Best Footwear for a Swollen and Painful Achilles Tendon

The best shoes for a swollen and painful Achilles tendon are the shoes that feel as if you are not wearing anything on your feet at all. These shoes don’t include cushioning, arch support and under heel cushioning. Essentially, you want a zero drop, thin, flexible shoe that can be rolled up into a ball as these shoes are safer on the Achilles tendon as compared with running shoes with under heel cushioning.

Best Footwear for a Swollen and Painful Achilles Tendon
Use barefoot running shoes, such as the Vibram FiveFingers, for running/walking because they restore foot function and improve arch strength.

Best Footwear for a Swollen and Painful Achilles Tendon

A study by Wearing et al. found that walking in a cushioned running shoe with a large heel-toe offset (heel elevation) increases tensile load in the Achilles tendon.

  • Tensile load is a stretching force that is a risk factor for tearing of fibers as the force increases.

In their study, the researchers used acoustic transmission to investigate the effects of standard running shoes (running shoes with a padded heel) and barefoot conditions on Achilles tendon loading during walking.

The ultrasonic device was positioned over the mid-line of the posterior aspect of the Achilles tendon where acoustic velocity was measured synchronously in the tendon during walking in both shod and barefoot conditions.

Earlier studies have found that acoustic velocity positively correlated with tension in the Achilles tendon. Therefore, a high acoustic velocity indicates high tension in the tendon.

Because most standard running shoe manufacturers insist their footwear prevents injuries, the researchers hypothesized that tension in the Achilles tendon would be smaller compared to walking barefoot. Unsurprisingly, their hypothesis was not supported by their results.

The researchers found that peak acoustic velocity in the Achilles tendon was significantly higher in heeled running shoes during walking compared with barefoot walking. Why?

Walking in a standard running shoe resulted in significant changes in several basic gait parameters compared to walking barefoot. Such changes included increased static ankle plantar flexion which was accompanied by increased acoustic velocity in the Achilles tendon during walking in the standard running shoe.

Walking in Cushioned Running Shoe Increases Achilles Injury
Just like in a heeled fashion shoe, the ankle is always plantar flexed in a running shoe with a large heel offset -this places greater tension on the Achilles tendon.

As for walking gait, both barefoot and shod-walkers were heel strikers. The researchers found that acoustic velocity in the Achilles tendon was highly reproducible during heel strike walking which in turn, illuminates how heel strike runners end up with Achilles injury.

Runners who heel strike typically run in running shoes with a large heel offset and Achilles injuries are among the top running-related injuries. In contrast, studies show that Achilles injuries are uncommon in habitual barefoot populations.

The traditional approach has been to give individuals with Achilles injury cushioned, heeled footwear, but here we have a population of runners who heel strike in heeled running shoes who are very vulnerable to Achilles injuries.

The exact significance of the findings represents the inadequate therapeutic effects of the standard running shoe and how the natural state of barefoot walking halts the progression of Achilles damage incurred by footwear.

More From Run Forefoot:


Crevier-Denoix N, Ravary-Plumio¨en B, Evrard D, Pourcelot P.Reproducibility of a non-invasive ultrasonic technique of tendon force measurement determined in vitro in equine superficial digital flexor tendons. J Biomech. 2009;42:2210–3.

Pourcelot P, Defontaine M, Ravary B, Lematre M, Crevier-Denoix N. A non-invasive method of tendon force measurement. J Biomech. 2005;38:2124–9.

Pourcelot P, van den Bogert AJ, Huang X, Crevier-Denoix N. Achilles tendon loads at walk measured using a novel ultrasonic technique. Comput Methods Biomech Biomed Engin. 2005;8(S1): 221–2.

Wearing et al. Running shoes increase Achilles tendon load in walking: an acoustic propagation study. Med Sci Sports Exerc, 2014; 46(8): 1604-1609.

Bretta Riches

"I believe the forefoot strike is the engine of endurance running..."

BSc Neurobiology; MSc Biomechanics candidate, ultra minimalist runner & founder of RunForefoot. I was a heel striker, always injured. I was inspired by the great Tirunesh Dibaba to try forefoot running. Now, I'm injury free. This is why I launched Run Forefoot, to advocate the health & performance benefits of forefoot running and to raise awareness on the dangers of heel striking, because the world needs to know.
Bretta Riches

P.S. Don't forget to check out the Run Forefoot Facebook Page, it's a terrific place to ask questions about forefoot running, barefoot running and injury. I'm always happy to help!

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