Achilles Tendinitis: A Running Problem
If you're a regular runner, chances are you've heard of, or experienced, Achilles tendinitis. It's one of the most common overuse injuries in the running community, often presenting as a pain somewhere between the back of the heel bone and the lower calf muscle. At Fairway Physio, we frequently see runners with this condition, and while it is a treatable condition, prehabilitation is better than having to rehabilitate.
What is Achilles Tendinitis?
The Achilles tendon is the thick, fibrous band of tissue connecting your calf muscles (gastrocnemius and soleus) to your heel bone. It plays a vital role in walking, running, jumping, and pushing off the ground.
Achilles tendinitis is most often an overuse injury that occurs when the tendon becomes irritated and inflamed by stresses that over exceed the capabilities of the tendon. It typically affects runners who suddenly increase their training load, switch training surfaces, or have biomechanical issues that overload the tendon.
Why Runners Are at Risk
1. Sudden Increase in Training Load
The Achilles tendon adapts to stress gradually. If a runner ramps up mileage, pace, or hill training too quickly, the tendon may become overloaded. This is especially common during pre-race training blocks or “New Year resolution” comebacks.
2. Poor Running Mechanics
Biomechanical inefficiencies such as overstriding, excessive pronation, or weak glutes can cause increased strain on the Achilles. Tight calves or poor ankle mobility can also alter gait mechanics and place extra stress on the tendon.
3. Footwear Changes
Worn out shoes, or, dramatically changing the type of running shoe you use can alter how the foot strikes the ground and how force is absorbed. Shoes with a low heel-to-toe drop (e.g. racing flats or barefoot shoes) can increase tendon strain if not introduced gradually.
4. Tight or Weak Calf Muscles
A lack of flexibility or strength in the calf complex can reduce the shock absorption capacity of the lower leg, forcing the Achilles to work harder than it should.
5. Running on Hills or Uneven Terrain
Uphill running increases calf muscle engagement and Achilles loading, while downhill running can lead to overstriding and eccentric overload. Trails and uneven surfaces can further increase the risk due to unstable footing.
How runners can reduce the risk of Achilles pain:
1. Gradual Load Progression
Monitor your weekly milage using wearable tech or using an app such as Strava. Resist large increases in weekly milage and instead plan gradual increases over time. This gives your tendon and other soft tissues time to adapt. Should you get injured, it is useful to see the weekly milage at which you started to get symptoms and adapt your running schedule accordingly.
2. Strengthen the Calf-Achilles Complex
Include some calf strength training into your schedule to help create some resilience of the calf and Achilles structures. Try adding a load that suits your ability. Don’t go too heavy, too soon, or you may end up with problems deriving from this. Aim for 2-3 sets of between 10-15 repetitions with a load that makes you work at a 7-8/10 level. You could start calf raises on two feet, rising from the floor. Aim for the ascent over 1 second, and your descent over 1 second. Your calf endurance training comes through running so you can focus on lifting heavier loads with lower reps during your strength training.
3. Stretch and Mobilise
Regularly stretch your calves and mobilise your ankle joint, especially after running when your tissues are warmer and more elastic. Dynamic warm-ups and foam rolling can by useful for this.
4. Cross-Train and Recovery Days
Swap in low-impact cardio sessions (like swimming or cycling) to reduce cumulative tendon load. Prioritise sleep, hydration, and recovery to support tissue healing.
5. Wear the Right Shoes – and Transition Gradually
Stick with shoes that support your foot type and running style. If you have a shoe that works well for you, stick with it. However, if you feel the need to change and you’re moving to either a higher or lower-drop shoe or barefoot running, take your time and give your tendons weeks to months adapt. More load is placed on the calf and the Achilles tendon with lower drop shoes. If possible, try before you buy. Good running shoe stores will have a treadmill in store to allow you to do this. Comfort is a good indicator whether the shoe is suited to you or not.
6. Address Running Form
A running gait analysis can help identify biomechanical faults and running inefficiencies that may place excessive load and demand through the calf and Achilles tendon. From this analysis, you can make technical changes to your running form to help reduce the stress on certain tissues, become more efficient and reduce the risk of injuries.
7. Movement screening
A movement screen can help to identify restrictions and weaknesses in your body that contribute to the way in which you move and run. Identifying these physical limitations allows you to tailor your workouts to improve what is required to become a more robust runner.
When to Seek Help
Early intervention of Achilles injuries can prevent the condition from becoming chronic or degenerative which is more difficult to treat. If you experience any persistent pain in the Achilles tendon, talk with your Physiotherapist / Sports Therapist about what they can do for you. We know that not running has a huge effect on your wellbeing, not just physically, but, mentally too. That’s why we try to keep our runners running as much as possible and guide you through your rehab step by step.
RUNNING ANALYSIS
At Fairway Physio, we offer a Running gait analysis service that can help reduce the stress on the Achilles tendon while running.
What we do during your session:
· A core battery of 15 movement tests: These tests provide us with details of your joint restrictions, joint instability, muscle weakness and/or tightness.
· Video gait analysis
You will receive:
· Real time technical feedback
· Video footage of running mechanics
· Cadence recommendations
· Tailored exercises to improve on joint restriction and muscle weaknesses.
· Prehab advice
· Foot strike and Footwear guidance
To book a Running Analysis session at Fairway Physio call us on 07493301568.
