Evidence for orthotic treatment of the posterior heel

Warning

Heel raise / FW adaptation / advice

Systematic Reviews

Hutchins, S., Bowker, P., Geary, N. and Richards, J., 2009. The biomechanics and clinical efficacy of footwear adapted with rocker profiles—evidence in the literature. The Foot, 19(3), pp.165-170.
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Interventional Studies

van der Zwaard, B.C., Poppe, E., Vanwanseele, B., van der Horst, H.E. and Elders, P.J., 2014. Development and evaluation of a leaflet containing shoe advice: a randomized controlled trial. Family practice, 31(3), pp.267-272.
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Observational Studies

Chimenti, R.L., Flemister, A.S., Ketz, J., Bucklin, M., Buckley, M.R. and Richards, M.S., 2016. Ultrasound strain mapping of Achilles tendon compressive strain patterns during dorsiflexion. Journal of biomechanics, 49(1), pp.39-44.
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Dixon, S.J. and Kerwin, D.G., 2002. Variations in Achilles tendon loading with heel lift intervention in heel-toe runners. Journal of Applied Biomechanics, 18(4), pp.321-331.
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Mündermann, A., Nigg, B.M., Stefanyshyn, D.J. and Humble, R.N., 2002. Development of a reliable method to assess footwear comfort during running. Gait & posture, 16(1), pp.38-45.
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Rowson, S., McNally, C. and Duma, S.M., 2010. Can footwear affect achilles tendon loading?. Clinical Journal of Sport Medicine, 20(5), pp.344-349.
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Sobhani, S., Zwerver, J., van den Heuvel, E., Postema, K., Dekker, R. and Hijmans, J.M., 2015. Rocker shoes reduce Achilles tendon load in running and walking in patients with chronic Achilles tendinopathy. Journal of science and medicine in sport, 18(2), pp.133-138.
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Thomas, J.L., Christensen, J.C., Kravitz, S.R., Mendicino, R.W., Schuberth, J.M., Vanore, J.V., Weil Sr, L.S., Zlotoff, H.J., Bouché, R. and Baker, J., 2010. The diagnosis and treatment of heel pain: a clinical practice guideline–revision 2010. The Journal of Foot and Ankle Surgery, 49(3), pp.S1-S19.
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Wulf, M., Wearing, S.C., Hooper, S.L., Bartold, S., Reed, L. and Brauner, T., 2016. The effect of an in-shoe orthotic heel lift on loading of the achilles tendon during shod walking. journal of orthopaedic & sports physical therapy, 46(2), pp.79-86.
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Case Series / Case Studies

Martín, F.J., Valdazo, M.D.A., Peña, G.D., Leroy, J.F., Herrero, D.H. and García, F.D., 2017. Haglund's Syndrome. Two Case Reports. Reumatología Clínica (English Edition), 13(1), pp.37-38.
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Insoles

Interventional Studies

Mayer, F., Hirschmüller, A., Müller, S., Schubert, M. and Baur, H., 2007. The effects of short term treatment strategies over 4 weeks in Achilles tendinopathy. British journal of sports medicine.
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Munteanu, S.E., Scott, L.A., Bonanno, D.R., Landorf, K.B., Pizzari, T., Cook, J.L. and Menz, H.B., 2015. Effectiveness of customised foot orthoses for Achilles tendinopathy: a randomised controlled trial. Br J Sports Med, 49(15), pp.989-994.
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Observational Studies

Donoghue, O.A., Harrison, A.J., Laxton, P. and Jones, R.K., 2008. Orthotic control of rear foot and lower limb motion during running in participants with chronic Achilles tendon injury. Sports biomechanics, 7(2), pp.194-205.
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Mündermann, A., Nigg, B.M., Stefanyshyn, D.J. and Humble, R.N., 2002. Development of a reliable method to assess footwear comfort during running. Gait & posture, 16(1), pp.38-45.
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Wezenbeek, E., Willems, T.M., Mahieu, N., Van Caekenberghe, I., Witvrouw, E. and De Clercq, D., 2017. Is Achilles tendon blood flow related to foot pronation?. Scandinavian journal of medicine & science in sports, 27(12), pp.1970-1977.
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AFO / Ankle brace

Observational Studies

Aujla, R., Kumar, A. and Bhatia, M., 2016. Non-surgical treatment of Achilles rupture: Does duration in functional weight bearing orthosis matter?. Foot and Ankle Surgery, 22(4), pp.254-258.
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Ellison, P., Molloy, A. and Mason, L.W., 2017. Early Protected Weightbearing for Acute Ruptures of the Achilles Tendon: Do Commonly Used Orthoses Produce the Required Equinus?. The Journal of Foot and Ankle Surgery, 56(5), pp.960-963.
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Karkhanis, S., Mumtaz, H. and Kurdy, N., 2010. Functional management of Achilles tendon rupture: A viable option for non-operative management. Foot and Ankle Surgery, 16(2), pp.81-86.
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Lantto, I., Heikkinen, J., Flinkkila, T., Ohtonen, P., Siira, P., Laine, V. and Leppilahti, J., 2016. A prospective randomized trial comparing surgical and nonsurgical treatments of acute Achilles tendon ruptures. The American journal of sports medicine, 44(9), pp.2406-2414.
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Lim, C.S., Lees, D. and Gwynne-Jones, D.P., 2017. Functional outcome of acute achilles tendon rupture with and without operative treatment using identical functional bracing protocol. Foot & ankle international, 38(12), pp.1331-1336.
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Walker boot

Meta-Analyses

Liu, X., Dai, T.J., Li, B.L., Li, C., Zheng, Z.Y. and Liu, Y., 2021. Early functional rehabilitation compared with traditional immobilization for acute achilles tendon ruptures: A meta-analysis. The Bone & Joint Journal, 103(6), pp.1021-1030.
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Lu, J., Liang, X. and Ma, Q., 2019. Early Functional Rehabilitation for Acute Achilles Tendon Ruptures: An Update Meta-Analysis of Randomized Controlled Trials. The Journal of foot and ankle surgery: official publication of the American College of Foot and Ankle Surgeons, 58(5), p.938.
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Systematic Reviews

Jamjoom, B.A., 2021. The Influence of Early Weightearing, Controlled Motion, and Timing of Orthosis Removal on the Nonoperative Management of Achilles Tendon Rupture: A Systematic Review. The Journal of Foot and Ankle Surgery, 60(4), pp.777-786.
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Interventional Studies

Lantto, I., Heikkinen, J., Flinkkila, T., Ohtonen, P., Siira, P., Laine, V. and Leppilahti, J., 2016. A prospective randomized trial comparing surgical and nonsurgical treatments of acute Achilles tendon ruptures. The American journal of sports medicine, 44(9), pp.2406-2414.
Click here for Article

Observational Studies

Aujla, R., Kumar, A. and Bhatia, M., 2016. Non-surgical treatment of Achilles rupture: Does duration in functional weight bearing orthosis matter?. Foot and Ankle Surgery, 22(4), pp.254-258.
Click here for Article

Ellison, P., Molloy, A. and Mason, L.W., 2017. Early Protected Weightbearing for Acute Ruptures of the Achilles Tendon: Do Commonly Used Orthoses Produce the Required Equinus?. The Journal of Foot and Ankle Surgery, 56(5), pp.960-963.
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Hullfish, T.J., Woods, M.M., Kwon, M.P., Boakye, L.A., Humbyrd, C.J. and Baxter, J.R., 2024. The Difference in Achilles Tendon Loading within Immobilizing Boots Based on Ankle Angle, Boot Type, and Walking Speed. Orthopaedic Journal of Sports Medicine, 12(10), p.23259671241283806.
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Karkhanis, S., Mumtaz, H. and Kurdy, N., 2010. Functional management of Achilles tendon rupture: A viable option for non-operative management. Foot and Ankle Surgery, 16(2), pp.81-86.
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Lim, C.S., Lees, D. and Gwynne-Jones, D.P., 2017. Functional outcome of acute achilles tendon rupture with and without operative treatment using identical functional bracing protocol. Foot & ankle international, 38(12), pp.1331-1336.
Click here for Article

Night splint

Meta-Analyses

van der Vlist, A.C., Winters, M., Weir, A., Ardern, C.L., Welton, N.J., Caldwell, D.M., Verhaar, J.A. and de Vos, R.J., 2020. Which treatment is most effective for patients with Achilles tendinopathy? A living systematic review with network meta-analysis of 29 randomised controlled trials. British Journal of Sports Medicine.<br/ > Click here for Article

Wilson, F., Walshe, M., O’Dwyer, T., Bennett, K., Mockler, D. and Bleakley, C., 2018. Exercise, orthoses and splinting for treating Achilles tendinopathy: a systematic review with meta-analysis. Br J Sports Med, pp.bjsports-2017.<br/ > Click here for Article

Systematic Reviews

Magnussen, R.A., Dunn, W.R. and Thomson, A.B., 2009. Nonoperative treatment of midportion Achilles tendinopathy: a systematic review. Clinical Journal of Sport Medicine, 19(1), pp.54-64.<br/ > Click here for Article

Scott, L.A., Munteanu, S.E. and Menz, H.B., 2015. Effectiveness of orthotic devices in the treatment of Achilles tendinopathy: a systematic review. Sports Medicine, 45(1), pp.95-110.<br/ > Click here for Article

Interventional Studies

de Jonge, S., de Vos, R.J., Van Schie, H.T., Verhaar, J.A., Weir, A. and Tol, J.L., 2010. One-year follow-up of a randomised controlled trial on added splinting to eccentric exercises in chronic midportion Achilles tendinopathy. British journal of sports medicine, 44(9), pp.673-677.<br/ > Click here for Article

De Vos, R.J., Weir, A., Visser, R.J.A., de Winter, T. and Tol, J.L., 2007. The additional value of a night splint to eccentric exercises in chronic midportion Achilles tendinopathy: a randomised controlled trial. British journal of sports medicine, 41(7), pp.e5-e5.<br/ > Click here for Article

Editorial Information

Last reviewed: 01/12/2024

Next review date: 01/12/2025

Approved By: British Association of Prosthetists and Orthotists (BAPO)

Reviewer name(s): Laura Barr, British Association of Prosthetists and Orthotists (BAPO) Professional Affairs Committee.