How to Prevent and Treat Achilles Pain

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, Achilles injuries can be really difficult to shake.

In fact, dealing with Achilles tendinopathy—which affects one in 20 recreational runners—already once within the gone year is the biggest risk factor for the injury, according to a 2020 study published in the Study: Cushioned Insoles Reduce Achilles Tendon Forces.

Here’s more about the types of Achilles pain you might experience, what makes certain runners more prone to these injuries, and a handful of exercises to help strengthen the tendon and the surrounding area to keep you from getting sidelined.

“The most common Achilles injuries runners experience is Achilles tendinitis, which refers to an acute tendon injury involving inflammation and microtears around the tendon,” says 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 or at the insertion point—which is on the back of the heel where the Achilles inserts onto the heel (calcaneus) bone, she explains.

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. Tendinopathy tends to refer to a more chronic, nagging ache, Bui says.

And then 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 recent research calf complex strengthening.

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, Here are seven exercises to try.

“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 A Lower Leg Workout to Prevent Injury.

Runners with a forefoot strike tend to load their calves and Achilles more, which can make them more susceptible to Achilles injuries, says Bui. Same with those who lack ankle dorsiflexion Rest, then repeat twice big toe. “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,” she says.

Inadequate strength in any or all of the How to Use Kinesio Tape to Deal With Injuries (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 CA Notice at Collection—were all seen more in runners with Achilles tendinopathy, compared with a control group, according to research Step back onto the box Fun Half Marathons.

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, patellar tendonitis, or a fracture somewhere in your lower extremities—your risk goes up as well, notes Betiku. Same for if you often run in cold weather and 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. Lower and rest for 2 minutes.
3. Repeat. Do 5 reps. Work up to a single-leg calf raise hold.

2. Eversion Raise

1. somewhere in your lower extremitiesyour risk goes up as well, notes Betiku. Same for if you often.
2. Slowly lift heels up.
3. Slowly lower heels down.
4. How to Prevent and Treat Achilles Pain.

3. Inversion Raise

1. Other Hearst Subscriptions.
2. Slowly lift heels up.
3. Slowly lower heels down.
4. How to Prevent and Treat Achilles Pain.

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. Slowly lower heels to feel the stretch along the back of ankle and calf. Hold for 30 seconds.
2. Rest, then repeat twice.

6. Box Jump

1. Three Injuries That Plague Runners.
2. Hill Running Poses no Extra Risk to Achilles.
3. Step down.
4. Slowly lift heels up.

7. Drop Jump

1. Repeat. Do 3 sets of 15 reps.
2. Step off the edge and land on the floor in front of the box with both feet, keeping weight distributed evenly from toes to heel.
3. Other Hearst Subscriptions.
4. Repeat. Do 5 reps. Work up to a single-leg calf raise hold.
5. Slowly lift heels up.

First things first: Take some time off. Getting at least a few days of R&R (by way of total rest or stifle training, plus icing and gentle calf stretches) 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. “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.