Preventing Achilles Tendon Pain: A Runner's Guide

As we approach the marathon season, physiotherapists are often kept busy dealing with one common issue: Achilles tendon pain.

What Is Achilles Tendon Pain?

This common issue affects both active individuals and those who lead more sedentary lifestyles. The Achilles tendon connects the calf muscles to the bony part at the back of your foot, playing a crucial role in lifting the heel as we walk or run. Under normal circumstances, our tendons adjust to the small variations in our daily activities. However, when the stress placed on the tendon exceeds its ability to adapt, it can cause an imbalance between tissue breakdown and repair, leading to a condition known as ‘tendinopathy’.

Running puts additional strain on our muscles and joints compared to walking, causing more force to be exerted on the Achilles tendon. This makes Achilles tendon pain particularly common in runners.

Initially, the pain may occur during running or walking, but can gradually worsen and be present all the time. It may feel tender to the touch or when pressed by footwear, and can cause mild localised swelling. Many runners notice it’s worse in the mornings or after being inactive for a period, such as after sitting for a while. The pain is often accompanied by stiffness when walking or moving the ankle.

Risk Factors for Developing Achilles Tendon Pain

Several factors can increase the likelihood of developing Achilles tendon pain, including:

• Activity-related sudden changes: Starting an exercise routine too suddenly, doing too much too quickly, or making rapid increases in training intensity or volume.

• Health and lifestyle factors: Age, body weight, diabetes, and hormonal imbalances can all play a role in how likely we are to develop tendon pain.

  
  

How Can Runners Minimise the Risk of developing Achilles Tendon Pain?

• Gradually adjust your training: Make incremental changes to the intensity, duration, frequency, and terrain of your runs to give your body time to adapt.

• Prioritise recovery: Avoid running on consecutive days, and ensure you’re allowing enough time for rest between runs. A 3-day-a-week running schedule is highly recommended to promote proper recovery.

• Incorporate strength and conditioning: Strengthening the major muscle groups that absorbs the forces as we run is fundamental to avoid running related injuries. These muscles include the quadriceps, glutes, calf muscles and hamstrings.

  
  

If you have developed Achilles tendon pain, it’s better to seek Physiotherapy advice early. Book in to see Anna here (Anna Birch Physio, Bury St Edmunds) for an individualised assessment and management plan for your symptoms, or additional advice on how to prevent running related injury.