Achilles Tendinitis: The Overuse Injury Every Runner Should Know About

The Achilles tendon, which connects the calf muscles to the heel bone,  is the largest tendon in the body. It’s a workhorse tendon. You rely on it when you walk, run, climb stairs, jump, and stand up on your toes. 

The tendon can withstand significant force and stress, but it’s also prone to tendinitis, inflammation that comes with overuse. It has a limited blood supply, so inflammation is difficult to resolve, leading to long-term or chronic pain. 

Every runner should understand the causes and effects of Achilles tendinitis to prevent the injury when possible and treat it properly when it occurs.

At Keck Medicine of USC, Orthopaedic Surgery, our team of expert orthopaedic specialists sees many cases of Achilles tendinitis at our Los Angeles, California, location. This overuse injury is common and easily preventable, so we’ve developed this guide to help you protect yourself from injury and know what to do if you experience Achilles tendinitis. 

How Achilles tendinitis gets started

Achilles tendinitis isn’t generally related to a specific injury but to repetitive stress or overuse.

Runners need to understand the training behaviors that increase the risk of developing Achilles tendinitis and those that help you avoid the injury altogether.

Runners are more likely to develop Achilles tendinitis if they:

• Rapidly increase their running mileage or speed
• Do too much too soon after a break from running or exercise
• Add hills or stair climbing to their training routine
• Neglect calf stretching before and after they run
• Wear worn-out shoes with no arch or heel support

Achilles tendinitis can also develop after a sudden trauma that involves a hard contraction of the calf muscles, such as a push to cross the finish line in a race. 

Your risk for Achilles tendinitis also increases as you age. You’re also more susceptible if you have high blood pressure, psoriasis, or obesity. 

If you have a naturally flat arch in your foot or fallen arches, your Achilles tendon experiences more significant strain with activity. We can help you choose the right type of shoes to support your arch and heel while running to prevent damaging the tendon. 

Treating Achilles tendinitis

We typically treat Achilles tendinitis with conservative measures. Start with the RICE method — rest, ice, compression, and elevation — to relieve stress on the tendon and allow it to begin to heal.

Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) are also a good option. Relieving the inflammation will help to ease the pain.

Physical therapy (PT) is a tried-and-true method for healing. Proper calf stretching and other exercises can target and strengthen the Achilles tendon, helping to prevent further injuries.

If your Achilles tendinitis doesn’t respond well to conservative treatments, we may recommend platelet-rich plasma (PRP). Some studies on PRP injections have shown improvements in pain. However, the treatment is still experimental, and more information is needed to determine how effective PRP is in this situation.

Night splinting uses removable braces that hold your foot in place with your toes pointing upward while you sleep, stretching the tendon. This provides significant relief from the pain that comes in the morning when you first get out of bed.

Orthotics are custom-made shoe inserts that support and cushion your foot. They pair well with tailored shoes that are softer inside or open at the back so they don’t irritate the heel bone and the Achilles tendon. Heel lifts are devices that decrease the strain on your tendon.

If you’re a runner, it’s important to take care of your legs and feet so they don’t suffer an acute or overuse injury. Keck Medicine of USC, Orthopaedic Surgery, can help you find a preventive routine that works for you. Call us at 323-442-5860 to learn more, or book online today.