What To Do If You Experience Achilles Pain While Running

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• What to Do if You Experience Achilles Pain Running
• Symptoms of Achilles Tendinitis
• Common Causes of Achilles Tendinitis
• Treating Achilles Tendinitis
• Preventing Achilles Tendinitis

If you’ve ever experienced Achilles pain while running, you already know how unpleasant it feels. And if you haven’t, congrats! Regardless, every runner should learn how to keep this important tendon healthy.

The Achilles tendon connects the two major calf muscles—the gastrocnemius and soleus—to the back of the heel bone. Under too much stress, the tendon tightens and is forced to work too hard. This causes irritation or inflammation, also known as Achilles tendinitis.

Over time, a layer of scar tissue, which is less flexible than the tendon, can cover it. Continued inflammation or stressing of the Achilles can cause a very serious injury like a tear or rupture.

If you’re dealing with a sore or painful Achilles tendon, especially while running, here’s everything you need to know to keep Achilles issues from derailing your performance.

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What to Do if You Experience Achilles Pain Running

If you start to feel Achilles pain during a run, the solution is simple: stop running. Take a break and chat with a professional in case something serious is going on in your lower leg.

“An irritated Achilles tendon can turn into more serious tendinitis and a partial or complete tear of the Achilles in very rapid succession,” says Jordan Metzl, MD, a sports medicine physician at the Hospital for Special Surgery in New York City. “So if your Achilles hurts and that’s changing the way you run, it’s time to start cross-training. You don’t want to make a bad injury worse by running through it.”

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Symptoms of Achilles Tendinitis

Achilles tendinitis is usually characterized by dull or sharp pain anywhere along the tendon, but usually closer to the heel. Other signs you might have Achilles tendinitis include: limited ankle mobility, redness or a burning sensation in the Achilles area, a nodule (lumpy buildup of scar tissue) that you can feel on the tendon, or a cracking sound (scar tissue rubbing against the tendon) when your ankle moves.

Pain in the lower portion of the Achilles region is more serious due to the limited blood flow to that area.

Over time, Achilles tendinitis can result in a degenerative tear of the tendon that shows as a lump in the area, especially if left untreated. If you feel a lump, consult a physician immediately.

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Common Causes of Achilles Tendinitis

Tight or fatigued calf muscles, which transfer too much of the burden of running to the Achilles, can be brought on by not stretching the calves properly, increasing mileage too quickly, or simply overtraining.

Excessive hill running or speedwork, both of which stress the Achilles more than easy or long running, can also cause tendinitis.

Stiff running shoes can also cause some cases because they may force the Achilles to twist. Runners who overpronate (when the feet rotate too far inward on impact) are most susceptible to Achilles tendinitis.

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Treating Achilles Tendinitis

If you feel a lump or a nodule in the Achilles area, go see a physician immediately.

Otherwise, to reduce swelling and ease irritation, Metzl suggests icing the area for 15 to 20 minutes several times a day until the inflammation subsides. You can also try anti-inflammatory medicines such as ibuprofen or anti-inflammatory creams. Self-massage of the calf muscles may also help.

If the injury doesn’t respond to home treatment in two weeks, see a doctor or physical therapist for next steps. Your last resort should be seeking out an orthopedic surgeon because generally, surgery to scrape scar tissue off the tendon is not very effective and often just stimulates more scar tissue.

What’s more important than just addressing the symptoms is treating the root of the problem. One common culprit is tightness in the calf muscles. Stretching your calves regularly—say for two minutes every day—can help.

Foam rolling can also offer relief. Be sure to target the calf muscles themselves and not the tendon area when foam rolling, Metzl adds. Rolling the tendon could provoke more unwanted issues.

Another treatment option is strengthening the calf muscles with eccentric strength exercises like this calf raise.

How to Do an Eccentric Calf Raise

Why it works: Eccentric exercises like this calf raise apply load to the calf muscle while it is lengthened, strengthening the muscle to take strain off of the Achilles tendon.

How to do it:  

1. Stand with heels off the edge of a step and come up onto toes of both feet
2. Then, lift left foot off step and stand on just right foot. Slowly lower right heel past the edge of the step for a count of 5.
3. Place left foot down to come up onto toes with both feet again.
4. Repeat. Do 2-3 sets of 15 reps, 2-3 times a week

Don’t start running again until you can do calf raises pain-free. Next, move on to jumping rope, then jumping jacks. Once you can do all those, gradually begin running again. You should be back to easy running in six to eight weeks.

Metzl suggests staying away from high-impact, weight-bearing exercises while your Achilles tendinitis is healing. He recommends low-impact activities like swimming, pool running, or cycling in a low gear.

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Preventing Achilles Tendinitis

To prevent Achilles tendinitis, it’s important to strengthen the muscles in your calves and feet. “The stronger the muscles, the less the loading force is on the tendon,” Metzl says.

Stretching your calves is also key for prevention. One of the best stretches is also the simplest, and very similar to the above calf raise exercise.

Calf Stretch

1. Stand on balls of feet on stairs or a raised platform so heels hang off the edge.
2. Lower both heels down towards the ground and hold for 30-60 seconds seconds. To increase the intensity of the stretch, keep one foot flat on the stair and lower the other heel. 
3. Then switch legs.

Achilles tendinitis is also linked to overstriding—when your foot touches down in front of your body. Metzl suggests shortening your stride and quickening your cadence to avoid this.

You can also try these additional preventative measures: Experiment with more supportive shoes or orthotics to help control foot pronation, avoid running in worn-out shoes, ease into any running program, and incorporate more rest days into your training schedule.

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