falke
The Achilles tendon and running

Achilles tendon complaints when jogging is some of the most common complaints among runners. They not only affect professional and amateur runners, but recreational runners also frequently complain. Here we will provide you with information on the most important points:

  1. General risks for the Achilles tendon in runners
  2. General risks for the Achilles tendon in runners that depend on the situation
  3. Possible consequences/diagnoses of Achilles tendon complaints in joggers
  4. Other diagnoses of Achilles tendon problems in runners
  5. Treatment of Achilles tendon problems in runners
  6. What to do if your Achilles tendon hurts when running
  7. Alternatives to jogging when you have problems with your Achilles tendon
  8. Prevention of Achilles tendon pain in runners
  9. FAQs on running and the Achilles tendon

 

The causes listed in the ‘Achilles tendon pain’ menu generally also apply to runners. The following risks particularly apply to runners.






1. General risks for the Achilles tendon in runners:
  • incorrect foot positioning, particularly flat feet
  • overpronation and in rare cases supination
  • muscular deficits in the lower calf muscles which stabilize the foot (tibialis anterior and posterior muscles)
  • unsuitable footwear or insoles

These risks are closely linked. Buy footwear and insoles that ensure your feet are in the correct position, particularly if you have flat feet! The same applies if you overpronate or, more rarely, supinate. All good sports shops or orthopedic footwear experts will be happy to give you advice.

When buying running shoes, pay attention to the top edge of the heel cap. This should be soft as otherwise it can rub against and irritate the Achilles tendon or bursa.

Of course, problems with other joints may also pose a risk: knee, hip and back problems, and even incorrect jaw positioning can be a cause. A good physiotherapist will examine these points and advise you.





2. General risks for the Achilles tendon in runners that depend on the situation:
  • running too often and for too long on hard ground/road surfaces
  • a bad running style – working the calf muscles too hard
  • training sessions that are too intensive (ascending runs, intervals) and/or too little recovery time between them
  • rapid changes in running technique from heel (heel running) to midfoot or forefoot strike (barefoot running)
  • insufficient warm-up time – also for the Achilles tendon – on cooler and cold days

Other risks:

  • a poorly developed ability to perceive foot movements (poor proprioception)
  • problems in functional chains
  • stress
  • poor diet
  • microinflammation (e.g. teeth, intestine, toenails, etc.).


3. Possible consequences/diagnoses of Achilles tendon complaints because of running


a. Most common – tendinopathy of the Achilles tendon because of running.

  • Tendinopathy – problem in the mid-portion of the tendon: the tendon can become thickened and hurt when pressed upon, when starting to move in the morning or after long periods lying down or sitting. Pain may also be felt under strain -> Achilles tendon pain when jogging!
  • Tendinopathy – problems in the transition zone to the heel bone: difficult to judge as it can also affect areas other than the Achilles tendon. In any case: pain when pressing on this point, pain when starting to move, pain in the Achilles tendon when under load.


b. Complete Achilles tendon tear – sudden snapping noise, like the crack of a whip, when running.

Intense, stabbing pain, swelling, no longer possible to stand on tiptoe – after a few days this becomes a dull ache. A gap can be felt in the Achilles tendon



c. Partial Achilles tendon tear 

Intense pain, swelling, discomfort when going uphill or climbing stairs.



d. Paratendinitis

Problems throughout the whole Achilles tendon. However, it is not primarily the tendon that is affected but the connective tissue/gliding layer around the Achilles tendon. Pain upon applying pressure or pinching (thumb and index finger around the tendon), however, the Achilles tendon is not thickened


e. Achillobursitis 

Inflammation of the bursa – Achilles tendon pain in the area just above the heel (above the base of the tendon), especially to the right and left of the tendon. Pain when wearing closed footwear, but not when barefoot. Pain when lifting the foot. Swelling and redness as typical signs of inflammation.




4. Further diagnoses of Achilles tendon problems because of running:
  • Haglund’s deformity: also linked to pain in the heel, especially when wearing shoes; caused by a protrusion of bone at the back of the heel
  • heel spur: pain under the heel caused by a thorn-like extension of the heel bone on the sole of the foot
  • plantar fasciitis: pain on the sole of the foot caused by inflammation or degeneration of the large tendon/fascia on the sole of the foot.



5. Treating the Achilles tendon – problems because of running

In runners too, the correct treatment depends on the diagnosis of the Achilles tendon problem. In this context, chronic tendinopathy in runners merits special attention. Complaints have often been there for so long that many are difficult to treat; meaning that full healing of the Achilles tendon is often no longer possible. This makes it even more important to do everything possible to ensure optimum treatment results. This depends on a correct diagnosis and consistent treatment.

The healing of the Achilles tendon must be your priority and not your next training session or marathon! This means that, depending on the healing phase, load should be placed on the Achilles tendon with strength exercises or through running, but in moderation. Be honest with yourself and pay attention to the pain, because an incorrectly healed Achilles tendon can cause problems for the rest of your life.





6. What to do if your Achilles tendon hurts when running:
  • If your Achilles tendon hurts a lot when running/jogging:
  • stop immediately and see a doctor!
  • If your Achilles tendon only hurts at the start of your run:
  • take enough breaks between runs. At least one day (preferably 36 hours) off to give the recovery processes enough time
  • see a doctor or physiotherapist if necessary
  • only go for relaxed runs
  • wear FALKE Achilles socks when running
  • If your Achilles tendon hurts towards the end of your running session:
  • an overload appears to be starting or is already present -> take a break and continue later for a shorter time and at a lower intensity
  • wear FALKE Achilles socks when running
  • If your Achilles tendon only hurts occasionally:
  • do regular eccentric training
  • wear FALKE Achilles socks when running.

In all cases find out what is causing the pain!




7. Alternatives to jogging when you have problems with your Achilles tendon

Those who need to take a break due to their Achilles tendon complaints can keep up their fitness level and continue strength training with other sporting activities:

Cycling: a good alternative for endurance
Swimming: although it obviously works out different muscle groups from running, it also gives the circulatory system and breathing a workout
Aqua jogging: a very good alternative with movements like jogging and the water pressure acts like an oxygen shower
Weightlifting: training the posterior chain (muscles on the back of the body), particularly the calves; a good opportunity to work out the core muscles that are also needed for running. Other muscles needed for running such as the front and rear thigh muscles and hip muscles (particularly the smaller gluteus medius for hip stabilization) can of course also be given a workout.



8. Prevention of Achilles tendon pain because of running

You should, of course, avoid all risks that can lead to complaints (see ‘General risks and risks that depend on the situation’ above)

  • Through correctly dosed training, the Achilles tendon will also become more resilient, meaning that it can adjust to increasing training loads. But be careful: the tendon needs more time to adapt than muscle!
  • Special training of the foot-stabilizing muscles in the lower leg, the tibialis anterior and posterior muscles.
  • Do Achilles tendon stretches regularly: most studies have been carried out on eccentric stretches (see the ‘Stretching’ menu).
  • Regular stretching of all other ligaments, tendons and muscles of course.
  • Also stretch the soles of your feet, e.g. by rolling your foot on a tennis ball or fascia massage ball.
  • Stretch the soles of your feet: crouching on tiptoes, with your knees pointing forwards so that there is tension in the toes and sole of the foot.
  • Roll a fascia massage ball under the whole length of the Achilles tendon.
  • Go through the ABCs of running or do coordination training from time to time to improve running style and coordination.
  • Proprioception training – training to improve personal perception and fine motor skill:
  • standing on one leg with additional exercises for the core and arms – preferably on a soft base (balance pad)
  • barefoot running, also on sand (also gives the small foot muscles a workout!)
  • carry out balancing exercises from time to time when running, e.g. walking along a tree trunk.



9. FAQs on running and the Achilles tendon

How can I protect my Achilles tendon from damage when running?

In our opinion, you cannot explicitly protect it from damage. Many recommend a slight heel elevation, however, this is not advisable directly after sustaining a tear. In later healing stages (see ‘Healing phases’) the Achilles tendon needs constant stimulus to be able to regenerate or so as not to lose elasticity, so no elevation. Furthermore, an elevation changes the ‘running program’ in the brain and can lead to problems in other places. It is better to bear in mind the tips provided here for prevention and when the tendon hurts, take the action recommended.

 

Can I still run with an inflamed Achilles tendon?

First, we need to clarify the word ‘inflammation’, as the problem is usually degeneration of the Achilles tendon or tendinopathy. The bursa and connective tissue around the tendon rarely become inflamed. Only continue to run if the pain is very mild and in all cases take a break of at least one day after the run and reduce the load on the next run. Also observe the tips on this website.

 

Can I still go running if I have an Achilles tendon tear?

No – see a doctor as soon as possible! Only resume running after treatment of a rupture (tear) if it is possible to put your full weight on the tendon, so in 4or 5 months.

 

Is it possible to run with an irritated Achilles tendon?

Yes, if the pain is not too intense and gradually subsides with suitable measures (see above).

 

Can I run if I have a heel spur?

If the pain is not too intense. Suitable insoles can help or massaging the sole of the foot (with a massage ball or tennis ball), stretching the toe flexors (crouching on tiptoe and with your knees facing forwards) and calf muscles.