Achilles Tendinopathy

Another often-seen running injury deals with one tricky piece of human anatomy – the achilles tendon. Achilles tendinopathy is a condition that causes pain, swelling, stiffness and weakness of the achilles tendon that joins your heel bone to your calf muscles. It generally presents first as tendinitis, and then, if left untreated or not treated properly, can progress to tendinosis.


The term achilles tendinitis is often used when describing achilles tendon pain and discomfort. Tendinitis is an inflammation of the tendon that provokes an immune response. It is an acute condition where the tendon is overloaded, causing pain and swelling from tears in the tissue. Tendinitis, if quickly identified, can be treated and disposed of, getting you back on the road eating up those miles.

Achilles Tendinopathy

The thick achilles tendon emerges from the heads of both parts of the gastrocnemius and the soleus muscle.

Left untreated, though, tendinitis can lead you down the road of a chronic condition (tendinosis) that takes significantly longer to remedy.

A good way to distinguish between tendinitis and tendinosis is thinking of the cause of tendinitis as one big traumatic event (perhaps a really long run, hard hill workout, or coming down awkwardly during a step), while the cause of tendinosis is a series of chronic smaller-scale traumas to an already-compromised tendon.

Achilles Tendinopathy Treatment

An MRI showing Achilles Tendinitis – the tendon is on the right of the screen in black – note the slight thickening of the tendon just above the heel.

The body is generally able to repair the hundreds of micro-traumas endured during a workout – this is how we build muscle. However, if the achilles tendon is already overloaded and inflamed, the body cannot adequately repair itself. The tendon keeps degenerating and the condition becomes chronic.

The achilles tendon (and all tendons) are made of thin fibers of collagen that group together to form a thick band that connects muscle to bone. In the case of tendinosis, there is a breakdown in the banding of these collagen fibers. The fibers pull apart, making the tendon weaker as a whole. The fact that tendons receive poor blood supply compared to muscles makes achilles injuries more difficult for your body to repair.



Rest is the single easiest way to cure any repetitive stress injury. Tendinopathy occurs when breakdown exceeds repair. You’ve got to give your body a little time to fix itself. For the achilles in particular, which during the push-off phase of running, bears SEVEN TIMES your body weight, rest is integral in reducing inflammation and preventing tendinitis from progressing to tendinosis.


Icing – try 15 minutes on, a few times a day – can help reduce inflammation related to the initial stages of tendinitis.


The achilles tendon attaches at the head of the gastrocnemius and soleus muscles. If these muscles are tight or weak, the achilles has to bear much of the load of running. Get on the foam roller or use The Stick (taking care to stay on the calf muscle and off the sore tendon).





Overuse is a huge factor in running-related injuries. Think back to when you first started running or came back to running after a layoff. After those first few runs to get the rust out, you feel great! You feel like you can run forever – so you do!

Some people can get away with this, but most cannot. You need to make sure that you’re not overdoing it – mix in some low-impact cross training (like swimming or biking), and make sure to factor in adequate rest days. As we mentioned earlier, when muscle or tendon breakdown exceeds repair, that is when injury takes place. Isn’t it much better to take a rest day once or twice a week and be able to then significantly build your mileage rather than skipping your rest days and then having to take a week or more off due to injury??


Achilles Tendon Pain RunningTraining in the proper footwear is an important tool in your injury prevention arsenal. Particularly in the case of achilles issues, untreated overpronation can put unnecessary strain on the achilles tendon, making the potential for injury much higher. If you’re overpronating too much, the achilles has to work harder to stabilize the foot as it goes through the gait cycle. So make sure that your shoes are 1) properly supportive and 2) not worn out! (General rule of thumb is: if you’re using your shoes to run, walk, or work out at least 3-4 days per week, don’t let them get past the six month mark before thinking about replacing)

Visit one of our stores to get a running shoe fitting anytime! And if you’re dealing with achilles injury, we’ll talk you through the recovery process and show you some stretches and strength exercises.