Insertional Achilles tendinopathy affects the lower part of the Achilles tendon, where it attaches to the heel bone. This condition can cause pain at the back of the heel, often accompanied by swelling and thickening of the tendon. It is typically associated with repetitive stress or wearing shoes that irritate the area. In some cases, it can lead to the development of bone spurs at the attachment point, further aggravating the condition. Patients often experience pain during physical activities, especially when running uphill or climbing stairs. Conservative treatments include rest, stretching, and physical therapy, but chronic or severe cases may require surgery.