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Achilles Tendinitis in Runners

by Nora Gilman, MS, LAT, ATC

The Rundown:

Achilles tendinitis is inflammation of the achilles tendon as it attaches to the heel. The achilles tendon is the tendon of the calf muscles. The calves are a large contributor to running and without proper training and recovery, the calves can become tight and add stress to the tendon.


Common symptoms include pain, inflammation, and tenderness in the tendon. Sometimes the calf muscle will have these symptoms as well. Pain occurs with running, walking, going up stairs, or jumping.

My Clinical Experience:

(Note: this experience has not been clinically trialed and are theories only)

Even though the pain and inflammation is in the tendon, the cause is likely due to something else. A quick, helpful assessment is if the tendonitis is in one foot or both. I find if the tendinitis is in both achilles tendons, the problem is with the core muscles. If the tendinitis is in one foot, the problem involves the foot, knee, and hip on that side. In some instances, older running populations might have a bone spur in the heel which causes persistent heel pain due to the tendon rubbing over the bone spur.

What you can try:

  1. Modify running: If you find running makes your symptoms worse, try to find an intensity or amount of running that you can sustain without making the condition worse.

  2. Update your equipment: Make sure your shoes do not have a lot of miles on them which can cause breakdown of the shoe and stress the foot and achilles tendon.

  3. Stability and strengthening: Adopt a strengthening and stabilizing regimen that trains bigger muscles to stabilize the body and not the calves and achilles tendon.

  4. Compression sleeves: Wearing calf compression sleeves can increase circulation and provide stability during activity.

  5. Contrast water therapy: Alternating placing your foot (or feet) in hot and cold water submersion can increase blood flow to the area which can aid in healing, recovery, and pain reduction.

  6. Cross Train: You can find other activities to engage in to keep your aerobic fitness while you turn down your running volume. Some alternatives are biking, swimming, or water jogging. These activities are low weight bearing which can aid in the recovery of the inflamed achilles tendon.

When to contact an athletic trainer:

  • If you need help and advice on properly modifying your activity, an AT can provide you with ongoing support.

  • If you need direction with the right stabilizing and strengthening protocol, an AT can get you started on effective exercise progression and regressions.

  • If your achilles tendon pain persists or worsens despite the efforts listed above, your AT can recommend more treatment and rehabilitation options.

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