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article 2026 12 pages

Insertional Achilles Tendinopathy with Haglund's Deformity: A Progressive Approach to Post-Operative Rehabilitation in Athletes

Mark Dudek, Anastasia BJ Robinson, Meghan Newcomer, C. Thomas Haytmanek

Journal
International Journal of Sports Physical Therapy
DOI
10.26603/001c.156435
Population
athletes
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Abstract

Haglund’s Syndrome is characterized by posterior superior calcaneal prominence with associated retrocalcaneal bursitis and insertional Achilles tendinopathy (IAT). Conservative management with physical therapy demonstrates strong evidence for efficacy and takes time. It is typically trialed for over a year, and if pain and dysfunction persist, surgical intervention is considered. Post-operative rehabilitation protocols described in the literature vary widely, with many restricting weightbearing for extended periods of time. This protocol emphasizes an expedited yet safe return to weightbearing for the patient to quickly normalize gait and return to evidence-based loading strategies. By aligning rehabilitation milestones with physiological healing timelines and objective criteria, this rehabilitation approach aims to optimize efficiency in recovery and facilitate a safe return to sport. The purpose of this clinical commentary is to review current literature and propose a criterion-based protocol recommending early weight bearing when significant repair of the tendon is not necessary.

Level of Evidence

5

Description

This clinical commentary reviews literature and proposes a criterion-based protocol for post-operative rehabilitation.