Braces, night splints, walking boots for Achilles Tendonitis – do they work?
Braces, night splints and moonboots are often considered in the management of Achilles Tendonitis. The reasoning behind braces for Achilles Tendonitis is to take some load off the Achilles Tendon.
The latest evidence would suggest that not all braces are beneficial in treating Achilles Tendonitis. Some braces could have a negative effect for Achilles Tendonitis, however, some may have a big positive impact.
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This makes it important to know which braces will give you the best chance at recovering quickly. It is also important to understand when you should use braces, nights splints or moonboots in managing Achilles Tendonitis.
Prefer to skip ahead?
- Types of Braces for Achilles Tendonitis
- Best Braces for Achilles Tendonitis
- Best Night Splints for Achilles Tendonitis
- Walking boots for Achilles Tendonitis
What is Achilles Tendonitis?
Achilles Tendonitis (now called Achilles Tendinopathy) is a process where your Achilles Tendon begins to change structurally, resulting in pain. The symptoms can often include a lump in your tendon, or pain in the morning. These changes are usually reversible with correct treatment and rarely need surgery to resolve.
For further information on Achilles Tendonitis – now called Tendinopathy you can visit our ultimate guide here.
What are the types of braces for Achilles Tendonitis?
Braces for Achilles Tendonitis can include anything from compression sleeves, to night splints and even moonboots (walking boots). Anything that helps support the Achilles Tendon can be called an Achilles Tendonitis brace.
The different types of braces for Achilles Tendonitis are mentioned below and have been further explained afterwards. We have not included Achilles taping, heel lifts or orthotics for Achilles Tendonitis in this article as these are covered separately.
The first type of brace for Achilles Tendonitis are compression sleeves . These provide support to the Achilles tendon, like an Aircast brace. The job of these braces is to provide pulsating compression as you walk which has been theorized to help increase circulation to the tendon and reduce swelling.
The next braces are splints, which hold the Achilles Tendon in a certain position, preventing shortening of the tendon – like a sustained stretch. The more common variation is the night splint for Achilles Tendonitis which stretches the tendon overnight.
The last type of brace for Achilles Tendonitis are walking boots, also known as CAM or moonboots. These boots will hold the ankle firmly at a 90-degree angle to keep the Achilles Tendon in the same position. Boots can be useful for Achilles Tendonitis if the tendon is extremely flared up and it is otherwise painful to walk.
In the following sections we will address the evidence for each brace, when they might be recommended, and which braces are effective for Achilles Tendonitis.
Best braces for Achilles Tendonitis
Braces like the AirheelTM brace were designed specifically for Achilles Tendonitis. Numerous studies have investigated whether they are effective in reducing pain and improving function for Achilles Tendonitis.
These braces generally have two pockets which compress and relax as you walk and sometimes some gentle compression around the leg itself. The manufacturer of the Airheel design claimed that this compression and relaxation of the air pockets helps to improve blood flow to the tendon itself.
Are braces for Achilles Tendonitis useful?
Braces like the Airheel may offer some benefits for people suffering Achilles Tendonitis. There has been some weak evidence that they might be effective on their own, but this is definitely not recommended. An exercise program including calf raises should always be completed in addition to any braces for Achilles Tendonitis.
One reason for their effect could be that they help increase the transport of nutrients via the cyclic massage mechanism. Another reason this brace could be effective in Achilles Tendonitis is that they could loosen adhesions (or scar tissue) that builds up in the tendon over time.
Remember, not all braces are made the same. Some braces advertised for Achilles Tendonitis offer simple compression which may help with swelling but will likely not change your pain.
Braces for Achilles Tendonitis that have been researched will have pads where air can be compressed and filled above the tendon.
If you would like to trial the use of a brace, then it is recommended that you continue an exercise program targeting the Achilles Tendon. We have written another article on why your exercises might be failing to give you some extra tips into what to avoid.
Which brace should you buy with Achilles Tendonitis?
There are many braces for Achilles Tendonitis on the market, so which ones should you buy?
One thing to take into consideration is the expense of the brace. As braces are not a guarantee it is best not to spend too much if you can avoid it. In saying this some patients have found great benefit from the more expensive braces, so we have put them below as an option.
It was mentioned previously but don’t be fooled by expensive braces only offering compression of the ankle.
In truth there may not be a one size fits all when it comes to finding a perfect Achilles brace. Due to this variability we sampled some Achilles sufferer’s and asked which braces they find most helpful.
So, what are the best braces for Achilles Tendonitis?
Our first choice is one version of the Airheel which has been researched and does show some effects for Achilles pain for some patients.
The next brace was favoured by others that have suffered Achilles Pain. It is very similar to the Airheel in that it provides an air pocket which compresses and relaxes as you walk. The difference, is this brace also incorporates a slight heel lift and some general compression of the ankle. This can be advantageous for people that have lots of swelling with their Achilles pain.
How to use them
These braces are very simple to use but the main thing is to ensure the right sizing. Some research mentioned poor fit as the main reason people stopped wearing their brace for Achilles Tendonitis.
If you get a brace and it’s the wrong size, try to return it for the correct size.
It’s important to check the sizing instructions from any website before purchasing – there will usually be measurements that can be performed.
The fit should be comfortable, if you feel that the brace is digging in anywhere – it’s probably too small.
Should I use an Achilles brace for running?
If you have progressed to running, then you are past the need for braces.
We wouldn’t recommend any braces for running with Achilles Tendonitis. Instead look up our article on running with heel pain so you can begin to load the tendon safely.
This includes sports like basketball, soccer, or anything else. If you have Achilles pain and are playing these sports, what you need to do is load your tendon correctly.
Night Splints for Achilles Tendonitis
One proposed treatment for Achilles Tendonitis are night splints. These are devices that keep your foot in a dorsiflexed position (where the ankle is bent up). The rationale behind these devices is that if you can increase the length of the tendon, it should reduce the amount of strain on the tendon as you use it.
Do Night splints work for Achilles Tendonitis?
Nights splints have been studied extensively and unfortunately; they do not have a lot of support for their use. This doesn’t mean that some patients won’t benefit from a night splint, but clinical practice guidelines recommend against the use of these devices as they don’t seem to be effective compared to other methods.
Nights splints on their own in the treatment of Achilles Tendonitis did have some effect in studies, however as soon as they were compared to any active exercise program, they were no better at relieving Achilles Pain.
For this reason and the fact that they cost money night splints are no longer recommended.
In saying this, some people still find benefit as research doesn’t account for every individual person. Some patients report the use of a night splint helps to ease the morning pain as they get out of bed.
That’s why we have still outlined how to use night splints and some brands we would recommend.
What night splints should you buy for Achilles Tendonitis?
There are many night splints for Achilles Tendinopathy on the market so which ones should you choose. Our choice is always something cheap (because they may not help you) and simple to use.
Below we have recommended on night splint from Amazon which only requires a few Velcro straps to be tightened. The easier and cheaper the better for night splints, so give this one a go if you were curious on the effects that a night splint may have for your Achilles Tendonitis.
How to use a night splint for Achilles Tendonitis
Night splints are encouraged to be used at night for Achilles Tendonitis simply for ease of use. Each night splint will be slightly unique. The foot is usually placed in the night splint and the you will do up the Velcro straps to fasten the foot in a bent position.
You should aim to get the foot to at least 90 degrees bend and a little further if possible. The aim is to have a little stretch on the Achilles as you go to bed. This stretch shouldn’t be painful. You have tightened the splint too much if pain occurs.
When you are using a night splint, trial them for at least two weeks and assess for yourself if there is any difference to your Achilles pain. If you find there is no difference you do not have to continue wearing the splint as they won’t be of further help to your tendon.
Boots for Achilles Tendonitis
Boots for Achilles Tendonitis have been used in the acute stage to protect the tendon for a short amount of time. We are referring specifically to immobilisation boots such as moonboots and not to footwear. (Click here for further information on the best shoes for Achilles Tendonitis)
These should not be considered for more than a couple of weeks as they begin to have a negative impact such as calf muscle wasting and ankle stiffness.
Do walking boots help Achilles Tendonitis?
Research has shown that walking boots reduce the amount of loading on the Achilles tendon. This can help an acute and sore tendon in the early stages, as reduced load allows the tendon time to settle.
As mentioned earlier, any more than a couple of weeks will begin to be negative as calf wasting will occur. Additional to calf wasting, prolonged use of a walking boot will lead to ankle stiffness and the Achilles Tendon will not adapt to increased load.
The main treatment for Achilles Tendonitis is load management, so reducing the load on the Achilles Tendon for too long will have a negative effect.
Should you walk in a moonboot?
Patients with Achilles Tendonitis should still walk as much as possible with the boot on. The only reason to need crutches and minimal weight bearing is if walking is too painful.
If you can walk with no or minimal pain, then you should be walking with the moonboot as normal without the need for crutches to support yourself.
Make sure that you wear sneakers on the other foot so there isn’t a big height difference between the soles of the two sides. A moonboot generally sits very high, so sneakers counteract this well.
What walking boot should you pick for Achilles Tendonitis?
Walking boots are all very similar and considering it would only be for short term use even comfort isn’t a big concern. We suggest starting with a cheaper boot if you need to go down this path.
We have suggested a boot that you can try below.
How to use a walking boot with Achilles Tendonitis
The easiest way to put on a walking boot is sitting.
First take the inside cover of the boot out and place it around your foot and leg. When the inside padding is secured, unstrap the boot, fastening the Velcro straps back onto themselves to make it easier for later.
Next place the boot on the ground and slide your leg with the cover into the boot. Make sure your heel is at the very back of the boot and your foot flat on the bottom of the boot.
Now you can start fastening the Velcro straps one at a time starting as the bottom and working your way up. The straps should be reasonably tight so that your leg feels secure. The leg and foot shouldn’t move in the boot as you walk.
Braces are often sought after to help relieve pain for Achilles Tendonitis. Most braces will offer only minimal short-term relief at best. Consider the type of padding a brace contains when looking for one.
Night splints have been shown to have minimal effect for Achilles Tendonitis and are not routinely recommended.
Moonboots can be useful in very acute Achilles Tendonitis to help settle the symptoms. However, they should only be used for a couple of weeks maximum.
Frequently Asked Questions
Do Braces work for Achilles Tendonitis?
Some braces can offer support during the acute stage of Achilles Tendonitis. However, this should not substitute more effective treatment like exercise therapy.
How long should I wear a brace with Achilles Tendonitis?
Wear your brace during the pain with maximum pain and swelling. When the tendon settles its best to come out of the brace quickly so that you don't begin to rely on it.
What braces work for Achilles Tendonitis?
There are many braces on the market, but the ones that were effective in research trials had air pockets above and below the Achilles Tendon. With or without compression.
Eveline Silvia Graf, Cristina Raaflaub, Andreas Hollenstein & Bettina Sommer (2021) Stability boots for the treatment of Achilles tendon injuries: how do they affect ankle biomechanics while walking?, Footwear Science, 13:sup1, S45-S47, DOI: 10.1080/19424280.2021.1917674
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