Achilles & Calf Issues: Treatment and Relief Options
Much like other insoles with a heel lift, Bridge Soles are intended to be worn only while or when expecting discomfort. Bridge Soles are meant to pull pressure off the Achilles and posterior chain. In the meantime, barefoot therapy, foot strengthening & exercises should be done to lengthen & strengthen the area to help promote recovery and prevent future injury.
Many researches and medical professionals believe that some of the most prominent acute causes of Achilles and posterior chain problems are from:
1) The body's "landing response" (muscle tuning) to "brace for impact" as the foot comes down for to engage the ground.
2) Instability strain or wobble caused by weak foot musculature and control, as well as tight laces and/or firm heel counters in shoes slightly yanking the foot and Achilles one way or the other each step.
Why do we believe Bridge Soles are better than traditional heel lifts for Achilles and lower calf issues?
Bridge Soles are PU insoles with a soft heel cup, soft arch, & met pad that aim to reduce instability and the 'landing response' of the foot & lower leg that may be responsible for Achilles and other lower leg pain and discomfort.
- Research has shown that PU insoles were associated with significant reductions in Achilles load...likely due to reduced landing response(1).
- Many medical professionals also believe that stability from a deep heel cup is preferable to a traditional heel lift as the foot doesn't slide around & cause instability strain on the posterior chain.
- Scientific literature questions the idea that heel lifts alone reduce loading on the Achilles(2), and some newer research indicates that wearing a shoe with a raised heel actually increases load on the Achilles compared to walking barefoot(3).
- Many medical professionals also believe that wearing shoes with elevated heels consistently can actually cause Achilles problems by shortening & weakening the area over time, which seems obvious. For casual activity, going barefoot and/or avoiding elevated heel shoes as much as possible (to tolerance) is recommended---to slowly lengthen & strengthen the posterior chain.
- Furthermore, a 2015 study showed that insoles improved symptoms significantly, but that custom orthotics were no more effective than basic insoles(4).
In addition to wearing PU insoles with a soft, deep heel cup (like Bridge Soles) when the feet are being stressed:
- Eccentric Heel Drop therapy with added 20+ pounds is the most research(5) backed (Google "Achilles Gold Standard Eccentric Exercises"), but heavily weighted bent-knee calf raises and drops
- Shockwave Therapy and even more so, Electromagnetic (EMG) Therapy (PEMF), are emerging treatment options showing promise
- Correct Toes worn in-shoe during activity may provide stability that reduces wobble and strain on the Achilles. We have personally seen a lot of success with this.
- Heavily weighted (20+ pounds) Bent Knee Calf Raises (within pain tolerance) and drops are becoming the new standard taking over for Eccentric Drops, as Soleus control reduces Achilles strain
- Loosen shoe laces significantly to reduce wobble and instability strain caused by the shoe pulling the foot, and achilles, off plane. When shoe laces are loose, the Achilles doesn't have to "fight" the shoe to stay vertical.
- Avoid treadmill & sand as they increase wobble/instability strain(9).
- Avoid forefoot striking as this increases Achilles loads dramatically(10).
- Use a Myostorm Meteor for Warmth & Vibration before & after activity to prevent strain and promote healing.
Research References:
- Sinclair J, et al...Clin Biomech 2014;29(4).
- Reinschmidt C, Nigg BM...Med Sci Sports Exerc 1995;27(3)
- Wearing SC, et al....Med Sci Sports Exerc 2014;46(8)
- Munteanu SE, et al. Br J Sports Med 2015; 49(15)
- Jonsson P, et al. ...Br J Sports Med. 2008;42(9):746-749.
Scientific References from Bridge Soles in-box user guide:
- Lemont H, Plantar fasciitis: a degenerative process (fasciosis) without inflammation. J Am Podiatr Med Assoc. 2003 May-Jun;93(3):234-7.
- Jacobs, J.L., et al. J Foot Ankle Res 12, 50 (2019).
- *Shulman, S. 1949 Journal of the Natl Assoc. of Chiropodists
- Sinclair J, et al...Clin Biomech 2014;29(4).
- Reinschmidt C, Nigg BM...Med Sci Sports Exerc 1995;27(3)
- Wearing SC, et al....Med Sci Sports Exerc 2014;46(8)
- Munteanu SE, et al. Br J Sports Med 2015; 49(15)
- Jonsson P, et al. ...Br J Sports Med. 2008;42(9):746-749.
- Willy, et al 2016, JOSPT, Patellofemoral Joint and Achilles Tendon Loads During Overground and Treadmill Running
- Almonroeder T, Willson JD, Kernozek TW. The effect of foot strike pattern on Achilles tendon load during running. Ann; Biomed Eng. 2013;41: 1758- 1766.
- Barefoot Running on Grass as a Potential Treatment for Plantar Fasciitis: A Prospective Case Series. MacGabhann S, Kearney D, Perrem N, Francis P.Int J Environ Res Public Health. 2022 Nov 22;19(23):15466. doi: 10.3390/ijerph192315466. PMID: 36497540; PMCID: PMC9741467. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9741467/#:~:text=Barefoot%20running%20on%20grass%20appears,completing%20a%20barefoot%20running%20intervention.
- High Load strength training and plantar fasciitis. Rathleff, M.S., Mølgaard, C.M., Fredberg, U., Kaalund, S., Andersen, K.B., Jensen, T.T., Aaskov, S. and Olesen, J.L. (2015), Scandinvavian Journal of Med Sci Sports, 25: e292-300. https://doi.org/10.1111/sms.12313 https://blogs.bmj.com/bjsm/2014/09/15/plantar-fasciitis-important-new-research-by-michael-rathleff/