When is custom orthotics recommended for achilles tendinitis?

Achilles tendinitis, also called Achilles tendinopathy, affects the tendon connecting the calf muscles to the heel. A clinician examines the painful area, ankle movement, calf strength, walking pattern, footwear, and activity demands. An orthotic is shaped to fit inside a shoe and may alter pressure distribution or the way the foot rolls during walking.

Custom support is an adjunct, not a replacement for progressive tendon loading. It may be more useful when a person's foot shape, alignment, or shoe tolerance makes standard inserts unsuitable. See [Achilles Tendinitis](/conditions/achilles-tendinitis/) and [Custom Orthotics](/treatments/non-surgical-orthopedics/custom-orthotics/).

Bring the shoes used for work, exercise, or daily walking to the assessment. Begin wearing a new orthotic gradually as advised, and report rubbing, pressure points, altered knee or hip pain, or worsening tendon pain. A good fit should work with a stable shoe and should not create new areas of irritation.

Continue the prescribed calf and tendon exercises, adjusting impact activities while symptoms settle. The clinician may change the insert, shoe, exercise load, or diagnosis if your response does not match the expected pattern. Do not rely on an insert to enable a sudden return to running or jumping.

Arrange prompt assessment after a sudden snap, immediate loss of push-off strength, marked swelling, or difficulty standing on tiptoe, as these can signal a significant tendon injury. Seek review for increasing warmth, redness, or swelling, or for pain that keeps worsening despite reducing load. New numbness or a cold, discoloured foot also needs prompt attention.

What feature of my walking or foot alignment makes an orthotic relevant? Would a ready-made insert be reasonable first? Which shoes should I use, and how quickly should I increase wear? What exercise and activity limits apply while the tendon settles?