Orthotic shoe inserts
for Achilles Tendonitis

Achilles Tendonitis (or ‘Tendinitis’) is Latin for ‘inflammation of the Achilles Tendon’.

Also referred to as ‘Achilles Tendinopathy’, it describes a condition characterized by inflammation, pain or structural weakness of the Achilles tendon, a key connective tissue linking the calf muscles (gastrocnemius and soleus) to the heel bone (calcaneus).

The Achilles Tendon is the longest tendon in the body. This tendon, essential for various activities such as standing on toes, walking, running, and jumping, endures immense stress, potentially supporting weights up to 12 times the body’s mass when running. Any discomfort just above the back of our heels is a sign of Achilles pain. You may also feel tightness in the calves and you’ll notice that the Achilles tendon in the affected area is thick and sore to the touch. You might experience pain as you walk or run, especially when you push off with your toes.

The diagnosis of Achilles tendonitis is typically made through a comprehensive medical history and physical examination. Key indicators include the onset of pain at the back of the heel and stiffness, particularly in the mornings or after periods of inactivity. As well as tenderness upon palpation and thickening of the tendon. Imaging techniques like ultrasound and MRI may be employed to evaluate structural changes, alterations in tendon thickness, or to rule out tears if the diagnosis remains uncertain.

Several factors contribute to the development of Achilles tendonitis, with overuse being the primary cause. When there is persistent strain or stress on the Achilles tendons it results in irritation and eventually inflammation. Some severe cases have been reported where the massive strain caused the tendon to rupture! Chronic overuse of this tendon is common in runners and is a frequent cause for changes in it. This leads to thickening and degeneration of the tendon.

Also tightness in your calf muscles contributes heavily to Achilles Tendonitis. Furthermore, our tendons tend to degenerate with age and this wear and tear over time leads to weakness in the fibers of the tendon, which in turn can lead to micro-tearing.

However, over-pronation has been found to be the most common cause of this condition. Excessive inward foot rolls cause our lower leg to rotate internally. This puts a shearing force on our calf muscles which are connected to the Achilles tendon. Now this is where the Achilles tendon gets over-stretched, which results in inflammation.
Sudden increases in training intensity or changes in activity level, overly pronated foot mechanics, and insufficient calf muscle flexibility or strength can exacerbate strain on the tendon. Additional risk factors include inappropriate footwear (with a lack of arch support), training on hard surfaces, prior tendon injuries, and certain medications, such as “fluoroquinolone” antibiotics.

Treatment predominantly focuses on conservative methods aimed at alleviating symptoms and addressing underlying issues to prevent recurrence. Key strategies involve modifying activities, incorporating low-impact workouts like swimming or bike riding and engaging in ‘eccentric exercises’ that promote tendon re-modeling—a noteworthy example being the “Alfredson Protocol”: stretching and strengthening exercises targeting the Achilles tendon and associated muscle groups can enhance flexibility and reduce tension. Orthotic insoles and heel lifts are an also very common (additional) treatment option for Achilles Tendonitis.

Orthotic insoles are made to address problems with the way your feet move (your gait), for example too much pronation (rolling inwards of the feet & flatting of the arches). Research has examined diverse orthotic interventions and showed reductions in Achilles tendon load, suggesting that biomechanical correction may assist in reducing strain on the tendon. Podiatrists and physical therapistists often prescribe orthotics. In some cases, heel lifts are added to the orthotic device to relieve tendon stress.

Footlogics offers 4 different orthotics for this common condition. In addition to wearing orthotics we highly recommend you do some simple daily exercises (please see further below).

Footlogics offers 4 different orthotics for this common condition. In addition to wearing orthotics we highly recommend you do some simple daily exercises (please see further below).

In cases where conservative treatment fails, particularly with partial tendon tears or persistent symptoms for six months, surgical intervention may be considered. Various surgical options are available depending on the nature and location of the tendon damage.

In summary, Achilles tendonitis is a prevalent condition affecting athletes and active individuals alike. Successful diagnosis hinges on thorough assessment techniques, with overuse and biomechanical factors being significant contributors. Conservative treatments — such as eccentric exercises, activity modification, and biomechanical correction with orthotic insoles — show promise in aiding recovery, allowing many patients to return to their usual activities with a minimized risk of recurrence, provided a comprehensive approach to rehabilitation is followed.