Member Case Study - Achilles Pain and Orthotics

author : AMSSM

comments : 0

Been having ankle and achilles pain. Went to sports med/therapy clinic...was given stretches to help achilles and had an appointment made for getting orthotics.

Question from Tritank

Been having ankle and achilles pain. Went to sports med/therapy clinic...was given stretches to help achilles and had an appointment made for getting orthotics. Any thoughts on orthotics (good...bad...suggestions)? I am a little hesitant but want to do it if it helps. They told me I am at a "mechanical disadvantage" because of my flat footedness, and that these would help me.

Answer

Achilles tendonitis tends to be an overuse injury. One way to approach overuse injuries is to consider the injured area the “victim,” and try to find the “culprits.” From your description of the problem, it sounds as though your Achilles tendon may be at least partially a victim of your flat foot. A flat foot puts extra load and motion on the Achilles tendon.

Theoretically, an orthotic should support the arch in a more neutral position and decrease the excess motion of the Achilles as you run. However, not everyone with flat feet develops Achilles tendonitis, so you should first look at your training to see if your Achilles pain is simply the result of training mistakes. Poor flexibility can also contribute to Achilles pain. There are some good off-the-shelf orthotics available in running shoe stores that you may want to try before you invest in a custom-made pair.

William O Roberts MD
AMSSM Member
Department of Family Medicine and Community Health
University of Minnesota Medical School

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date: October 30, 2005