Achilles Tendonitis

Achilles tendonitis is a common overuse injury in runners. The Achilles tendon is located under the calf muscles and above the ankle.

The tendonitis injury is usually accompanied by pain, inflammation, and even small tears in this area of the lower leg (see the picture below).

The Achilles tendon is a tough band in a protective sheath that provides a lot of the flexibility and strength in a runner’s leg movements.

As you run downhill, the tendon stretches to allow the forefoot to go farther down the hill. When you run uphill, the calf muscles are producing force in the foot’s push-off movement which causes an even greater stress on the tendon.

Runners with Achilles tendonitis usually feel the pain and irritation the most when running up and down hills.

There are many causes for this type of tendonitis, but the most common causes are:

Common Causes

  • Overuse: Doing too much too soon.
  • Tight leg muscles: Muscles that are tight and rigid will transfer a greater amount of force through the tendon and cause greater stress and chance of injury.
  • Pronation / Uneven surfaces: Feet rolling to the outside which places a lateral stress on the tendon. Runners that run consistently on the same side of the road may get this injury from the affects of road crowning (road slopes to the shoulders or side, making one leg work harder than the other over time).
  • Pronounced Heel Strike: Runners that land too far back on their heels can experience this injury. Check your shoe wear for signs.

Now that we know the signs, symptoms and causes of Achilles tendonitis, what can we do about it?

First, the good news: Most cases of this tendonitis are easily treated and can heal rather quickly.

The bad news? The longer you ignore the pain and just run through it, the longer you may extend your road to recovery. Severe cases of Achilles tendonitis can also cause a rupture of the tendon which can takes months to heal and will likely be a permanent location for pain and irritation in the future.

What’s the morale of the story? Listen to your body and heed its warnings.

Here are some ways that you can avoid and/or treat minor cases of Achilles tendonitis:


  • REST!: This is still the best way to recover & heal. If you give your body a chance to rest and rebuild it will grow stronger and more durable. Many injuries, like tendonitis, are a result of not getting rest in between hard workouts.
  • Stretching / Warm-ups: Rigid muscles can put undue strain on the tendons. A simple stretching routine of the leg muscles and/or a gentle warm-up before rigorous activity can ease your system into the exercise and reduce some of the strain on the tendons.
  • Stability Shoes / Inserts: If you pronate when you run (see The Right Shoe to determine if you pronate), then a stability running shoe may help reduce some of the fot roll that is straining your lower legs. I’ve also found that a simple heel cup insert can alleviate pain caused by Achilles tendonitis, by reducing the range of motion of the tendon to allow it to heal.
  • Mix-up your path: Running on the same surfaces and road crowns can cause one leg to do more work than the other. This imbalance could result in the straining of tendons and may be the cause of your Achilles pain. Try running on smooth and soft surfaces and shy away from hills until the injury is healed.
  • Strength Training: By strengthening the calf muscles, the Achilles tendon will see less stress and strain from the leg movements in running. Try some simple heel raises. These can be done on the edge of a raised surface or with weights for added benefit, but try doing them with no weight as you first start off. Try these strength training tips for runners, if interested.

Achilles tendonitis can turn into a nagging injury that may plague your running routine. To avoid a serious injury, be sure to check with your doctor rather than running through the pain.

You may also notice that the pain may subside after you warm-up. This happens as tendon fibers can more pliable, but they will stiffen up after activity and this may prolong the necessary healing and recovery that you need.

I hope that this helps you on the road of avoidance or recovery.

Happy running!

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