Achilles Tendonitis from Running: What Runners Should Do

Running is a great way to improve fitness, but the repetitive impact and loading involved can sometimes lead to injuries. One common problem among runners is Achilles tendon pain, which can make running, walking, and even everyday activities uncomfortable.

The Achilles tendon connects the calf muscles to the heel bone and plays an important role in running, jumping, and pushing off the ground. When the tendon is unable to keep up with the demands being placed on it, pain and stiffness can develop.

The good news is that Achilles tendon pain can often be successfully managed with physiotherapy and a gradual strengthening program.

At Physical Edge Physiotherapy in Oakville, Ontario, our physiotherapists can help runners understand what may be contributing to their Achilles pain and develop a plan to safely return to running.

What Is Achilles Tendonitis?

Achilles tendonitis is commonly used to describe pain and irritation involving the Achilles tendon. The term Achilles tendinopathy is often preferred because the condition is usually related to changes in the tendon and its ability to tolerate load rather than simply inflammation.

Achilles tendinopathy can occur in runners of all levels.

Common symptoms include:

• Pain or stiffness at the back of the ankle

• Pain when running or jumping

• Stiffness when taking your first steps in the morning

• Pain after a run

• Tenderness around the Achilles tendon

• Swelling or thickening of the tendon

• Pain when pushing off the ground

Some runners notice that the tendon feels better once they get moving, only for symptoms to return later in the day or after their run.

Why Do Runners Develop Achilles Tendon Pain?

The Achilles tendon is designed to handle large amounts of force. Problems can occur when the amount of load placed on the tendon increases faster than the tendon can adapt.

Increasing Mileage Too Quickly

One of the most common contributors is a sudden increase in running volume.

For example, increasing your weekly mileage, adding an extra running day, or suddenly introducing longer runs can increase the stress placed on the Achilles tendon.

Adding Hills or Speed Work

Hill running and faster running can increase the demands on the calf and Achilles tendon.

If you recently started incorporating hill repeats, intervals, or sprinting into your training, your Achilles may need time to adapt.

Returning to Running After a Break

Returning to your previous running volume immediately after time away from running can also overload the tendon.

Your cardiovascular fitness may return faster than your muscles and tendons are able to tolerate the workload, so gradually rebuilding your running volume is important.

Muscle Weakness

The calf muscles play an important role in controlling and producing force while running.

If the calf and surrounding muscles aren't strong enough to handle your running demands, the Achilles tendon may be exposed to greater stress.

How Can Physiotherapy Help Achilles Tendonitis?

Physiotherapy can help you understand why your Achilles tendon is painful and how to gradually rebuild its capacity.

Your physiotherapist may assess:

• Calf strength

• Ankle mobility

• Hip and leg strength

• Balance

• Running mechanics

• Training volume

• Recent changes to your running program

Based on your assessment, treatment may include progressive strengthening, mobility exercises, running modifications, and a gradual return-to-running program.

The goal isn't simply to reduce pain. It's to help your Achilles tendon become strong enough to tolerate the demands of running again.

Exercises for Achilles Tendon Pain

Strengthening is one of the most important parts of Achilles tendon rehabilitation.

The appropriate exercises and resistance will depend on the severity of your symptoms and your current strength.

1. Calf Raises

Calf raises are a simple way to begin strengthening the calf and Achilles tendon.

Stand with your feet about hip-width apart and slowly raise your heels off the ground. Pause at the top before lowering back down.

As your strength improves, you can progress from double-leg calf raises to single-leg calf raises and eventually add resistance.

2. Seated Calf Raises

The calf is made up of several muscles, and seated calf raises can place greater emphasis on the deeper calf muscle.

Sit with your feet on the floor and gradually raise your heels while keeping your toes on the ground.

Resistance can be added as you become stronger.

3. Single-Leg Calf Raises

Running is primarily a single-leg activity, so eventually your rehabilitation should prepare your Achilles tendon to handle the demands of supporting your body on one leg.

Single-leg calf raises can be progressed by increasing repetitions, adding resistance, or performing the movement from an elevated surface when appropriate.

4. Gradual Plyometric Exercises

As your symptoms improve and your strength increases, your physiotherapist may introduce jumping and hopping exercises.

These exercises help prepare the Achilles tendon for the faster and more explosive forces involved in running.

Progressions might include:

• Small two-leg jumps

• Skipping

• Single-leg hops

• Running drills

• Gradual return to faster running

These exercises should be introduced progressively rather than immediately after an injury.

Do You Need to Stop Running?

Not necessarily.

Whether you should continue running depends on your symptoms and the severity of your Achilles tendon pain.

For some runners, completely stopping activity may not be necessary. Instead, your physiotherapist may recommend temporarily reducing:

• Running distance

• Running frequency

• Speed

• Hills

• High-intensity workouts

You may then gradually increase your running as the tendon becomes stronger and better able to tolerate the workload.

If running significantly aggravates your symptoms, temporarily replacing some running with lower-impact activities such as cycling or swimming may help you maintain fitness while reducing the load on the tendon.

How Can You Prevent Achilles Tendon Problems?

You can't prevent every running injury, but there are several ways to reduce your risk.

Increase Training Gradually

Avoid suddenly increasing mileage, intensity, or frequency. Give your body time to adapt to changes in your training.

Strengthen Your Calves

Regular calf strengthening can help your muscles and Achilles tendon handle the forces involved in running.

Don't Ignore Persistent Symptoms

Some mild soreness after a new training session is normal, but persistent or worsening Achilles pain should not be ignored.

Pay attention to changes in morning stiffness, pain during runs, and how your tendon feels later that day.

Be Consistent With Strength Training

Running alone doesn't necessarily provide all the strength training your muscles and tendons need. Including regular strength work can help improve your body's ability to handle running demands.

When Should You See a Physiotherapist?

Consider seeing a physiotherapist if:

• Your Achilles pain has lasted for several weeks

• Your symptoms are getting worse

• You have pain every time you run

• Morning stiffness is increasing

• Your running has been affected

• You keep experiencing Achilles tendon problems

• You're unsure how to safely return to running

A physiotherapist can help determine how much load your Achilles can currently tolerate and create a progressive rehabilitation plan.

Important: Sudden Achilles Pain

If you experience a sudden popping sensation, severe pain, significant swelling, or difficulty pushing off your foot, seek prompt medical assessment. These symptoms can be associated with an Achilles tendon rupture and require different management.

Getting Back to Running

Achilles tendon pain can be frustrating, especially when you're training for a race or simply enjoy running as part of your routine. However, rehabilitation doesn't have to mean giving up running permanently.

The key is gradually rebuilding your Achilles tendon’s ability to handle load.

With progressive strengthening, appropriate training modifications, and a gradual return to running, physiotherapy can help you work toward getting back to the activities you enjoy.

At Physical Edge Physiotherapy in Oakville, Ontario, our physiotherapists can assess your Achilles tendon, identify contributing factors, and develop an individualized rehabilitation program based on your running goals.

Don't let Achilles pain keep you on the sidelines. Book a physiotherapy assessment and start working toward a stronger, more confident return to running.