– Over time becomes a chronic degenerative condition and adhesions occur.  Hypovascular 2-6cm above insertion.     

– Easily treated if caught early, made more difficult by calf contracture, calcification or necrosis.

– Weight gain, over weight, pregnancy, aging, leg length discrepency, inappropriate shoes (high heels, changes in heel height, worn out shoes.

– Direct trauma as the cause is rare.

– Increased pain in the morning and/or beginning of activity.

– May lead to achilles tendon rupture, espescially with a history of steroid injections.

– Chronic thickening my lead to surgery for debridement of necrotic or calcified tissue, adhesion release followed by immobilization.

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