Achilles tendon injuries

How to keep them from happening when running.

June 3, 2020


Think of the Achilles tendon as a shock absorber for your body. It connects the calf muscles in your leg to your heel bone and helps your foot move. The faster you move, the greater the force on the Achilles — up to five times your weight. 

If the fibers in the tendon are overstressed, they can come apart. This releases chemicals that cause swelling. When all of these fibers fail, the Achilles tendon tears and no longer works.

Causes of Achilles tendon injuries:

  • Overtraining, including adding miles too quickly or doing high-intensity training, such as interval or sprint sessions
  • Changing the type of running shoes you wear, for example, from a shoe with good support to one with less support
  • Changing running surfaces, for example, from hard pavement to a forest trail

Signs and symptoms of an Achilles injury:

  • Stiffness
  • Pain when you “push off” of the foot to walk or run
  • Tenderness when you press on the tendon with your fingers
  • Symptoms get better after warming up
  • Symptoms get worse the day after a long or high-intensity run

When to seek care for an Achilles injury

It’s important to get care when you notice pain and symptoms don’t improve. Continued stress of the Achilles can cause more damage and hurt your short- and long-term ability to run.

When the Achilles is injured, it naturally starts a healing process by laying down scar tissue. But scar tissue isn't as strong as the original tissue. When force is applied to an Achilles tendon with scar tissue, it causes more pain.

That’s why, once any swelling goes away, the tendon must be strengthened. This is best done with the guidance of a physical therapist or other health care professional who understands this type of injury.

How to protect the Achilles tendon

Stretch. Make a habit of stretching before and after you run. Tip: Try heel raises and calf stretches.

Cross train. Vary your routine by adding activities like strength training, yoga or swimming. These can increase your flexibility, balance, mobility and strength when running. Tip: Try a seven-minute, high-intensity workout. 

Recover. It’s important to give your muscles enough time to heal after long or high-intensity runs. If you don’t, the tissues will break down faster than your body can recover. Tip: Take it easy for a few days after long runs or high-intensity workouts.

Add miles gradually. This allows your body to adapt to new stresses. Tip: Increase distance or training intensity by no more than 5% each week.

Wear the right shoes. Give yourself time to break in new shoes and adjust to different running surfaces. Tip: Don’t try out a new pair of shoes on a long run. The first few times you wear new shoes, run shorter distances instead. 


By James McGavin, PT, MSc, DipMDT

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The information provided is for general informational purposes only and is not intended to be medical advice or a substitute for professional health care. You should consult an appropriate health care professional for your specific needs.