Many athletes who experience painful Achilles tendon injuries could prevent them by being more careful when selecting athletic shoes, according to a prominent sports medicine expert with the American College of Foot and Ankle Surgeons.

"Athletic shoes that bend in the midfoot area lack proper support and put more pressure on the heel and Achilles tendon," said Michael K. Lowe, a foot and ankle surgeon in Salt Lake City and team podiatrist for the NBA's Utah Jazz. "If you can bend a shoe in the middle, it shouldn't be worn for any sport that requires running or jumping."

The Achilles connects the calf muscle to the heel bone and is the largest tendon in the body. Injuries occur when the tendon is stretched excessively, causing severe inflammation or a tearing or rupture of the tendon. "When the middle of the sole in an athletic shoe collapses, the pressure is transferred from the midfoot area to the heel, which can stretch the Achilles tendon too much," said Lowe. "Eventually, Achilles tendonitis will result or, worse, a rupture that requires surgery."

Lowe also said that excessive wear weakens midfoot support, so athletes should replace worn shoes on a regular basis to reduce injury risk. "Runners, for example, should replace their shoes every 350 to 400 miles," Lowe advised.

The warning signs of Achilles tendonitis are pain and swelling in the tendon area following exercise. It usually worsens over time and often the leg will feel stiff or tired. Achilles tendonitis can be treated with rest, ice and anti-inflammatory drugs.