Achilles tendon pain is a common and bothersome issue for many runners. Both beginners and experienced athletes can be affected. But what factors contribute to this problem, and what can you do to prevent it? Here are the most important facts and tips for prevention and treatment.
Author:
David Schaad
Head of Therapy Bischofszell and Amriswil
MSc in Physiotherapy
Achilles tendon pain is caused by overuse
Correct. Overuse is indeed the main cause, but not the only one. A rapid increase in training volume or intensity can overstrain the tendon. Additionally, insufficient strength in the core and legs plays an important role, as weak muscles increase the load on the Achilles tendon. Factors such as inappropriate shoes, unsuitable running surfaces, or poor running technique can also contribute. Anatomical characteristics and misalignments, such as an inward-tilting foot (overpronation), or the use of certain medications like antibiotics or cortisone, can also increase the risk.
Only beginners have problems with the Achilles tendon
No. Experienced runners aren’t immune either. In fact, it’s often ambitious athletes who suffer, especially if they increase their training volume too quickly or don’t adjust the load adequately. External factors, like an unusual heel design on new shoes or training on snow, can also trigger issues.
Absolute rest is the only solution for Achilles tendon pain
If only it were that simple! Rest is important, but complete inactivity rarely helps in the long term. It’s crucial to adjust training and daily activities to load the tendon in a targeted and measured way. This allows you to gradually rebuild the tendon’s load capacity. Moderate training is more helpful than complete rest.
With mild pain, you can continue running without any problems
Yes and no. Caution is advised. Whether it’s safe to continue running depends on the intensity and cause of the pain. Mild discomfort that disappears quickly is often harmless. However, persistent or worsening pain should be taken seriously and checked by a sports physician or physiotherapist to prevent chronic inflammation. Medbase has a large multidisciplinary sports medicine network.
Lots of stretching helps with Achilles tendon problems
No. Stretching alone is rarely enough. It’s more important to strengthen the Achilles tendon specifically and mobilize the entire leg and core muscles. Warming up and loosening exercises before running can also help prepare the tendon for the load.
Muscle tension can have several causes, including overuse due to rapid increases in training, muscle weakness, altered running gait, and biomechanical factors. It’s unlikely that stretching alone can address all of this.
You should always warm up before running
Yes. Warming up should include stretching, strengthening, and balance exercises, sports-specific mobility drills, and landing techniques. However, current literature lacks sufficient high-quality research to determine whether warming up helps prevent running injuries.
It’s important to increase training volume slowly to prevent Achilles tendon overload
Correct. A sudden increase in training volume is one of the most common causes of Achilles tendon issues. The body needs time to adapt to new loads. A gradual build-up in training volume and frequency is therefore essential. Regular breaks and adequate recovery are also important. A comprehensive approach that combines activity management, progressive training, and patient empowerment is key to successfully treating Achilles tendon pain.
Once you’ve had Achilles tendon problems, you’ll always have them
Not true. With the right treatment and tailored training, Achilles tendon issues can heal completely. It’s important to identify potential causes, such as running technique, shoes, or training load, and to assess and optimize leg and core strength over the long term. If the Achilles tendon is anatomically your weak point – everyone has a weak point – you may be more prone to issues. In that case, you should pay particular attention to prevention.
Tailored physiotherapy
Medbase has an extensive network and a wide range of physiotherapy services. The therapists are happy to advise and treat you individually, according to your needs, with or without a doctor’s prescription. If you choose treatment without a prior doctor’s visit, costs will not be covered by health insurance or accident insurance. Book now
In case of Achilles tendon pain, you should stop running immediately
No, a complete halt to running isn’t always necessary. Instead, you should reduce the intensity and, as mentioned earlier, adjust your training. Depending on the severity of the symptoms, light movements and specific exercises may even promote healing.
It’s important to train on different surfaces to help prevent Achilles tendon problems
Correct. Changing surfaces can help strengthen the tendon and engage the muscles in a more varied way. If you always run on the same surface, such as asphalt, this repetitive strain can lead to irritation. A varied terrain (e.g., forest paths or grass) can, on the other hand, have positive effects. Ideally, choose a route that includes a mix of surfaces.
Being overweight increases the risk of Achilles tendon problems
Exactly. Being overweight increases the risk, as it can lead to constant overloading. It also promotes inflammatory processes in the body. Weight loss can, therefore, be preventive and provide relief.
Treating Achilles tendon pain requires patience
That’s correct. Therapy requires patience. With targeted exercises, you can gradually reintroduce load to the tendon. This includes stretching and strengthening exercises. Data shows that stimulating the structure with slow, heavy eccentric exercises – where the muscle lengthens while under tension – is effective. Eccentric training refers to a specific phase of movement where a muscle is stretched while exerting force. Regular use of a foam roller to loosen the calf muscles can also be helpful.
Minor discomfort is treated differently than chronic issues
This is also correct. For minor discomfort, training adjustments and targeted rehab exercises are often sufficient. It’s important to understand the causes and course of inflammation to choose the right treatment. It’s essential to consider the technique and load in your regular running routine. Make sure to seek professional advice so that you’re guided in your planning.
Conclusion
The Achilles tendon is more sensitive than many runners think. However, by focusing on targeted prevention, adjusting training, and avoiding common mistakes, the risk of Achilles tendon issues can be significantly reduced.
Source:
https://bmcmedicine.biomedcentral.com/counter/pdf/10.1186/1741-7015-10-75.pdf