Achilles Tendonitis is felt as pain in the Achilles tendon which is the long tendon that connects the calf muscle to the heel bone. The pathology of Achilles tendonitis is complicated but I like to explain it in a very simple way. Basically the Achilles tendon will be painful when it is not strong enough to do it’s job.
Therefore, treatment for Achilles Tendonitis basically involves making it’s job a little easier for a while and making the Achilles tendon stronger. To do this you can modify your training and running technique to reduce the load on the tendon and “make it’s job easier”. This reduces the pain a little and lets you keep running. You can then get to work on making your Achilles tendon stronger.
Identify the problem activity and scale back
- Long runs: Does the tendonitis pain only come on after 8km? Then run 7km and see if you can still reach your weekly mileage over more short runs.
- Fast runs: Only getting the tendonitis pain when you up the pace. Run at a medium pace (pain-free) but increase the distance.
- Hills: If the tendonitis pain is only provoked by hill training why not substitute a session on sprints? You can also do your runs by the canal or a river to ensure minimal elevation change.
- Sprints: Same advice as for hills, if sprints provoke your tendonitis pain but hills don’t, swap the sprints for a hill session.
Identify training errors
- Volume: most people use an app to track their runs. Pull up your activity history and switch it to week view or month view. If you see a big increase in volume around when the pain started you need to bring the volume back down to where your knee was feeling good.
- Rest: Is your pain worse if you run two days in a row? A simple 24 hours rest between runs rule often helps in this situation.
- Intensity: The Achilles tendon experiences more stress at higher running speeds and on hills. If you recently increased these runs it’s wise to scale back to the amount you were doing before the pain started.
It’s probably not your shoes, so don’t bother changing them
- This is the number one thing on my clients list of potential contributing factors when they come in to see me with pain. It’s usually about number 20 on my list! Unless you changed your shoes and had pain within the week, look elsewhere for the reason.
- If it is your shoes, it’s usually pretty obvious. For example, you switched to the five fingers from some cushioned Brooks and had pain within a couple of weeks.
- The human body is AMAZING at adapting to stress. Tiny little changes in your shoes are unlikely to be causing your pain.
- Okay, sometimes it is the shoes! Sometimes the back of your shoe pushes on the Achilles tendon and can contribute to Achilles tendonitis. If the part of your tendon that hurts is right where the top of the back of your shoe is then your shoes might be an issue.
Incorporate some strength training
- Heavy strength training of the calf muscles has been scientifically proven to resolve Achilles pain. However, the amount that you should do varies by the individual. You can try incorporating some calf raises into your regular strength training, but if you really want to resolve this issue I would recommend that you get help from a qualified professional.
- Strength training has better evidence to support its ability to prevent injuries during sport than any other activity. It’s better than stretching, foam rolling, footwear, orthotics and even technique optimization. If you’re not incorporating at least 2 days a week of strength training, you’re increasing your injury risk.
- Strength training also improves the ability of your muscles to absorb impact throughout your kinetic chain. Focus on the gluteals, quadriceps and hamstrings. If you would like more specific advice on what to do, just contact me through my website.
Check the technique
- Certain running styles cause you to direct the stress more to a certain area.
If you have a long stride and a slow cadence, more stress will go to your knees.
If you have a shorter stride and a faster cadence, more stress will go to you feet and ankles.
- If you are careful you can make small changes to your stride length and cadence and see if the pain lessens, If it does you can incorporate that technique change SLOWLY. For example you could run 20% of you total running volume for the week in the new style, then 30% the following week, and so on.
Stretching probably won’t help, so don’t bother
- If you go and see a physio about achilles pain with running and they give you a few stretches and nothing else, please don’t go back.
- Your Achilles tendon is hurting because it’s not strong enough to do it’s job, stretching it will not make it any stronger.
Get a specific diagnosis from a qualified professional
- If you’ve taken the time to read this blog I know one thing for certain. Your achilles is bothering you. A lot. Most likely because it is interfering with your running. You’re probably also worried about doing more damage if you keep going.
- If you are this worried about your Achilles, get it looked at by a professional.
I’d be more than happy to talk through the trouble you are having over the phone, free of charge. Just get in touch.
I know you may be apprehensive about booking a physio appointment. You don’t know if it will help. You may also have had less than perfect experiences in the past. That’s why I like to have a good chat with anyone who is interested in working with me before we make any decisions. I also try to get clients in for a free in-clinic discovery session. This gives us the chance to get to know one another so we can see if we would work well together. You can schedule your free in-clinic or phone consultation here.