How To Treat Achilles Tendinitis

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I was recently asked by a fellow runner if I had any recommendations for treating ‘Achilles Tendinitis’, which is a common running injury. Chances are you won’t have heard of this injury unless you’ve suffered with it yourself. If that’s the case, then well done. You are lucky. I, however, haven’t been so lucky.

When asked the question, lots of painful and annoying memories immediately sprang to mind. I’ve had Achilles Tendinitis once before, and it wasn’t very fun.

The definition of Achilles Tendinitis

‘Achilles Tendinitis is an overuse injury of the Achilles tendon, the band of tissue that connects calf muscles at the back of the lower leg to your heel bone.’ It commonly occurs in runners who have suddenly increased the intensity or duration of their runs. It feels like it sounds, not pretty and not fun.

I empathise with any fellow runner who has this annoying injury because I’ve been there. After being asked the question I thought I’d make an article about it to help runners to treat Achilles tendinitis or, even better, prevent them getting it in the first place.

What are the causes of Achilles tendinitis, and how we prevent it?

We like to think that we’re invincible and we can take on the world, training to our heart’s content and pushing ourselves to the limit. Unfortunately, we’re not superman. We’re humans. Our joints and muscles suffer wear and tear, much like a bicycle or car.

There are a few potential causes, and ways of preventing Achilles tendinitis. They include:

Overtraining

If you’re clocking up tonnes and tonnes of miles, without allowing time for muscle recovery in between, there’s a good chance you’ll develop Achilles tendinitis.

Think of your Achilles like a car tyre. If you drive for miles and miles and don’t re-inflate the tyre or take regular breaks, there’s a chance the tyre will deflate or even blow-out. Ouch.

You may think this analogy is a bit dramatic, but it is effective to explain overuse as a cause of Achilles tendinitis. If you’re running lots, without proper periods of rest in between (sleep and suitable time in between each run), you’re Achilles are going to get weaker and eventually result in it being worn down and possibly even torn.

Overtraining is a common cause of Achilles tendinitis.

How do you prevent overtraining?
Start your training off moderately, then steadily increase the intensity. Try and follow a training plan, if you can. A good plan will be designed carefully to gradually increase the intensity in training over a set period of time.

No going from 0 to 80 miles per hour, like the Stealth ride at Thorpe Park (pardon the poor joke). But seriously, taking it slow and steadily to start with will always pay off.

 

• Poor form

I cannot stress the importance of proper form enough for running. It might seem simple and easy to implement, but time and time again runners everywhere (including myself) are guilty of running with poor posture, slamming their feet too hard, not flexing the ankle and lower leg enough, and so on.

Maybe you’re leaning your body weight to one side when you’re running, and one leg is taking the bulk of the impact as you contact the floor. Perhaps you’re flat-footed, and you pound the floor causing the ankle muscles (including the Achilles) to absorb the full brunt of the shock.

Don’t feel too bad about poor form as a cause for this injury. Many runners (I included) have learnt a valuable lesson about form the hard way, by developing this injury.

How do you prevent poor form?
The answer seems simple, run with proper form. Easier said than done. You can get a few tips on decent form from a running coach, other seasoned runners, watching YouTube videos or even asking knowledgeable shop staff when you go and get some new gear.

If they have a running style analysis machine, even better. You’ll be able to test your running style and get a few tips on how to improve your form, and some shoes which might be appropriate for you.

I particularly like watching YouTube videos on how to run with proper form. Videos are handy because you get a spoken low down of how to run with decent technique, and then you’re treated to a demonstration of a real runner in action. I’d recommend you use a variety of sources to work on your form.

Try and get someone to film you running, then you’ll be able to watch the footage and make a self-analysis and work on your form. If you have the funds, it might even be worth getting a coach for a few technique sessions. It might be a bit of money up front but think of it as an investment. You’ll retain the knowledge for the rest of your running career. If it prevents Achilles Tendinitis, even once, you’re in with a winner.

Not being conditioned enough

This is probably the main reason I encountered this injury for the first and only time (touch wood!). Some runners get excited and pumped to go for a run and take on more than they could handle. You could call it biting off more than you can chew. This is incredibly common for beginner runners who are less experienced, though it can catch us all off guard.

If you run too far and too hard, extremely outside of your limits, your legs won’t be able to cope, and you’ll probably have a bad Achilles experience. I’m all for challenging yourself, but when you go for something completely out of your limits it can only end badly.

If your leg muscles aren’t strong or developed enough to take on a challenging workout, they won’t be able to support you properly and will probably succumb to wear and tear very quickly. Think of an amateur weightlifter trying to lift 20 pounds above what he is comfortable with.

If you’ve seen one of the fail videos on YouTube of weightlifters dropping the bar, you’ll know how this scenario ends. That’s the same taking on a running work-out that’s too much for you to handle. Your body can’t cope with it, and you’ll probably injure yourself.

How do you prevent not being conditioned enough?
Be modest in your training. Start small and manageable, then gradually work yourself up to a quicker pace and longer distances. This way you’re more likely to have a smooth and controlled training experience, without going in too hard and injuring your Achilles.

It sounds square and boring, I know, but it is a smart and sensible way to do it. Do you think Olympic coaches tell their athletes to run 10 miles on their first training session, flat out? Of course not. That’d end in disaster!

Athletes, coaches, and professional runners know their limits and recognise the importance of a gradual training programme. Be modest with your training, start small and build yourself up gradually. It’ll help prevent Achilles tendinitis. I promise.

• Running through pain

When a runner voluntarily decides to run through Achilles pain, they’re extremely likely to develop Achilles problems. I’ve been there. Pain is there for a reason, and it’s a positive reason yet us runners like to ignore it.

We don’t realise it, but we’re blessed with the gift of being able to experience physical pain. Stay with me, I have an explanation. We’ve evolved with millions of pain receptors to send an unpleasant sensation to your brain when you encounter something potentially dangerous and threatening.

Back in the day of our evolutionary ancestors, the danger would have been a sting from a plant or an insect or maybe the bite of a predator. Having pain receptors informed the brain something was threatening the body, causing the human to take action and either remove or run away from the source of the pain. This is pretty handy.

You wouldn’t want a pair of hair straighteners to keep searing your leg, or a sharp object to keep pricking you. That’d end in disaster! Having pain receptors keeps us vigilant and safe from danger. Okay, how does this relate to Achilles Tendonitis?

You’d think that when runners start to experience pain in their Achilles and calves, that they’d stop running for a while and take a break. After all, it’s better to have a few days out than to risk injury, right?

This sounds ideal, but it’s usually never the case. Runners often decide to grin and bear it. Voluntarily choosing to run through the pain, despite the obvious warning signs from a painful Achilles. I’m guiltier of this than anyone.

On week one of my half-marathon training, I ran 7 miles at a 7:25 minute per mile pace. I didn’t even have a baseline level of fitness or conditioning, I was a cold and untrained athlete. As you can probably guess, I started to experience a sore and painful leg quickly but decided to run through the pain. As a result, I woke up with a nasty case of Achilles Tendonitis the next morning. Should have been on fail blog.

Running through pain is a common cause of Achilles Tendonitis.

How do you prevent running through pain?
When you start to notice pain, make a smart decision and stop running. It’s annoying, but it’ll do wonders for you in the long term. It’s better to have a few days out than to stop running for a couple of weeks, recovering from injury. Trust me.

• Running in old and worn shoes

Though old and worn running shoes are often associated with knee pain and shin splints, they can also have a hand in Achilles Tendonitis. Those pesky shoes again.

Running shoes are designed with a thick layer of cushioning in the sole, which absorbs lots of the shock from this high impact sport. If you’ve ever tried running in regular, everyday shoes, you’ll know how painful this can be for your feet. I once had a spontaneous race down a high street, with a mate on a night out and my feet felt extremely sore afterwards. Unlike running shoes, my casual shoes had thin and cushioned soles which made running painful.

Old an worn shoes have lost their shock absorption, cushioning and stability. They increase the stress and impact on your legs, joints, and muscles. Running with worn shoes can cause degeneration, wear and tear within your leg muscles, including your Achilles. Ouch.

How do you prevent running in old, worn running shoes?
It’s recommended that you replace your running shoes roughly every 500 miles. Like a car needing a service every few thousand miles, your running shoes need a check-up and possible replacement every now and then.

If the thought of forking out money to replace your running shoes is a difficult pill to swallow, remember it’s an investment in your physical health. Don’t let old and worn shoes throw a nasty obstacle in the way of your running career. It doesn’t have to be that way. Replace them roughly every 500 miles.

For more information on when it’s time to replace your running shoes, check out the blog post here:

 

How do you relieve the symptoms of Achilles Tendinitis?

• Resting the sore tendon

Try to move the tendon as little as possible. Avoid excessive walking, sudden movements, and under no circumstances go for a runner. Yes, it’s annoying to be out of action for a while, but it’s the best and most simple remedy there is.

When you have Achilles Tendinitis, your body needs time and energy to work on restoring the worn muscle. Help your body out and rest the sore tendon.

• Use pain relief

If the pain is extremely uncomfortable, use some pain relief to make things easier for yourself. A classic pain-relieving method is to apply ice to the area. Achilles Tendinitis means your Achilles are incredibly inflamed, and the tissue is damaged.

When you put something cold, like ice onto the area, it reduces the swelling and relieves the pain of the inflammation. If you don’t have ice, a bag of peas usually does the trick. Alternatively, you can use over the counter medication like paracetamol or ibuprofen to keep the pain pangs at bay.

Make sure you read the guidance notes on the back of the packet though. Taking pain relief medication inappropriately can be incredibly dangerous. Safety first, injured runner second!

• Stretching the tendon gently

Gently moving the affected tendon can be effective pain relief and help keep blood flowing to the injury.

A good stretch to do is to stretch the foot upwards using a towel or a t-shirt. Whatever you have close to you. Hold this positive for about 20 seconds and repeat for five repetitions. Try doing this about five times a day, or whenever the pain is severe.

Don’t go overboard with this one though, and make sure you’re gentle with your injured Achilles. If it hurts a lot doing this stretch, stop doing it. Remember the pain warning earlier. When you feel pain, it might be a good idea to take it easy or stop doing something for the time being.

Another decent stretch is to place the injured foot behind you, and gently bend your knees down. Pressure will be applied to your Achilles, and it will slowly stretch out. Hold this position for approximately 20 seconds and repeat for 5 repetitions.

Again, repeat as many times throughout the day as necessary but don’t get trigger happy with your stretching and overdo it.

• See a physiotherapist

Nasty cases of Achilles Tendinitis may require professional attention. Though not ideal, it is a sensible option if you’re in constant pain and the symptoms don’t seem to be getting any worse.

A physiotherapist is someone who has undergone professional training in treating disease, injury and deformity with a variety of methods. Popular methods include massage, heat, exercise and stretching. Depending on the nature and extent of your injury, a physiotherapist will give you a tailored recovery programme to get your Achilles back to health.

If you’re in extreme pain, go see a doctor for a check-up. You might think this is unnecessary, but it’s better to be safe than sorry.

Note: All information from this article is taken from personal experiences and conversations with fellow runners, and friends that are professional athletes. I am in no way a medical professional or passing my self off to be one. If you think your symptoms are extremely bad, seek professional medical attention immediately.

 

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