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Introduction

Achilles Tendinitis is a condition that causes pain, swelling and stiffness of the Achilles tendon that joins your heel bone to your calf. There are two types of Achilles Tendinopathy pain:

Insertion pain - pain in the heel at the bottom of the achilles

Mid-portion pain (most common) - Pain around the middle of the tendon, a few cm above the heel

Signs and Symptoms

Common signs and symptoms of Achilles Tendinitis may include:

  • Pain when you take your first few steps in the morning

  • Stiffness and discomfort in the Achilles when you wake up

  • The pain subsiding as the day goes on

  • Your Achilles tendon warms up as it gets loaded

  • The pain gets worse in your Achilles the day after you exercise

Causes

1. Sharp increase in training load

A common cause of Achilles Tendinitis is increasing your training load too early too soon. When running, you want to make sure you are increasing your weekly mileage and the number of runs that you do per week steadily. For your weekly mileage, you should look to increase this no more than 10% per week and your days per week no more than once when starting a new plan. Sharp increases in your training load (e.g., jumping from running once per week to three times per week) can put excess straight on your body, including your Achilles tendon, which in turn can result in Achilles Tendinitis.

2. Reduction in your calf strength

Poor calf strength can also put excess stress through the achilles and result in Tendinitis.

Treatment

1. Decrease your training load

When returning to exercise, you should adapt the traffic light system so ensure you are are not delaying your recovery. If you get any pain in Amber or Red, it is advised that you stop running as this will likely delay your recovery.

Green = 0-3 pain, Amber = 3-5 pain, Red = 5+ pain

In the short-term, make sure to take time away from running to let your tendon pain reduce. Stay active with activities such as walking and cycling, but avoid high impact sports. Once your pain has subsided, look to gradually build back into running with some easier runs until you are able to run comfortably without pain. You can adjust the number of runs per week, or your running ability, easily from within the Runna app and your plan will adapt accordingly.

2. Increase your strength and mobility

As well as the above, you should look to build up control and strength around the tendon. Watch the video above for the full tutorials.

Heel raises (source)

Stand on a raised platform (e.g., a step) with a single leg and take 3 seconds to raise your body up and down. This will both strengthen your calf but also stretch it when your heel is lower than your toes. Look to do this 2x per day at the start, each time doing 3 rounds of 10-12 reps. You can look to add on additional weight to further strengthen your calf muscles and reduce the risk of your tendon flaring up again.

Romanian deadlift (source)

Take a dumbbell in one hand and stand on the opposite leg with a slight bend in the knee. Extend the dumbbell down towards the floor, tilting your body forward and lifting the leg on the same side of your body up behind you. Gradually increase the weight to further strengthen your hip.

Hip external rotation strengthening (source)

By strengthening your hip external rotators, it will help keep your legs straight as you run. Lie on the ground on your front and bend one of your legs at 90 degrees. Loop a band around your foot and tie the other end to a chair, fixture or get another person to hold it for you. Drive your foot inwards over the other leg for 3 rounds of 10-12 reps. Look to gradually increase the resistance of the band.

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