Achilles Tendonitis and Achilles Injury - Basics
The Achilles tendon connects your calf muscle to your heel bone. It is the largest tendon in the human body and is used to complete a number of tasks that push the foot in a downwards motion during walking, jumping and running. Other examples of movements that require the use of the Achilles tendon is walking on your tip toes, climbing stairs, etc. It is strong, but that doesn't exclude it from being susceptible to sudden injuries (Achilles Rupture) or injuries as a result of overuse (Achilles Tendonitis).
Achilles Tendonitis
The ending of the word 'tendonitis' is '-itis', which is latin for inflammation. So Achilles Tendonitis is inflammation and irritation of the Achilles Tendon. This irritation can be caused by overuse as a result of tight calf muscles, improper increase in exercise intensity and/or amount. This overuse results in micro-tears and thickening of the tendon over time. This can occur right at the heel bone at the site of insertion, or it could happen higher up on the tendon. Pain and swelling can be increased during an activity, and still be felt the next day. An additional reason for tendonitis at the heelbone would be if a bone deformity (known as Haglund's deformity) is present and causes addition rubbing at the insertion site. With constant pulling at the insertion site, a bone spur may also develop over time. Achilles Tendonitis symptoms include heel pain (starts slowly and worsens over time) and pain at the back of the leg. Pain may be worse when running or after physical activity, as well as stiffness or tenderness in the mornings after waking up (which may improve as you start going about your day). There may also be mild swelling around the heel that gets worse with activity.
Recommended Braces and Supports for Achilles Tendonitis
- Night Splinting
- Heel Raise Shoe Inserts
- Compression Ankle Sleeve/Brace with massage pad
Rehabilitation Options
- Rest - Reducing activities that cause discomfort and switching to low impact activities such as swimming, biking
- Ice (ice packs or cold therapy machine)
- Strengthening and stretching exercises - under the direction of your physiotherapist
- Surgical intervention for more severe cases
Tendonitis
Recommended Braces and Supports for Achilles Rupture
- Non-operative - cast immobilization at a plantar flexed (toe pointing) position
- Operative - following surgery, immobilization by cast or immobilization boot (also in a pointed toe position).
- Use a shoe balancer on the opposite leg to balance your hips for easier walking
Rehabilitation Options
- Full tears can be rehabilitated in a non-operative or operative method.
- In both cases (post injury or post surgery) involvement of physiotherapy to regain the range of motion back in your ankle is required
- Post surgery / injury cold therapy
Rupture
Achilles Tear, Rupture
An Achilles Rupture is when a sudden tear of the tendon is present causing an impairment to normal function. Ruptures present commonly as sports related injuries for individuals in their thirties to fifties. When a tear occurs, it can be felt as a snap sensation at the back of the heel, or slightly higher towards the calf muscle.
The primary types of supports for Achilles Tendonitis and Achilles Injury are compression ankle braces / sleeves, night splints, and walking boots. Shoe inserts (heel lifts or orthotics) can also be helpful.
Compression ankle braces / sleeves provide support to the Achilles tendon. Most ankle braces for Achilles treatment include compression to reduce swelling. Some designs also include 'pulsating' massage (two pockets or a pad which gently moves as you walk) which help increase circulation to the tendon.
Shoe inserts can be helfpul for mild treatment and pain management. They lift your heel to reduce the pull on the Achilles tendon as you walk during your day.
Night splints hold the Achilles tendon in a 90 degree position as you sleep, preventing shortening of the tendon (like a sustained stretch) so that the first steps in the morning are more comfortable. These splints are not designed to be walked in.
Finally, walking boots (also known as CAM boots) hold the ankle firmly at a 90-degree angle to keep the Achilles Tendon in the same position. A heel wedge may be advised to be used in addition to the boot to reduce the pull on the achilles tendon. These boots are used for Achilles Tendonitis if the tendon is extremely flared up and it is painful to walk. Please consult your doctor or physiotherapist before ordering this product to ensure it is the correct option for you.
Tips when using a compression ankle brace, night splint, or boot
- The fit of the brace should be comfortable, if you feel that the brace is digging in anywhere then it's too small.
- Achilles ankle supports can be used for walking and running. We do not recommend a brace with a heel lift, or a heel lift by itself for running as it could cause your foot to shift inside your shoe with quick cutting movements.
- With night splints the foot should be at least 90 degrees bend and a little further if possible. This stretch shouldn’t be painful.
- For walking boots, a tall boot model is required to provide proper leverage to immobilize the ankle joint. A heel lift is worn to reduce the pull on the achilles and as you progress in your recovery the lift layers will be removed one by one.
- If you're using a boot, please consult your doctor before returning to weight bearing.
Selecting the Correct Brace or Support for Achilles Tendonitis and Injury
Our Top Rated Braces and Supports for Achilles Tendonitis and Injury
Top Rated Ankle Sleeves and Braces
OS1st AF7 Compression Ankle Sleeve:
Compression sock style option for the management of mild Achilles Tendonitis. The AF7 Ankle Brace Sleeve helps treat swollen ankles, without restricting movement. The Brace is lightweight and is made up of nylon and K-zone (compression) technology. This nylon technology allows for more flexibility in and around the ankle area. K-zone technology has some of the same benefits of taping while avoiding the restrictiveness of tape.
This everyday bracing option contains medical grade compression, a massaging pad at the Achilles tendon to stimulate blood flow, as well as a heel lift for acute cases of Achilles Tendonitis. This option can also be used after the completion of an immobilization boot. By offering a lift under the base of the heel, it slightly reduces the pull on the Achilles tendon as it shortens the needed length. In time, you can then remove the insert so that you are back to 90 degrees in standing. Also suitable for individuals with Haglunds Deformity.
An alternative brand option to the Bauerfeind AchilloTrain Pro. Offers higher medical grade compression of 30-40 mmHg, as well as a massaging pad on the back of the achilles tendon.
Ossur Formfit Night Splint with Slip-Resistant Tread:
This splint is designed to be worn during the night to provide a gentle stretch to the achilles tendon. The diagonal straps on the side of the splint can adjust how much pull is provided while in use. This is designed to reduce the pain during the first steps of the morning where the Achilles Tendon is forced to stretch out during walking. Having the foot surrounded by cushioning adds additional comfort for use.
As an alternative to the Ossur Formfit, this model has the rigid shell on the front of your foot. This could be more suitable for you if you're prone to kicking backwards in your sleep. Also comes with a diagonal strap to adjust the amount of upwards pull is provided while in use. This option is also meant as a night time option to reduce the stretching that occurs with the Achilles Tendon during the first steps of the day.
As an option that is designed to fit comfortably within your shoes, this insert will lift your heel to reduce the pull on the Achilles tendon as you walk during your day. As a gel compound, it provides added cushioning underneath the heel for added comfort.
Latex Free
This heel option absorbs shock to reduce the pain of the inflamed Achilles tendon. As a heel lift, it reduces the stretch applied to the achilles tendon while in use. Made of silicone for easy to clean, long duration use.
Top Rated Night Splints
Top Rated Heel Inserts
Top Rated Immobilizing / Walking Boots
VacoCast Achilles Walking Boot:
This boot was designed specifically for achilles tendon rehabilitation in mind. As you regain your range of motion back in your ankle, you will need to stretch the achilles tendon slightly from the pointed toe position back to 90 degrees. That is done over the course of several weeks/months. Traditional immobilization boot options in the past for this used a standard fracture boot and inserted wedges inside the boot that would reduce the room for your foot. The VacoCast boot puts comfort first and the shape of the boot changes to your needs in 5 degree increments as you progress in your recovery. Instead of having an additional insert in your boot, you have the boot set to limit the range of motion you need. Not to mention, this boot can be used in the water and would only require the additional purchase of a liner in order to do so! The foot bed length is adjustable for ideal fit, and the bean bag liner creates a vacuum seal around your foot. Opposite to standard boot function, this boot pushes the air out of the liner as you use your bulb.
For Proper Hip Alignment, we recommend purchasing with the EvenUp Shoe Balancer with your boot.
BREG Genesis Full Shell Walker with Foam Achilles Wedge Insert:
The BREG Genesis boot was designed to be 27% lighter in weight compared to the average for immobilization boot. With a single inflation bulb, you can inflate two aircells on either side of the ankle at the same time to assist with swelling at the joint. As it comes with a thinner base than other immobilization boots, it offers a better hip alignment than some of the other models we carry so no EvenUp Shoe Balancer is required. In order to be suitable for achilles rehabilitation, the purchase of the Foam Achilles Wedge insert is required. As you progress in your recovery, you drop the layers present in the boot to drop your heel back down to 90 degrees over time.
Aircast AirSelect Standard Walking Boot with ProCare Achilles Wedge:
Aircast has been used as a synonym for immobilization boots for many years now so they are well regarded for these boots. Just like the BREG Genesis, this boot option has aircells on both sides of the ankle to assist with reducing swelling. This model, however, allows you to select which side of the boot you want to inflate separately from one another with the turn of the dial. Made with a built in pump, the boot is easy to use. To make this fracture boot suitable for achilles tendon rehabilitation, the ProCare Achilles Wedge should be purchased with the device. This will allow you to remove a layer as you progress in your rehabilitation and drop your heel down to be at a joint angle of 90 degrees.
For Proper Hip Alignment, we recommend purchasing with the ProCare Shoe Lift with your boot.
This shoe balancer is designed to level your hips (help offset the additional height) when you are walking with a walking boot or wound care shoe. Lightweight rubber outer sole does not add bulk to your shoe and it includes a non skid bottom.
Another great option designed to level your hips with the same features as the EvenUp Shoe Balancer.
