Science/Medicine : Fitting a Size-14 Achilles Into Ache-Free Sneakers
‘We’re not even just talking about (pain while) running. We’re talking about walking. Getting out of bed. . . . It’s very, very painful.’
Earvin (Magic) Johnson
Magic Johnson has reached a new height.
A few weeks ago, pain from Achilles tendinitis threatened to do what no opponent has done: stop the Los Angeles Laker star.
But now the 6-foot, 9-inch guard, the National Basketball Assn.’s most valuable player last season, has effectively become 6-foot-9 1/2, and, in the process, defeated his Achilles pain.
His doctor and a shoe company accounted for the difference by designing and implanting an unusual wedge in the soles of his sneakers.
The lift, brainchild of Laker physician and sports medicine pioneer Dr. Robert Kerlan, is much more sophisticated than the felt heel pads athletic trainers have long used to treat Achilles inflammations. Kerlan said he has applied it with success to quite a few weekend athletes.
Kerlan said traditional shoe inserts are inadequate because they usually flatten under a player’s weight. Moreover, by raising only the player’s heel, they change the relationship of the rest of his foot to his shoe, the doctor said.
For Johnson, Kerlan prescribed a wedge-shaped lift that is half an inch thick under the heel and comes to a point just before the ball of the foot.
Kerlan said he also specified that the lift be built into the soles of Johnson’s shoes for work and play, rather than merely stuck on top of the insoles.
That way, the built-in wedges raise Johnson’s heels without changing the relative position of his feet within his shoes.
Raising the heels eases Achilles tendinitis because it reduces the work the tendons have to do.
The Achilles tendon is a mass of fibers that connects calf muscles to the heel bone. When calf muscles contract, the Achilles tendon pulls the heel up, making it possible to walk, run and jump.
By raising the heel with a wedge, the Achilles tendon has to make “less of an excursion . . . to take the heel up from the floor to an upright position,” Kerlan explained.
This eases the tension upon it.
Doctors trace Achilles tendinitis, a common athletic injury, to repeated, forceful use of the Achilles tendon in running and jumping that results in microscopic tears of the tendon’s cells.
Kerlan theorizes that many athletes get these tears but “heal overnight and therefore, (most athletes) never have a problem that they’re aware of.”
“I think . . . there’s a certain amount of microtrauma (for) . . . anybody who takes part in a repetitive activity,” Kerlan said. He theorized that a microscopic inspection of the tendons of “competitors who were in a tough game, or ran a long distance--it doesn’t even have to be too long--” would show chains of collagen cells that have been broken. But the “collagen healing process usually takes care of it” while the athlete is not exercising, he said.
For a minority of athletes, including Johnson, “inflammatory reactions (develop because) these little cells aren’t healed. . . . The body . . . mobilizes . . . to get a reparative process going . . . automatically. This results in something this group of people can identify: pain or swelling.”
Johnson, in his ninth NBA season, said he has been bothered by tendinitis in both Achilles tendons for three years. Until this year, however, the problem did not come until about the middle of the league’s grueling schedule. Ice and anti-inflammation drugs helped him play through the pain.
This year, the tendinitis in his left leg struck early--in training camp, which features five hours of play every day.
Johnson was looking at the probability of playing more than 100 games, counting playoffs, with pain in every step.
“We’re not even just talking about (pain while) running,” Johnson explained in an interview. “We’re talking about walking. Getting out of bed. . . . It’s very, very painful.”
Laker trainer Gary Vitti grew concerned on an exhibition road trip. “We could get him feeling pretty good by game time,” the trainer said. “Once he gets on the floor . . . he gets all pumped up inside. He’s not thinking about that Achilles tendon. . . . The next day is when he really feels it.”
Kerlan prescribed new shoes.
Like most NBA players, Johnson has a deal with a shoe company that pays him a fee to use its athletic footwear exclusively.
Johnson’s deal is with Converse Inc.
Kerlan called Converse’s biomechanics laboratory in North Reading, Mass., and explained what he wanted.
Shoemakers and designers there have molds of Johnson’s size 14 feet, which, by the way, are on the small side for the NBA.
Johnson said he runs through about 120 pairs of the custom basketball shoes in a season.
Within two days, they made a pair with wedges inside.
“It was an engineering challenge,” recalled Rick Bunch, manager of the lab, where designers gather data on better shoes by putting tiny sensors in the sneakers of athletes to measure the pounding their feet take when they run.
For Johnson, Bunch said, “we had to design extra padding under the (ball of the foot) because, when you lift the heel, biomechanically you shift forces forward.” The extra padding toward the front was necessary to “balance the load,” Bunch explained. He said it was also necessary to beef up the structural integrity of the shoe to offset the heel height increase from three-eighths of an inch to seven-eighths.
“When I first started playing in these shoes, it was awkward,” Johnson said. “But you adjust to it. . . . It’s helped me a lot.”
Kerlan said it is too soon to tell whether Johnson has been cured.
Kerlan, who said there may be other doctors using the same method to treat Achilles tendinitis, said he has also prescribed wedges for a number of non-celebrity patients, sending them to a local shoemaker who has shown a facility at splitting heels.
He said, however, there is an even simpler alternative for do-it-yourself weekend athletes with Achilles pain: Buy a pair of cowboy boots, desirable for their high heels, and wear them all the time.
Johnson had what may be even better advice: Get plenty of rest between bouts of exercise. “You don’t want this,” he said.
THE FOOT STANDARD WEDGE, SUPPLEMENTAL WEDGE, METATARSAL CUSHION, SUPPLEMENTAL CUSHION, ACHILLES TENDON THE INJURY Los Angeles Laker basketball star Magic Johnson suffers from chronic inflammation of his Achilles tendon, a mass of fibers that connects calf muscles to the heel.
THE SOLUTION A half-inch-thick wedge added to the shoe raises Johnson’s heel, thereby relieving stress on the tendon. Unlike a conventional heel lift that attaches to an insole, the wedge does not alter the relationship of the foot to the shoe.
