How to Heal Achilles Tendonitis

Mike hadn’t run for 9 months due to his Achilles pain. He was trying to train for his first marathon, but he couldn’t even run around the block. 

He’d just been for another visit to the doctor who told him to continue to rest and if it wasn’t better in a month he was going in a boot. At this point, he felt completely hopeless. Like the healthcare system had failed him. He figured he’d just have to quit running for good. He came to me wondering how on earth to heal his Achilles Tendonitis.

I told him that, essentially, tendons hurt when they’re not strong enough to do their job. If you want to make it stop hurting, you have to make it stronger. Healing an Achilles tendon is a lot like raising a child. There are different phases. And with each phase, come new challenges.

The Baby Phase

The first phase is the baby phase. The tendon is totally useless and incapable of doing anything, just like a baby. It gets angry really easily for even the tiniest reason. You can’t even think about running on it. Even walking hurts a lot of the time. When you try to run, it hurts immediately and the next day it feels terrible.

In the baby phase, you have to protect the tendon. Keep it safe and don’t do anything that might upset it. Just rest and wait, give it a week or two to calm down. Just like with a baby, your only job is to do whatever it wants.

Mike had nailed this phase. He had rested from running and was completely avoiding anything that would make the tendon angry. This worked really well. Once he stopped running, the pain went away completely. The only problem was, whenever he tried to run, the pain would flare up straight away.

Mike couldn’t baby his tendon forever, he had to move on to the next phase.

The Kid Phase

The next phase is the kid phase. Now the tendon is not completely useless, but it’s not all that useful either. Just like a kid. You can run a little bit, but not very much. Maybe doing some run:walks for less than 20 minutes is okay, but if you went for an hour run, you’d be limping home.

In the kid phase, you have to start to challenge the tendon a little bit, but within a very safe environment. Don’t do things it’s not ready for, but make sure you’re challenging it a little bit every day. Just like with a kid, your job is to tread the fine line between being an overbearing helicopter parent and a deadbeat absentee father. 

This is where Mike needed some guidance. We started gradually challenging the tendon a little bit. At first, we just did really slow calf raises with no weights. We got him to do lots of reps, but took it slow and monitored the pain. If it was more painful in the morning when he got out of bed, we knew we had to back off a little bit. 

We continued this every day for a few weeks. Gradually challenging the tendon more and more, as it proved to us that it could handle it. In due time we were able to add a little bit of weights to the calf raises and some hopping exercises. As the tendon adapted to the challenges, we started to move towards the next phase.

The Teenager Phase

The next phase is the Teenager Phase. The tendon is actually pretty capable in some ways, but completely useless in others, just like a teenager. You can do steady runs for maybe an hour, you can even handle some tempo runs, but when you try to push it, the tendon gets angry again. The tendon is good at most stuff, but has trouble with specific things, like hills, sprints or long runs.

Much like parenting, the teenager phase is the hardest. It’s also where most runners get stuck. You need to push the tendon. Force it to do the things that it doesn’t want to do. To adapt to the type of challenge that it can’t handle yet. 

You have to take more risks and trust that your tendon can rise to the occasion. Just like with a teenager, your job is to start to step back and let your tendon fend for itself.

When Mike reached this phase, he was having trouble with long runs and hills. He was running 30k per week without pain, but when he tried to run longer than 2 hours, his Achilles would hurt the next day. He also found that hilly routes irritated it. Rather than avoid those things as we had done previously, it was time to lean into them.

We had Mike do hill sprints and long runs every week. Not so much that his tendon flared up, but just enough so it started to complain. When it was complaining, we knew it was working hard enough, just like a teenager.

The Adult Phase

The next phase is the Adult Phase. Now the tendon is fully capable and well adapted to its environment. It can handle anything you throw at it and remain calm. Just like an adult (most of them anyway). You can run as long as you want or as fast as you want. Uphill or downhill. In Hokas or barefeet. The tendon is strong enough to do its job, whatever you decide that job is.

In the adult phase, you need to continue to push the tendon. If it’s not being challenged regularly, it will become weak and incapable. It needs that stimulus to adapt and retain its strength. You mustn’t protect your tendon at all, it needs to be trained regularly, so it’s ready for anything.

When Mike reached this phase, he was back in his element. Training hard and pushing his body and his tendon to its limits. For Mike, the job of the tendon was to tolerate the rigours of Marathon Training. Long runs, high weekly mileage, speed intervals and hill repeats. To keep his tendon up to task, he continues to hit the gym and strengthen it. 

After 9 months of rehabilitation, Mike ran his first Marathon. His Achilles Tendon didn’t hurt at all.

If you’re having trouble with your Achilles Tendon, and you just can’t seem to get it to heal, click the button below to book a free call with us.