Efficacy of heel lifts for managing midportion Achilles tendinopathy (The LIFT Trial): A participant and outcome assessor–blinded randomized controlled trial

Review written by Shruti Nambiar info

Key Points

  1. Use of heel lifts showed small reduction in pain intensity and VISA-A score improvement in midportion Achilles tendinopathy patients at 12 weeks versus sham intervention, but these changes may not be clinically meaningful.
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BACKGROUND AND OBJECTIVE

Mid-portion Achilles tendinopathy (MAT) results from tensile overload causing microdamage, tendon structure disorganization, increased cellularity and vascularity, and impaired healing (1). It affects ~6% of the general population and up to 50% of elite long-distance runners, with 20% experiencing symptoms for up to decade (1). Evidence on heel lifts for MAT is limited, with one other high-quality study comparing it to another intervention (2). Research on their impact on pain, disability, and biomechanical variables during running and walking is limited by small sample sizes and methodological issues.

This study aimed to determine the effect of heel lift versus sham shoe-inserts on pain associated with MAT and to investigate if heel lifts were more effective at reducing Achilles tendon load during walking and running.

Mid-portion Achilles tendinopathy affects ~6% of the general population and up to 50% of elite long-distance runners, with 20% experiencing symptoms for up to decade.
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Heel lifts adjusted for comfort and wear time may be appropriate in early tendon rehabilitation when tendons demonstrate low capacity and high irritability.

METHODS

  • This parallel-group, participant- and assessor-blinded, sham-controlled RCT used a 1:1 allocation. Participants were recruited between August 2023 and May 2024 through Facebook advertisements and emails to previous Monash University study volunteers.
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