Achilles Tendinopathy

Ok, first of all I am an endurance runner who is 52 years old who loves her running. However sadly over the last year since August 2019 that has not been possible because as stated in the title I have Achilles Tendinopathy. As suggested by my private physio I did the eccentric exercises and they were having a good effect. However when capable I started running again following the program of 2 minutes run 1 minute walk = 21 minutes. Unfortunately the worst thing happened I felt a fibre go in my Achilles whilst running. Since then it has been back to square one followed on by acupuncture, which didn't work for me. My Achilles is still inflamed and sore and I'm not running at all, I cant it hurts.  I just cant see a way out of this injury sometimes I wander if I'll ever run again. Can anyone give me advice on this injury please, I would be grateful.         


  • TTTT ✭✭✭
    I can understand your pain, literally, I started with Achilles issues in March 2019. I am now, running pain free, from about six weeks ago. 

    I do masses of exercises most days (five to six days a week up to 20 mins at a time) to keep it under control. Physio has helped massively and has been a regular occurrence!

    It seems to me the only way is regular, and constant exercise. Sorry I do not have a miracle cure.
  • If only someone did have a cure I would be up and running by now. 
    Thank you for answering my forum, when I went to see a physio they gave me the eccentric exercises to do and overtime to add load. She also gave me isometric exercises for the calf but my calf seem to get worse. 
    As runners we are all different biomechanically the way that we run, and for some people certain exercises will work and for others they may not. However out of interest if you don't mind please what exercises were provided by your physio, I'm not saying they'll work for me but I may put this information to my physio. To ask her advise.              
  • TTTT ✭✭✭
    Not a problem, I do have an adjustment incline board, I found it made me do the exercises more.

    I do:
    Calf raises
    Eccentric calf raises
    Pole isometric holds
    Single to double box squats
    Wall isometric holds
    Glute bridges 
    Single leg glute bridges (box and floor)
    Clams (with and without band)
    Single leg raises

    Before lockdown I was also pool jogging which really helped.

    I walk for a mile before I start each run and have a set of exercises based on the ones above I do before each run. I also rotate six pairs of trainers, with three different types so I am not becoming used to one pair. 

    Hope this helps.
  • Ian5Ian5 ✭✭✭
    Do you try and run early or later in the day.
    I can't run early but find when I run later in the day it is ok as the Achilles has warmed up throughout the day.
    I also run .most of my runs very easy,by doing this I've been able to continue running with AT for 3 years.
  • Hi 
    Thank you TT for the exercises it certainly is a big help, Ill   
  • Sorry didn't finish post and before I knew it, it was sent!
    So to continue.....
    I'll explore and try these exercises thank you so much. 

    As for running in the evening Ian I'm afraid at the moment its not making any difference. I tried many of time whilst walking my dog its still sore and my calves get tight.           
  • Tracy I had this injury in both feet and run in pain for a while without realising what it was. You seem to be doing all the exercises I was given. I paid private and had my gait analysed and then had insoles made for my trainers. With some rest I am now back running pain free from the Achilles injury.

    The Achilles tendon and plantar fascia are energy-absorbing and energy-releasing structures that are working throughout each stride. They absorb the load as your foot impacts the ground (loads are often 3 times your body weight) and convert the energy to propel yourself during the push-off phase of a stride (where forces are as high as 7 times your body weight). The Achilles tendon and calf muscle are therefore an essential unit, critical for efficient and effective running. The Achilles tendon is prone to overuse purely by the nature of its function. Pain occurs because of weakness or dysfunction in the tendon rather than what was previously thought to be an inflammatory reaction. This can be a challenging area to treat due to the tendon’s poor perfusion (blood flow), which may need longer recovery periods, so it’s best to tackle this injury at the earliest point possible.


    Pain close to the heel, which is often sharp, poking and incapacitating.
    Pain along the Achilles tendon, at the back of the lower leg.
    Occasionally there can be mild swelling at the base of the tendon (near the heel) and redness.
    If you pinch the Achilles and it’s very sore, then the source of the problem is likely to be the tendon.
    Pain during and after running (Stop! This is not an injury you can run through)
    In chronic cases there can be thickening or a thickened ‘lump’ along the tendon, especially when compared to the uninjured leg


    The Achilles tendon is the extension of the calf muscles, gastrocnemius and soleus where it attaches to the back of the heel and is responsible for plantarflexion (pointing your toes). Sometimes excessively tight, weak calves are the culprit. Tight lower legs put added strain on the Achilles tendon, and over the course of many months of hard training, this overuse injury can develop. A weak posterior chain (the muscles that work together along the back of your body including the back extensors, gluteus muscles, hamstrings, calves) can also be a cause of Achilles tendinopathy.

    Constantly running on hard surfaces like concrete or asphalt can contribute to developing Achilles tendinopathy as the loads absorbed by the tendon are greater than running on grass or dirt roads. Unsupportive footwear can overburden the Achilles tendon with time, as it must work even harder to control ankle movement whilst running.

    Worn out shoes or shoes with inadequate cushioning can exacerbate Achilles tendon issues as they add no benefit in absorbing load during heel strike. Rapid increase in volume and/or intensity or training can have the same effect much more quickly, so it’s important to pay attention to both your feet and your sessions—especially when you’re training hard. Severe pronation, foot instability, a leg- length discrepancy and muscle asymmetries can also contribute to Achilles pain.


    Rest, icing, and strapping can relieve symptoms in the early/acute stages. Reducing training intensity and volume may be required, possibly even complete rest for a few weeks depending on pain and the severity of the injury. The earlier you get treatment the shorter your time off running in the ‘long run’. Soft tissue massage can be used to release tight structures throughout the lower limb and back. Physical therapy treatment will mobilise tight structures, possibly use acupuncture and prescribe rehab exercises to strengthen your calves, hamstrings, glutes and core. Stretching is also a key component to rehab. Eccentric heel drop exercises (lengthening under load), taught by your physical therapist, will be an essential part of your recovery. Advice about your shoes, orthotics and running technique can help. Importantly, keep an eye on your training. Don’t do too much, or go too hard, too quickly.


    When people experience Achilles tendinopathy, it often starts as a simple feeling of stiffness in the tendon. If you take steps to increase flexibility, strengthen the ankle and calf muscles and decrease stress on the tendon at the first sign of stiffness, it’s possible to prevent the problem from escalating.

    One of the easiest ways to prevent Achilles tendinopathy is to keep the tendon strong and flexible. Regular strengthening of the calf, especially eccentric exercises will be beneficial, along with a regular stretching programme.

    It is important to strengthen the entire limb from the pelvis, core, hip, gluteus muscles and hamstrings as these will all ensure the entire kinematic chain is working efficiently and minimising overload of the Achilles tendon. Then address any underlying risk factors (like shoes, orthotics) and finally a key prevention strategy is monitoring your training capacity. Slow and steady wins the race!



    This programme has specific exercises for Achilles Tendinopathy. Remember the key is to strengthen the calf muscle and tendon eccentrically, whilst maintaining good flexibility; and don’t forget the rest of your leg! It is important to ensure the exercises are performed with good technique and good postural control. Make sure to repeat the same number of exercises on both legs. Make sure you are always pain-free and take care not to progress too quickly. We have given suggested sets and repetitions, and the exercise routine should be performed twice a day. Remember everyone is different so your therapist may give guidance that is more specific to you.


    If muscles are tight, weak or injured, it is particularly important to warm up (unless advised otherwise by your practitioner) with a brisk walk or a gentle jog at a pain-free pace for 5 minutes before you start your exercises. This increases your circulation and helps prepare the muscles for the activity to come. When you have finished your exercises, end the session with a 5-minute gentle walk or slow jog to allow your heart rate to slow down gradually.

    Read more on running injuries
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