Achilles Tendon Treatment Using Heel Lifts or Shoe Lifts

The intent of this document is to offer information about heel lifts used to treat Achilles' tendon inflammation.

The goal of using a heel lift in these circumstances is simply to reduce the strain on the Achilles tendon while allowing you to remain mobile; to permit it to be less stretched and relaxed while healing slowly occurs. Because tendons have no blood supply this healing typically requires weeks or months, and the tendon can easily be re-injured if it is stressed during this time. A standard reference for the effectiveness of this treatment is: "Electromyographic changes of leg muscles with heel lift: therapeutic implications."

Achilles' tendon strains and other related problems are often treated with heel lifts or shoe lifts, to temporarily reduce stress on the tendon:

• Achilles' tendonitis, or chronic inflammation, often caused by overuse or athletic strains,
• Post-surgical rehabilitation after repairs to ruptured or injured Achilles' tendons,
• Tight Achilles' tendons caused by disease, lack of stretching, or muscle and connective tissue shortening in the lower leg.

Heel lifts are commonly prescribed  with anti-inflammatives as the most conservative treatment for mild inflammation or hyper-extension of the Achilles tendon, and also after surgical repair of Achilles' ruptures, once any immobilizing cast has been removed.

Suggestions for Heel Lift Use in Achilles Tendon Therapy

• In-shoe lifts should be used in both shoes, for balance and to avoid creating other body stresses. You will need to buy heel lifts in pairs and use them with each pair of shoes you wear.
• Because you may be using the lifts for some time during healing, maximum comfort will be important; see Selecting Heel Lifts and Shoe Lifts - A Guide for more information on choosing heel lift products.
• The same elevation should be added to all shoes that are regularly worn, including house-slippers and flip-flops. Walking barefoot should probably be minimized during the healing period.
• It is generally accepted that no more than 12mm (½") of heel elevation can be used in a shoe without purchasing oversized shoes. The maximum height you can use in a pair of shoes will be affected by the style and fit of the shoes, as well as your foot size - ½" or more is often prescribed for Achilles' tendon therapy. Adjustable heel lifts and added external heel height can be useful to deal with those shoes where ½" simply won't fit.
• Achilles' treatment requires the use of firm heel lifts, rather than soft gel or foam materials; soft materials can cause vertical heel motion and rubbing in shoes, which could create additional inflammation of the tendon and potentially worsen tendinitis.
• When your health-care professional determines that healing is complete, you should reduce the elevation gradually over a few weeks, to slowly re-stretch the tendon. Adjustable heel lifts are useful for this purpose.
• A  prescribed program of gentle stretching will assist in restoring full function after the Achilles' tendons have healed.