Efficacy of heel lifts versus calf muscle eccentric exercise for mid-portion Achilles tendinopathy (HEALTHY): a randomised trial.

Researchers at La Trobe University in Melbourne tested two common treatments for mid-portion Achilles tendinopathy (a painful condition affecting the main tendon in the back of the calf) by randomly assigning 100 people to either wear in-shoe heel lifts or do eccentric calf exercises. They measured pain and function using a standard questionnaire at 12 weeks and found that the heel lifts group improved slightly more than the eccentric exercise group. However, the difference between them was small and fell just short of what the researchers considered clinically worthwhile.

Both approaches did help, but the study leaves some real uncertainty about whether one is meaningfully better than the other in practice.

This study looked at two ways to treat painful mid-portion Achilles tendinopathy and found that both approaches improved how people felt and functioned after 12 weeks. The group using heel lifts in their shoes improved by about 26 points on a pain and function scale, while the group doing eccentric calf exercises (controlled stretching movements) improved by about 17 points.

The heel lift group did come out ahead, but the difference was fairly small, and the researchers noted that patients might not actually notice a real difference between the two approaches in their daily life. This means either approach could be worth exploring with your physiotherapist, and the choice might depend on what fits better with your life or preferences.

This is a summary of research, not medical advice. Talk to your own healthcare provider about anything affecting your care.

This single-centre trial compared heel lifts to eccentric exercise for mid-portion Achilles tendinopathy using the VISA-A questionnaire as the primary outcome at 12 weeks. The heel lifts group showed a between-group advantage of 9.6 points, which was statistically significant but fell just shy of the predetermined 10-point minimum important difference.

While the point estimate favoured heel lifts, the authors themselves note there is uncertainty in this effect estimate and that patients may not experience a clinically worthwhile difference. The 80% retention rate is reasonable, though loss to follow-up did reduce the final sample.

Both interventions appeared to produce measurable improvements in pain and function, which suggests either may have a role in clinical practice, though the evidence for differential efficacy is modest.