Treating Achilles Tendonitis in Runners

achilles tendonitis in runners


Achilles tendonitis is characterized by inflammation and pain in the Achilles tendon and can significantly impact a runner’s performance and overall well-being. The Achilles tendon is one of the body’s largest tendons and bears a substantial load with each foot strike on the ground. Gradual increments in running intensity enables the achilles tendon to toughen and strengthen, allowing it to effectively manage the imposed load. Pain in the tendon typically arises from overexertion or a sudden increase in activity levels.

If you’re a runner struggling with Achilles tendonitis or simply want to learn more about this condition, keep reading. We have gathered all the information you need to understand the causes, treatments, and recovery methods to get you back to running pain-free.


Common causes of achilles tendonitis in runners

The achilles tendon is the largest tendon in the body, connecting the calf muscles to the heel bone. It plays a crucial role in running by enabling the foot to push off the ground. However, repetitive stress on the achilles tendon can lead to micro-tears and inflammation, resulting in achilles tendonitis.

Achilles tendonitis can be acute or chronic, with the latter being more common among runners. Acute tendonitis is usually caused by a sudden increase in intensity or duration of training, while chronic tendonitis develops gradually over time due to repetitive strain on the tendon.

  1. Overuse: Overtraining, sudden increases in mileage, or intense workouts without adequate rest can lead to achilles tendonitis. It’s important for runners to gradually increase their training volume and intensity.
  2. Improper footwear: Wearing worn-out or ill-fitting shoes can contribute to achilles tendonitis.  Changing you footwear to track spikes or Minimalist Running Shoes can cause trauma to the achilles tendon.
  3. Tight calf muscles: When the calf muscles are tight, they put additional stress on the achilles tendon during running, increasing the likelihood of tendonitis.
  4. Running on uneven surfaces: Uneven surfaces can create imbalances in the lower limbs, causing abnormal stress on the achilles tendon.
  5. Poor running technique, such as landing heavily on the heels or overstriding, can also increase the risk of developing achilles tendonitis.
  6. Age and gender: Older runners and males are more prone to developing achilles tendonitis due to natural degeneration and higher muscle mass, respectively.


Signs and symptoms of achilles tendonitis

The symptoms of achilles tendonitis may vary from mild discomfort to severe pain, depending on the severity of the condition. Common signs and symptoms include:

  1. Pain and stiffness in the back of the heel or calf, particularly in the morning or after periods of inactivity.
  2. Swelling and tenderness along the achilles tendon.
  3. Increased pain during physical activity or when standing on tiptoes.
  4. Thickening of the achilles tendon.


Diagnosing achilles tendonitis

To diagnose achilles tendonitis, a healthcare professional will typically perform a physical examination and review your medical history. They may also order imaging tests, such as an ultrasound or MRI, to assess the extent of the inflammation and rule out other conditions.

It is essential to seek medical attention promptly if you suspect achilles tendonitis, as early diagnosis and treatment can prevent the condition from worsening.


Treating achilles tendonitis: Non-surgical options

Rest and recovery for achilles Tendonitis:

Resting the affected leg and avoiding activities that exacerbate the pain are crucial for the healing process. This may involve temporarily reducing or modifying your running routine and incorporating low-impact exercises like swimming or cycling.

Icing the affected area for 15-20 minutes several times a day can help reduce pain and inflammation. Compression and elevation of the leg can also aid in reducing swelling.

Physical therapy exercises for achilles Tendonitis:

Physical therapy plays a vital role in the rehabilitation of achilles tendonitis. A physical therapist can provide exercises to stretch and strengthen the calf muscles, improve flexibility, and restore normal movement patterns. Examples of exercises include calf stretches, eccentric heel drops, and balance training.



Anti-inflammatory medications:

Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and naproxen can help reduce pain and inflammation associated with Achilles tendonitis. However, it is essential to consult with a healthcare professional before taking any medication.



Preventing achilles tendonitis in runners

Prevention is key when it comes to achilles tendonitis. Here are some tips to reduce the risk of developing this condition:

  1. Gradually increase training intensity and mileage to allow the body to adapt to the increased demands.
  2. Choose running shoes that provide proper cushioning and support for your foot type.
  3. Incorporate regular stretching and strengthening exercises for the calf muscles into your routine.
  4. Avoid running on uneven or hard surfaces whenever possible.
  5. Listen to your body and rest when you feel pain or discomfort.


Surgical treatment options for severe achilles tendonitis

In severe cases of achilles tendonitis that do not respond to conservative treatments, surgical intervention may be necessary. The specific surgical procedure will depend on the extent of the tendon damage and may involve removing inflamed tissue, repairing the tendon, or lengthening the calf muscles.

Surgery is typically followed by a period of immobilization, followed by a structured rehabilitation program to restore strength and flexibility in the affected leg.


In conclusion, achilles tendonitis can be a frustrating condition for runners, but with proper understanding, treatment, and prevention strategies, it is possible to overcome this setback. By addressing the underlying causes, seeking appropriate medical care, and following a comprehensive rehabilitation plan, runners can get back on track and enjoy pain-free running once again.

Remember, if you are experiencing symptoms of Achilles tendonitis, consult with a healthcare professional for an accurate diagnosis and personalized treatment plan.


When can I return to running after achilles tendonitis?

Here are simple tests to determine if you should continue to run with your sore achilles:

  1. If you have pain when you walk or your tendon feels sore you should not continue running.
  2. Once you can walk with no pain try 10x heel raises.  If you have pain when doing these exercises you should not continue running.
  3. Once you can walk and do 10X heels raises with no pain, try to do 10 single leg hops and if you feel pain continue to rest.
  4. Once you can perform all of these exercises with no pain you can try a short 5 – 10 minute jog and then stop and see how you feel the following day.  If you feel no paing the next day, you can gradually begin running.