25 y/o gymnast w/bilateral insertional achilles pain for 15 months after levaquin (levofloxacin) therapy. 6 months of pt failed. seeking recovery/return to function.

Not unheard of: I've had patients, with this observation following Levaquin (levofloxacin) usage. 15 months of pt was long enough. Consider immobilization via a cam walker and then hit it hard with both an oral steroid and oral nonsteroidal anti-inflammatory. Consider cortizone injection to one side by your local area podiatrist. Do the other side, if vast improvement putting 3-4 weeks between injections. Stop living in pain!

Tough question: This is a tough question to answer on this. That type of medication for a young person can cause damage to tendons. I would suggest a visit to podiatric surgeon for full work-up and evaluation.

MRI: I suggest an MRI to evaluate if any tearing is present. You might need to have a surgical repair of the tendon especially given that you're a gymnast.