Sports physio Alison Gould gives advice on the best shoes for Achilles tendonitis for everyday use. She also shares some tips and tricks when having to wear the “worst” types of shoe for Achilles tendonitis due to work or other circumstances, including how to use shoe insoles or inserts. Remember, if you need help with an Achilles injury, you're welcome to consult one of our team via video call.
The terms tendinitis, tendonitis, tendinosis, and tendinopathy mean the same thing for all practical purposes, and we use these interchangeably in most of our articles.
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Why footwear “heel-to-toe drop” matters for Achilles tendonitis
Reducing the amount of stretch on the injured tendon is one of the cornerstones of Achilles tendonitis pain relief.
The further your foot goes into dorsiflexion (see picture below), the more your tendon is stretched and compressed against your heel bone. This is not a problem for a healthy tendon, but when it’s injured, it can irritate the tendon and might delay the healing process.
On the other hand, having your foot in a plantar flexion position takes some tension off the tendon, and the injury can calm down.
When you walk and move about, your foot inevitably flexes in both directions, but in footwear where your heel is somewhat higher than your toes, the overall stretch in your injured tendon is reduced.
The term “heel-to-toe drop” is mostly used when describing by how much a runner’s heel is higher than their forefoot in a running shoe. However, it is also very useful when deciding on everyday footwear that will take some of the strain off your painful Achilles tendon.
How much heel-to-toe drop? Any drop where your heel is roughly between 1 cm and 2 cm (about half an inch to an inch) higher than your forefoot is useful.
Best trainers/sneakers for Achilles tendonitis
I’m distinguishing here between running shoes, which are designed for actual running, and trainers (or sneakers for our North American readers) for wearing as you go about your daily business. Some of these offer the same level of comfort and support for your feet as running shoes.
If you’re willing to wear heel-to-toe drop running shoes in everyday life for your Achilles tendonitis, good for you! (If you are indeed a runner, you might be interested in our article on the best running shoes for Achilles tendonitis.)
However, not everyone is a runner or goes for the “sporty” look (the colour combinations on running shoes can be quite psychedelic!). Some people prefer something a bit more … “stylish”. Hence the trainers/sneakers.
👉 So, here are some examples of trainers/sneakers with a heel-to-toe drop that’s good for an injured Achilles tendon and that won’t make people think you’re training for a marathon - they come in more colours than in these pics.
Best sandals for Achilles tendonitis
There might be reasons why you would not want to wear trainers/sneakers around the house or when you’re going out casually (we’ll deal with work and formal occasions later).
One is when the back of the trainer/sneaker presses or rubs against the injured part of your Achilles tendon, especially if you have tendonitis right at the bottom of the tendon, where it inserts into your heel bone. This can also be a problem if you have heel bursitis – when the fluid-filled sac between your tendon and heel bone is inflamed and painful.
Another reason for not wanting to wear trainers/sneakers is that you simply prefer sandals!
Most types of sandal don’t have a heel-to-toe drop, but there are some out there that do have it (see below).
Go for sandals that have a strap across the back of your foot so that you don’t have to “grip” with your toes as you walk. But take care that the strap doesn’t go over the painful part of your tendon.
Worst shoes for Achilles tendonitis
We’ll first look at types of footwear you want to avoid when you have Achilles tendonitis, and in the next section we’ll discuss some workarounds if you can’t avoid wearing them.
❌ Flat shoes
Here we’re talking about any footwear without a heel-to-toe drop. Examples are:
most types of flip-flop and sandal
ballet pump-type shoes
some types of formal shoe.
❌ Shoes that press or rub on the back of your heel
Like we said above, some trainers/sneakers could press or rub on the back of your heel in such a way that it aggravates your Achilles and/or bursitis pain, especially if you have insertional Achilles tendonitis. This is even more true of footwear that is made of more rigid materials, such as:
some types of formal shoe
some types of hiking boot
most types of safety boot.
It is important to note that such pain caused by shoes does not necessarily mean that your injury has become worse. It is more analogous to pressing on a bruise, causing the injured part to go “Hoy! I’m here! What are you doing?”
❌ Shoes that make you walk differently
When you walk in some types of footwear, you have to “grip” with your toes and/or walk slightly differently to keep your feet from slipping front-to-back and/or side-to-side. This can make your Achilles and calf work harder and irritate your injury.
Examples are:
flip-flops or sandals with straps that only go between your toes or over the front of your foot
pull-on rubber boots for wet conditions, e.g. fishing or gardening (Wellies, for our British readers).
What about going barefoot?
It’s very pleasant having cool floor tiles underfoot on a hot summer’s day, but going barefoot obviously puts your foot in the same flexion position as wearing flat flip-flops or ballet pumps. And walking barefoot on the beach will make your feet go into even more dorsiflexion.
So, if your Achilles is very irritated, it is usually best to avoid walking around barefoot until it has recovered a bit.
What if you have to wear “incorrect” shoes?
Sometimes work or a formal social occasion dictates that you don footwear that is not ideal for alleviating Achilles pain, e.g. safety boots or formal shoes without a heel-to-toe drop and/or that press on the injury.
Here’s what you can do to deal with such situations.
Shoe inserts for Achilles tendonitis
These are either small wedges (typically made out of rubber, cork, or foam) or heel cups (typically made out of silicone) that you insert into the back of your boots or shoes to raise up your heels.
Heel raise inserts can solve two problems in one go:
The insert takes the strain off your painful Achilles tendon by creating a heel-to-toe drop,
and it can lift your heel in such a way that the back of the shoe or boot doesn’t press on the painful part, if that’s an issue.
Some heel wedges are adjustable, i.e. they come in several layers that you can add or remove to fine-tune how high you want to raise your heels.
👉Remember to put them in both shoes so that your gait remains even.
If you’re already using orthotics that have been prescribed to you, whether they are custom made or off-the-shelf, it may be worth contacting the practitioner who gave them to you and asking how you can increase that heel-to-toe drop.
The orthotics might need to be modified, or it might be as simple as inserting a heel wedge as well as the orthotics.
If you're getting orthotics for the first time, it's also worth following the advice of the person who has prescribed them. They might give you a way of building up the period of time that you're using the orthotics. So, you only use them for short periods in a day, and then you might increase that time.
Workarounds to counter “incorrect” footwear
I realise that the following is not always possible for everyone, but here are some examples of modifications to your work and daily activities to alleviate the effect of unavoidable “incorrect” footwear on your Achilles injury. (Some of these would also be useful in the “right” footwear.)
Wear it only when necessary. So, only wear those boots or formal shoes when clients, HR, or the bride’s mother will have something to say about it if you don’t. E.g. commute to and from work in footwear that is kind to your injured Achilles tendon.
Take the easy way out. E.g. could you go up a lift/elevator rather than multiple flights of stairs?
Could you, instead of standing, sit down, or perch on something like a desk?
Could you temporarily delegate some tasks at work or at home that require you to be on your feet?
Do this in addition to wearing the right shoes for Achilles tendonitis
Following all of the advice above will help you to alleviate the pain in your Achilles tendon, but on its own it won’t heal the injury that is causing the pain.
To get the injury to heal (which will allow you to break out the ballet pumps again), you have to follow a two-pronged approach that has been shown by research to be the most successful way of getting rid of Achilles tendonitis.
Relative rest: This means avoiding the things that aggravate your injury, of which incorrect footwear is but one. Here’s our article on relative rest for Achilles tendonitis.
Restoring the tendon’s strength: This means doing exercises, starting at a level that your injured tendon can tolerate, and then progressively making then more challenging as the tendon becomes stronger. Here’s our article on progressive treatment exercises for Achilles tendonitis.
We've also previously discussed the best research-backed treatments for Achilles tendonitis.
How we can help
Need help with your Achilles injury? You’re welcome to consult one of the team at TMA online via video call for an assessment of your injury and a tailored treatment plan.
We're all UK Chartered Physiotherapists with Master’s Degrees related to Sports & Exercise Medicine or at least 10 years' experience in the field. All of us have a wealth of experience working with athletes across a broad variety of sports and ranging from recreationally active people to professional athletes. You can meet the team here.
About the Author
Alison Gould is a chartered physiotherapist and holds an MSc in Sports and Exercise Medicine. You can follow her on LinkedIn, Facebook, Instagram, and Twitter.