Achilles tendonitis is characterized by inflammation and irritation of the large tendon connecting the calf muscles to the heel bone. This condition can make simple activities like walking or standing painful and challenging. Heel lifts are a widely used, non-invasive method employed to immediately reduce strain on the affected tendon. This approach provides a temporary mechanical advantage, creating an environment where the tendon can begin healing. Understanding the correct duration and method of using heel lifts is paramount for a successful recovery.
How Heel Lifts Aid Achilles Recovery
The primary function of a heel lift is to alter the biomechanics of the foot and ankle during movement. By placing an insert under the heel inside the shoe, the lift elevates the heel relative to the forefoot, essentially shortening the effective length of the Achilles tendon unit. This elevation reduces the degree of ankle dorsiflexion, the upward bending motion of the foot that stretches the Achilles tendon during walking and standing.
When the tendon is less stretched and subjected to less tensile load, the strain placed upon the injured tissue is lowered. Studies have shown that adding a lift of around 12 millimeters can decrease tendon loading during walking, supporting their temporary use to offload the tendon. Lifts may also reduce compressive forces for cases involving the tendon’s insertion point at the heel bone. This reduction in mechanical stress creates a protected state, allowing inflammation to subside and the tendon to begin tissue repair.
Recommended Daily Usage Schedules
The initial phase of treatment requires consistent use of the heel lifts to maintain the offloading effect throughout the day. Patients are typically advised to wear the lift in all shoes, ensuring the tendon is consistently protected from excessive strain. This consistent use helps prevent repeated micro-trauma and maximizes the resting environment during the most acute and painful stage of the condition.
The duration of this initial consistent-wear phase is individualized and depends on the severity of the tendonitis. For acute symptoms, medical professionals commonly recommend daily use ranging from two to six weeks, or sometimes up to twelve weeks. This timeline is often determined by symptomatic improvement and is usually combined with other therapies, such as icing or gentle stretching. A recent randomized trial suggested that heel lifts produced greater improvements in pain and function over a twelve-week period compared to eccentric exercise alone in patients with mid-portion tendinopathy.
The lift is a temporary measure designed to provide immediate relief and facilitate early healing. The true recovery plan relies on a progressive rehabilitation program, which includes strengthening exercises. Therefore, the exact timeline for wearing the lifts should always be established in consultation with a physical therapist or physician who can assess the specific injury.
Transitioning Away from Heel Lifts
The process of discontinuing heel lifts is as important as their initial use and must be executed gradually to prevent a relapse or re-injury. Abruptly stopping the use of a heel lift can suddenly re-expose the recovering Achilles tendon to the full tensile load it was previously unable to tolerate. Using the lift for too long can also lead to a physiological shortening of the calf muscles and the Achilles tendon itself. This shortening can make future rehabilitation more difficult and increase the risk of injury once the lift is removed.
A structured weaning process involves the gradual reduction of the lift’s height or the frequency of its wear. Common methods include reducing the lift height by one or two millimeters per week, or removing a layer from a multi-layered lift. Another approach is to begin wearing the lifts for a few hours less each day, slowly transitioning to walking in regular shoes without the inserts for short periods. This systematic reduction allows the tendon and calf muscles to slowly adapt to the increasing demands placed upon them.
Indicators that signal readiness to begin weaning include a significant reduction in pain during daily activities and the ability to perform basic strengthening exercises with minimal discomfort. The total treatment time, encompassing the initial consistent-wear phase and the gradual weaning, can span several months. The final goal is a complete transition to supportive footwear without the lift, ensuring the tendon has recovered its full strength and tolerance for normal load.