The Runner’s World Guide to Common Running Injuries: Achilles Tendinitis

Your Achilles tendon bears three times your body weight when you run, and, because of this, taking care of your lower legs and feet is an important key to staying on the road. It’s doing a lot of work, and if it gets injured, you will not be able to run.In The Runner’s World Guide to Common Running Injuries, host Winnie Yu, PT, DPT, CSCS, and podiatrist Alicia Canzanese, DPM, ATC, explain how easy it is for the Achilles, at the back of your heel, to get tight or overworked. Overuse creates tiny tears that can turn into a more serious injury over time.Fortunately, with attention in the form of warmups and exercises, you can do a lot to help prevent injuries to your Achilles.What You’ll LearnIn The Runner’s World Guide to Common Running Injuries: Achilles Tendinitis, we’ll teach you:How to recognize Achilles tendinitis and understand the common causes in runners Why your Achilles is sensitive to running and prone to injuries. The difference between two distinct types of Achilles tendinitisWatch VideoGo DeeperUnderstand the InjuryThe Achilles tendon connects the calf muscle to the heel bone (official name: calcaneus). When you get Achilles tendinitis, it may feel like a dull ache, stiffness, or burning pain behind the ankle or the back of the heel (not the bottom of the foot).You will often feel it the most in the morning or at the beginning of a run if you haven’t warmed up. It may ease when you run, but if there are tears or inflammation, then more running will end up exacerbating the injury.“Any pain that is along the back of the heel and the back of the ankle, that starts out, eases, and goes away, and is worse when you’re going up steps is very classic of Achilles tendinopathy,” says Canzanese.Underlying causes of Achilles tendinitisOne of the most common causes is overtraining, although tight calf muscles can contribute to the problem. Muscle imbalances can cause problems in one Achilles more than the other Changing from one style of shoe to another without adjusting the way you run or giving your feet time to get used to a new shoe can also be an underlying issue.There are two types of Achilles tendinitis (insertional and non-insertional) and the treatment differs, so seeing a doctor is important.How Serious Is It?How your pain behaves during and after a run can help you determine what to do next.🟢 Green FlagMild soreness without acute or sharp painMay improve with modified training and early strengtheningPain lessens while you run, but this doesn’t mean you should ignore the problem because you want to avoid further injury, and have them ensure you are wearing the right shoes and doing the right exercises Ignoring the pain because it feels better after the first few steps can lead to a more serious problem. If you do something at this point, you probably won’t have to stop running. 🟡 Yellow FlagPersistent pain when you wake up, and when you start a run that continues during or after runningSwelling or noticeable weakness🔴 Red FlagSudden sharp pain that immediately stops your runInability to continue running or walking comfortablySeek medical evaluation promptlyIf you see redness, soreness, or inflammation on the back of your heel, stop running. Recover and Return to RunningStrength exercises, like calf raises, not only help relieve the pain, but also prevent the injury from recurring.Lots of people massage their Achilles, but the injury originates in the calf, so while your calves may not hurt, you do need to massage, strengthen, and stretch these muscles, but don’t apply direct pressure on the inflamed Achilles tendon itself.Eccentric Heel RaisesStraight-Leg Calf StretchBent Leg Calf Stretch Single-Leg Heel Raise❌ Common recovery mistakes:Try foam rolling, massage guns, and compression boots on your lower legs. Remember that hill training and speedwork rely on your Achilles tendon in ways that regular running doesn't, so if you notice reactions after these workouts, back off until you see a doctor. Stay Healthy and Run StrongerIf you suspect the problem stemmed from shoe choice, go to a run store or podiatrist to have them tell you what kind of foot you have (high arch, flat feet) and which shoe style would most help you.Training habits to reduce reoccurrence of Achilles tendinitis: Consider alternating a running day with a nonimpact cardio day (such as cycling or swimming). You should have a strength training routine, a warmup routine, and a cooldown routine to support your calves and ankles. Doing foot and ankle mobility exercises will help support your Achilles tendon, and continue to do the exercise that Yu demonstrates. Always ramp up your running slowly, and that includes speedwork, hillwork, and other types of intensity. Be sure to give your legs and feet plenty of time to recover between long runs and speed work. Ready to build a stronger, more resilient running routine?Whether you're beginning to run or you're training for that next marathon, the Runner’s World Guide to Common Running Injuries will help you spend less time sidelined and more time doing what you love. You’ll learn how to recognize the signs of common running injuries, understand their causes, and determine when you can safely modify your training versus when it’s time to seek medical care. This holistic program is available exclusively to Runner’s World+ members and launches on October 6!Donna Raskin has had a long career as a health and fitness writer and editor of books and magazine articles. A certified run coach who has practiced yoga for many years, she also loves to lift weights, dance, and go for long walks with her hound dog, Dolly.