stubborn mid-portion cases. Activity modification during early treatment prevents further tendon damage.
When does Achilles tendonitis require surgery?
Surgery is considered after 3–6 months of dedicated conservative care without adequate improvement. Mid-portion tendinopathy is treated with open or minimally invasive tendon debridement with excellent outcomes. Insertional tendinopathy with calcification may require Haglund’s resection combined with tendon debridement. Full return to running typically requires 4–6 months of progressive rehabilitation after surgery.
Seen at our Bloomfield Township office on Woodward Ave — convenient for Oakland County patients.
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.
More questions patients ask
What is the difference between insertional and non-insertional Achilles tendonitis?
Insertional Achilles tendonitis affects where the tendon attaches to the heel bone and often involves bone spur formation (Haglund's deformity). Non-insertional tendonitis affects the mid-portion of the tendon, about 2–6 cm above the heel. This distinction is critical because treatments differ: insertional tendonitis typically requires heel lifts and specific eccentric exercise protocols, while non-insertional responds better to a different eccentric loading program. Mixing up protocols prolongs recovery.
How long does Achilles tendonitis take to heal?
Acute Achilles tendonitis typically resolves in 6–12 weeks with proper management. Chronic tendinopathy (present 3+ months) can take 3–6 months of structured eccentric exercise protocol (Alfredson protocol) to resolve. The tendon heals slowly because of poor blood supply. Continuing to run or exercise through pain converts acute inflammation into chronic tendinopathy with structural changes that are much harder to reverse.
When should Achilles tendonitis be treated with surgery?
Surgery is considered after 6 months of failed conservative care including physical therapy, eccentric exercises, orthotics, and in some cases PRP injections. Surgical options include debridement of diseased tendon tissue, gastrocnemius recession to reduce tendon load, or bone spur removal for insertional cases. MRI prior to surgery is essential to assess the extent of tendon degeneration and plan the appropriate procedure.
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