Achilles tendonitis – preventative exercises and how to treat it

skipping and jumping, introduced gradually so as not to overly irritate the tendon plantar fasciitis and runner's knee, Achilles tendonitis, alongside running injury. The terminology, however, isn't quite right. ‘In most cases,’ says running physio Tom Goom, ‘the more accurate term is "achilles tendinopathy". That’s because ‘itis’ suggests the tendon’s inflamed, and it’s rarely an inflammation problem.’

For the purposes of this article, we’ll use the more commonly understood achilles tendonitis, but just know that, technically, achilles tendinopathy more accurately labels the symptoms most runners will experience.

It's an injury that can significantly impact performance, halt running completely and, at its worst, impact quality of life. With the help of Goom, in this article we’ll explore the signs, treatment options, rehabilitation phases and preventative measures runners can take to manage the condition effectively.

What are the signs of achilles tendonitis?

For fast and effective treatment, the key is recognising the signs early. Symptoms typically include:

• Pain located within the tendon itself, often aggravated by running
• If youre unsure whether youve got potential achilles tendinitis/tendinopathy, or just some general
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If you're unsure whether you've got potential achilles tendinitis/tendinopathy, or just some general post-run soreness, Goom advises paying attention to where exactly the pain or discomfort is located. 'If the pain feels like it's within the tendon itself,' he says, 'that’s a concern.'

What causes it?

Most of the time, symptoms of achilles tendonitis stem from overuse. ‘What often happens in runners,’ says Goom, ‘is that they increase some part of their training too much – they might start doing more speedwork or hill training – and the tendon reacts by swelling and becoming sore.’

There are also several risk factors can predispose runners to the condition:

• Age: It’s more common in older athletes due to structural changes in the tendon
• Gender: Research suggests older male athletes are at a higher risk
• Calf strength: If the calf muscle isn’t very strong, the tendons start to get overloaded and irritated

‘General health factors can also influence tendon health,’ says Goom. ‘Factors such as diet, BMI, and lifestyle choices can directly impact recovery. For that reason, good nutrition Advertisement - Continue Reading Below.'

How to treat achilles tendonitis

Before taking any recovery steps, Goom stresses the importance of seeing a healthcare professional, should you be experiencing symptoms of achilles tendonitis. 'Understanding the specific issue within the tendon is crucial,' he says, 'as different regions may require different approaches.'

Strength exercises

The best way to prevent achilles tendonitis from occurring in the first place, advises Goom, is to 'plan training so it’s at a manageable level and progresses gradually.' This steady approach, he adds, is 'essential to prevent tendon overload and irritation.'

With a gradual training plan in place, it's time to build up your calf muscles. ‘Generally speaking,' says Goom, 'strengthening the calf muscle in a manageable way for the tendon is likely to help.' That's mainly because strong calves are better able to tolerate the forces of running. Weak calves, on the other hand, can lead to the achilles tendon being overloaded, making it more susceptible to irritation and injury.

How to spot and fix IT band syndrome:

1/ Standing calf raise

Stand with your feet hip-width apart and place your hands on a sturdy surface for balance if needed. Slowly rise onto the balls of your feet, lifting your heels as high as possible while engaging your calf muscles, then hold for a moment at the top of the movement. Lower your heels back down to the starting position in a controlled manner. Aim for 3 sets of 10-15 reps, adding gradually heavier weight (by holding a pair of light dumbbells) to progress.

2/ Seated calf raise

Sit on a sturdy chair or bench with your feet flat on the ground, shoulder-width apart. Keeping your knees stable, lift your heels off the ground by pushing through the balls of your feet. Hold the top position for a moment, feeling the contraction in your calves, then slowly lower your heels back down to the starting position. Aim for 3 sets of 10-15 reps. To progress, increase the resistance by positioning a dumbbell across your knees.

3/ Calf raise on seated leg press machine

Start by sitting upright in the machine, with your back against the seat and your feet placed shoulder-width apart on the footplate, with your heels hanging off the edge. Choose an appropriate weight for resistance. Push through the balls of your feet to raise your heels as high as possible while keeping your legs straight, engaging your calf muscles. Hold the elevated position for a moment before slowly lowering your heels back down. Aim for 3 sets of 10-15 reps.

Rehab phases for treating achilles tendonitis

Goom explains rehab typically involves a three-phased approach. Although he warns that 'it's essential any challenging exercises or weights are supervised by a professional'.

Phase 1: Reduce pain

'Phase one would focus on reducing pain,' he says, 'especially if someone has severe achilles pain. In this phase, we might use isometric exercises or low-level calf work that's comfortable for the tendon, alongside load management, encouraging the runner to reduce their training to a manageable level or take a short break if necessary.'

Phase 2: Build strength

'Phase two involves more progressive rehabilitation,' says Goom. 'Once symptoms have settled, we might start progressive calf work and gradually rebuild their running.'

Phase 3: Restore power

'The final phase, which may not be necessary for all runners, is a power phase aimed at restoring springiness and power to the tendons,' adds Goom. 'This includes plyometrics, What everyones reading.'

How long does it take to recover from achilles tendonitis?

As with any injury, recovery time can vary wildly from runner to runner. ‘Someone might experience improvement within a week or two if they manage symptoms quickly,’ says Goom. ‘But complex cases can require a year or more for a full recovery. Because of that, it’s important runners don’t wait until symptoms become severe before seeking help.’

If you suspect you have achilles tendonitis, the first thing to do is speak to a physio. They will be able to properly diagnose the issue and potentially provide you with a tailored strength programme. By focusing on calf strength, following a structured rehab approach, and fine-tuning overall health, it's possible to effectively manage and prevent the injury. However, as Goom concludes, ‘If in doubt, get checked out.’