Having suffered from insertional achilles tendinitis in the past I thought I would share a crucial component of my recovery: the running shoes. Please note that, although I try to reference as many leading research articles as possible, I’m not a physician.
Insertional Achilles Tendinitis is a nasty and nagging running injury. It’s an inflammation of the tendon at the point where it attaches to the foot.
Unlike the classic version of Achilles Tendinitis that designates pain above the foot, Insertional Achilles Tendinitis does not respond as well to eccentric loading exercises. Even more frustrating is the fact that rest alone often does not work.
Additionally, it’s quite common with Insertional Achilles Tendinitis to develop a painful bump on the back of the foot (Haglund’s deformity), which can be aggravated by shoes with a stiff or tight heel counter.
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Should you keep running with Insertional Achilles Tendinitis?
It may seem counter intuitive to run with such injury but as noted above rest often doesn’t help. The achilles tendon has a poor blood supply and, therefore, it could help to keep it active to support the healing process. In this 2007 study, Silbernagel et al. found that “no negative effects could be demonstrated from continuing Achilles tendon-loading activity, such as running and jumping, with the use of a pain-monitoring model, during treatment.” In this research, runners were allowed to pursue their activity provided their pain level didn’t exceed 5 on a scale of 10.
In other words, listen to your body and check with your doctor but some running is potentially safe while recovering from Insertional Achilles Tendinitis.
What are the best running shoes for Insertional Achilles Tendinitis?
After reading the experience of many runners recommending the Nike Free 5.0, I decided to give it a try and was not disappointed. Thanks to a soft and loose heel counter it didn’t bother my achilles and I was able to run while my tendon was healing.
However, the Nike Free 5.0 have now been discontinued and replaced by the Nike Free RN Flyknit. While the counter of these shoes is also flexible, it felt very tight to me and actually caused some pain.
Cutting the back of the running shoe
Say what? Yes, you have read correctly. Most running shoes, even the ones that have a flexible heel counter, are likely to cause some pain if you suffer from insertional achilles tendinitis. Therefore, the best solution is to cut the back of the running shoe.
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So how do we do this?
A single cut with scissors or a box cutter should be enough. You just need to identify the part of the shoe that rubs against your achilles tendinitis and causes pain.
Below is an example of how I perform this operation on my Nike Air Zoom Pegasus 32:
Do you have any shoe tips to deal with insertional achilles tendinitis? Please share them in the comments section below.
Going to Basic Training in one month- severe insertional achilles tendonitis (With Haglunds Deformity).
Glad I read this little gem. Lets go!
Good luck! 🙂
My Salomon Spikecross are hurting my insertional tendonitis. I don’t want to cut into them! But, no donuts or similar padding help. Thinking about using a high end drill bit with cutting spurs to cut a clean hole in the heel below the top of the heel collar to retain feeling of heel lockdown. And the shoes are SO pretty!
Hi AHK,
Yes, it may be especially tricky for trail shoes as it could reduce the lockdown. Cutting a clean hole sounds like a good idea. Please keep us posted! There are many of us with this issue. Personally, I feel like the worst is behind, but I still avoid stiff counter as much as possible.
All the best,
Kevin
ummmm What is the answer to the question?
The Best Shoes For Insertional Achilles Tendinitis = ???
thank you
Hi Mark, shoes with a flexible counter like the Nike Free 5.0 (discontinued, unfortunately) may be suitable. However, there’s no guarantee; it’s really a matter of personal experience.
The solution I recommend is to cut the heel. It can work with any shoe, even the ones with a hard counter. If you’re afraid to ruin your new shoes, I would recommend giving it a try with an old pair and see how it goes. For me, it has been an enormous relief!
I hope this helps. Please let me know if you have questions.
All the best,
Kevin
Salomon Sonic Confidence, Soft heel counter, good 10mm drop, great comfort.
Thanks, Ross! I’ll update the article with the Confidence.
The Solomon Predict has been the best running shoe for my haglunds, but I am looking for a trail shoe with a similiar flexible backing.
Thanks, Kevin! I’ll update the article with this.
Hi Kevin. This agrees with advice from my Achilles tendon consultant surgeon, that most running shoes are badly designed at the back. More for fashion and looks than safety and support. Very few running shoes are made properly with a low back for the Achilles.
On the advice of the Achilles tendon specialist I consulted, I always make two nicks on either side of the shoe heel.
I consulted him after several bouts of Achilles tendonitis in both heels. I was crippled for very long periods. And never ran again properly.
He wanted to open up the tendons and strip them down, but I balked at that. Didn’t have enough confidence in surgery at the time (many years ago). The consequences if anything went wrong would have been dire.
Hi Bill, thank you for sharing, and good that you didn’t do the surgery indeed.
It’s always sad to cut new shoes but it just has to be done 🙂
Hope you’re back at running and doing okay.
How’s the Saucony Endorphin?
Which one? From my experience with the Endorphin Pro, I’d say it’s one of the shoes where I would have to cut the heel personally. It’s not a big deal, though. I find it easier than wearing exclusively shoes with a soft heel counter.
I was thrilled to see that I was not the only one with this problem, although not excited for any of us. What I have done is I do 10 toe raises every day on each foot to make sure I keep the Achilles strong and stretched but not overstretched. I’ve also taken insoles and cut them about 3/4 of the way up from the toe. The rest of it I piece under my shoe and leave part of it lapped over itself and tape it with either duct tape or athletic tape. This keeps my heel from rubbing too much on the back of the shoe. It seems to work.
I too tried the Nike Frees, but they do not have enough stability or cushion and the newer versions do rub. I recently tried the new balance 1080. The heel counter is split down the middle and that’s helpful, but I still keep my little implement on the back inside of it.
For those looking for suggestions w/o cutting the back of the shoe, I discovered the Nike Odyssey React 2 a few months ago and have not been disappointed. I was dealing with IAT pain for months before putting these on and the pain went away almost instantly. I went through a couple of pairs this fall/winter and just recently started wearing a different brand; now the pain is back and strong as ever. I guess I may have to wear Odyssey React 2s forever – which isn’t the worst since they are excellent, responsive, stylish shoes that last for a long time. They can also be had for a very good price. Just thought I’d share – best of luck to all of you.
Keoth,
I am curious about exactly what you are doing here. Are you creating a heel lift?
Recently, a really intelligent doctor told me that whenever I increase the arch in the shoe it will put more stress on my lateral insertional Achilles tendinitis. I wonder how anyone else is dealing with this. I think this is what makes this malady so difficult to treat.
Really to read all your article and all the comments, have struggled with this for years and recently back on a physio regime to help with it as also starting to develop it in my other heel! physio recommended I try and find some shoes which has space at the back but these seem impossible to find so will be experimenting with cutting up my shoes! Was really good to hear that it doesn’t mean I will have to stop running permanently (I play ultimate frisbee) thanks all
I’ve had this in both heels I’m far From a athlete but do like going to the gym 3 times a week…. I recently had a flare up from doing incline on the treadmill…. It’s lasted about a month now….. I’m at the physio and trying out electrowave shock treatment for it…. 2nd treatment seems to have eased it some what….
The solution for me was to start walking with no shoes all the day at home plus lots of calf stretching. Now I can run half marathon with the Endorphine Pro 2 without cutting the counter
I recently had prp surgery in both my ankles. It reduced my Haglunds deformity by 50 percent. I may going in in a few months and see if they will inject a second time. I am still in recovery and am walking in hopes of increasing circulation and healing.
There’s a shoe insert you can buy online…I’m finally going to be purchasing some athletic shoes (maybe glycerin gts 20s) and so I was going to dig mine up as I’m afraid about rubbing on my Achilles. I remember they are black in color and were basically a thinnish heel wedge that curved around and up BEHIND the heel. The idea is that they provided a “buffer” against your shoes heel collar. I remember wearing them when I had to put on dress shoes to be in front of clients at work and I remember they helped. It’s been many years since I’ve used them (I’ve basically been wearing mule type shoes for years…), but it’s worth trying them….they were maybe $15 each…can’t remember…
Splashy here again…
Just found them:
verticalinsoles [dot] com [/] products [/] achilles-shield
Sport version: verticalinsoles [dot] com [/] products [/] achilles-shield-sport
I recognized the web site…yes, that is one I bought them from. They’ve maybe gone up in price a few dollars since I bought them several years ago. They kind of create a “space” between your Achilles and the heel collar, preventing direct rubbing.
I was never told I had insertional AT, but I certainly experienced extreme tenderness and a bump/swelling would develop. So not sure if these would work for someone with bonafide I AT. But at $20 for a pair it’d certainly be worth trying!
Looks like they come in more colors now.
I’m guessing maybe I’d ordered men’s version since I wear women’s 11 shoe.