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Female gymnasts are the athletes that are most likely to experience Achilles tendon rupture, due to the high energy and eccentric load place on their Achilles tendon related to their sport. It is postulated that degenerative changes, watershed vascular supply, calcifications, and high amounts of inflammatory cells may play a role. This case report highlights an athlete with an asymptomatic Achilles tendon that was visualized to be normal utilizing ultrasound. She was found to have no evidence of underlying tendon pathology. The athlete then ruptured her Achilles tendon 8 months later during a gymnastic meet with no proceeding symptoms. This case report challenges the accepted theory that preexisting tendinosis or pathology proceeds Achilles tendon rupture. In this case, it is postulated that tendon rupture may be secondary to significant mechanical force even without underlying pathology.Level of evidence: Level 4.

Minimal literature is available on the diagnosis and treatment of proximal plantaris tendinopathy. Calf pain is a common complaint in runners, ranging from myofascial pain to acute strains. Rarely, the plantaris tendon can be involved in mid-calf pain. This case highlights a 23-year-old female elite runner with a case of symptomatic proximal plantaris tendinopathy. Insidious mid-calf pain and/or tightness with tenderness to palpation was noted, and ultrasonographic examination provided an accurate diagnosis. An ultrasound-guided corticosteroid injection was performed, providing complete pain relief without recurrence, even 1 year after the initial injection. The patient was able to return to full activity. Successful treatment of this rare condition with ultrasound-guided corticosteroid injection should be considered once a proper diagnosis is made.