How to Prevent Achilles Tears, Including Exercises

No running injury is good news, but an Achilles injury can be especially painful. It typically feels like a sharp pain that shoots through the back of your ankle every time you push off the ground with that foot. And unfortunately, figuring out how to protect your Achilles from pain isn’t always easy.

In fact, dealing with Achilles tendinopathy—which affects 1 in 20 recreational runners—once within the past year is the biggest risk factor for experiencing it again, according to a 2020 study published in the Journal of Science and Medicine in Sport.

Here’s more about the types of Achilles pain you might experience, exactly how to prevent more serious injuries like Achilles tears, and what makes certain runners more prone to injuries Effective Exercises to Ease Foot Pain.

Plus, steal a handful of expert-backed exercises to help strengthen the tendon and the surrounding area to keep you from getting sidelined.

Many runners experience Achilles tendinitis, which refers to an acute tendon injury involving inflammation and microtears around the tendon, explains Anh Bui, D.P.T., C.S.C.S., a former collegiate runner, physical therapist, and biomechanics specialist in Oakland, California.

“Acute” means the pain is usually fairly short-lived (i.e., it lasts less than three months). You can feel the pain in the middle of the tendon (more common) or at the insertion point—which is on the back of the heel where the Achilles inserts onto the heel (calcaneus) bone, she explains.

John Vasudevan, M.D., director of the running and endurance Sports Medicine Program at Penn Medicine says acute Achilles tendinitis is usually caused by a sudden or out-of-the-ordinary change to running pace, terrain, or shoe type.

Achilles tendinopathy (which is sometimes used as a catch-all term for tendon issues), typically involves a gradual onset of pain and stiffness around the Achilles. It’s often caused by a cumulative strain on the tendon, Vasudevan says, which is why it’s common in runners.

What to Do If You Have Achilles Pain.

Vasudevan says experiencing Achilles pain at the insertion point and on both heels at once could relate to other medical issues, like diabetes or rheumatologic diseases, especially if you feel other body aches. So you definitely want to visit a doctor if that’s the case.

Finally, there’s an Achilles rupture, which is much more severe. “This is when tears in the tendon eventually cause a partial or complete break,” says Adefemi Betiku, D.P.T., C.S.C.S., a physical therapist in New Jersey. “It feels like a pop at the back of your heel or calf and is extremely painful.”

This injury is less common, but the incidence is on the rise. Nearly 82 percent of all Achilles ruptures occur in people participating in a sport or recreational activity; basketball is by far the most common, but running (along with hiking and stretching) accounts for 5.8 percent of ruptures, according to research A big risk factor is limited.

Aside from that telltale pop or snap associated with a rupture, there’s a good chance you’ll feel a shooting pain in the back of your ankle with Achille tendonitis or tendinopathy—especially when you’re on your tiptoes or pushing off the ground while running. But the ache doesn’t always present the same way and can vary in severity, says Hamish Vickerman, a physiotherapist based in Australia.

“Morning stiffness in the tendon is a common sign in Achilles issues, particularly tendinopathy,” he says. “In milder cases, some people may experience an initial improvement or reduction in pain with activity or movement as the tendon warms up—that’s known as the ‘warmup effect.’”

You may also notice swelling or redness in the area, but not always, and the area will also likely be tender to the touch.

Upping your mileage quickly is a common cause of Achilles aches, as is increasing your intensity aggressively—that is, adding in too many speedy intervals or too many hills too soon, notes Vickerman.

Runners with a forefoot strike tend to load their calves and Achilles more, which can make them more susceptible to Achilles injuries, says Bui. (This is particularly true when runners switch from rearfoot or midfoot striking to a forefoot strike too quickly, Vasudevan adds.)

A big risk factor is limited ankle dorsiflexion Advertisement - Continue Reading Below big toe can also increase risk of Achilles issues. “You might not realize it, but you can be compensating for this by increasing the load to the soft tissue structures around the ankle joint, such as the Achilles,” Bui says.

Inadequate strength in any or all of the John Vasudevan, M.D (read: your gastrocnemius and soleus, peroneals, posterior tibialis, and tibialis anterior) can also up your risk. These contributing factors—along with low hip abduction and and tibialis anterior can also up your risk. These contributing factors—along with low—were all seen more in runners with Achilles tendinopathy, compared with a control group, according to research Three Injuries That Plague Runners Physical Therapy in Sport.

Weak gluteus maximus muscles (the biggest muscle of your backside) can also lead to Achilles pain, as it’s meant to provide the most power on your push-off, Vasudevan says. Sometimes it’s that runners lack London Marathon Results, London Marathon Results.

Men and older runners have a higher incidence of Achilles injuries, especially tendinopathy. And if you have a history of other injuries in the area—including plantar fasciitis, Nutrition - Weight Loss fracture somewhere in your lower extremities—your risk goes up as well, notes Betiku. Same for if you often resistance training and or if you’ve used medical steroids for a long period of time.

Luckily, there are several easy, no-gear exercises you can add to your routine to gradually increase the load on your Achilles tendons and help prep it for running injury-free.

“To proactively negate the risk of Achilles issues, the emphasis should be on maintaining Achilles load capacity,” says Vickerman. “This can be achieved through a consistent regimen of calf complex strengthening, incorporating heavy, slow resistance training and plyometric exercises, all aimed at improving tendon health and optimizing energy storage and release within the tendons.”

Here are seven exercises to try:

1. Calf Raise Hold

1. Stand with heels off the edge of a step, then lift heels. Hold for 45 seconds.
2. Slowly lower and rest for 2 minutes.
3. Repeat. Do 5 reps. Work up to a single-leg calf raise hold.

2. Eversion Raise

1. The Great Tendinopathy Debate.
2. Immediately hop up straight, landing softly again.
3. Weak gluteus maximus muscles.
4. How to Treat Tight Calves.

3. Inversion Raise

1. Vasudevan says experiencing Achilles pain at the insertion point and on.
2. Immediately hop up straight, landing softly again.
3. Weak gluteus maximus muscles.
4. How to Treat Tight Calves.

4. Single-Calf Drop

1. Stand with heels off the edge of a step.
2. Lift heels, then stand on the affected leg and slowly lower that heel off the edge of the step.
3. Repeat. Do 3 sets of 15 reps.

5. Step Stretch

1. Stand with heels on the edge of a step.
2. Repeat. Do 5 reps. Work up to a single-leg calf raise hold.
3. Rest, then repeat twice.

6. Box Jump

1. Stand with feet hip-width apart in front of a box at least 12 inches high.
2. Lower into a half squat, then jump up onto the box, landing softly at the top.
3. Stand up.
4. Step down.
5. aggressively—that is, adding in too many speedy.

7. Drop Jump

1. Stand with feet hip-width apart on a box.
2. Step off the edge and land softly on the floor in front of the box with both feet, keeping weight distributed evenly from toes to heel.
3. Immediately hop up straight, landing softly again.
4. The Different Types of Achilles Injuries.
5. aggressively—that is, adding in too many speedy.

First things first: Take some time off. Getting at least a few days of R&R (by way of total rest Health & Injuries calf stretches, as well as core strengthening) at the first signs of aches in your Achilles can help a lot when dealing with the initial painful stage, says Bui.

But after those few days of dialing it back, get back to activity (as long as the pain isn’t getting worse or you’re feeling any numbness, weakness, tingling, or instability). “Tendons need progressive loading over time to heal,” Bui explains. “Resting a tendon for weeks or months usually does not promote healing.”

For any ongoing tendinopathy (a.k.a., aches that last three-plus months), Betiku advises talking to a doc or physical therapist. They can help you figure out the best plan to get you back up and running while nixing the aches for good—instead of risking re-injury.

Laurel Leicht

Laurel Leicht is a writer and editor in Brooklyn. She's covered health, fitness, and travel for outlets including Well+Good, Glamour, and O, The Oprah Magazine.

Medically reviewed byJohn Vasudevan, M.D.

Sports Medicine Director & Medical Advisor

John Vasudevan, M.D. is an associate professor at the University of Pennsylvania. He is board-certified in Physical Medicine & Rehabilitation and Sports Medicine. He is a Team Physician for UPenn Athletics and  medical director of the Broad Street Run and Philadelphia Distance Run, and previously for the Rock 'n' Roll Half-Marathon and Tri-Rock Triathlon in Philadelphia. He is a director of the running and endurance Sports Medicine Program at Penn Medicine.  Dr. Vasudevan provides non-operative management of musculoskeletal conditions affecting athletes and active individuals of all levels, and combines injury rehabilitation with injury prevention. He utilizes a variety of ultrasound-guided procedures and regenerative approaches such as platelet-rich plasma and percutaneous ultrasonic tenotomy. He sees patients at the Penn Medicine and the Philadelphia Veterans Administration hospital. Dr. Vasudevan attended medical school at the University of Wisconsin School of Medicine and Public Health in Madison. After his Transitional Year in Tucson, Arizona, he went to residency in PM&R at Thomas Jefferson University in Philadelphia and onwards to Stanford University for his fellowship in Sports Medicine. He has been in practice at the University of Pennsylvania since 2012.