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Achilles tendinopathy, one of the most common overuse injuries in runners, results from the gradual degeneration of the Achilles tendon due to repetitive stress. As the thickest tendon in the body, the Achilles is built to handle heavy tensile loads, but it isn’t immune to injury, especially if stress builds up faster than the body can adapt. The tendon connects the calf muscles—primarily the gastrocnemius and soleus—to the heel, allowing for the powerful push-off motion that propels you forward while running. Let’s break down the main culprits behind Achilles tendon issues and how to prevent them.
Top Reasons for Achilles Tendon Pain
1. Training Errors: Doing Too Much, Too Soon: The most common cause of Achilles issues is a training error—essentially, adding intensity or mileage too quickly. The Achilles tendon takes time to adapt to new stress levels, which vary by individual based on factors like sleep, nutrition, muscle flexibility, and mental stress. Going from 10 to 20 miles in a week or introducing fast intervals before your body is prepared creates strain beyond what the tendon is ready to manage, leading to breakdown at a cellular level.
2. Limited Hip Extension: If your running form is restricted by a lack of hip extension, your calf muscles end up doing more work to propel you forward. This overuse, especially during the push-off phase, places an extra load on the Achilles. Poor hip extension may also force your ankle to compensate by driving the foot back excessively, which can overload the tendon. To prevent this, incorporate exercises to improve hip mobility and activate your glutes.
3. Excessive Pronation: When you overpronate (rolling your foot inward excessively), the Achilles tendon experiences a “wringing” effect. This twist stresses the tendon, which is designed to handle straight, tensile force rather than twisting stress. Over time, microtrauma from this torsional force weakens the tendon. Addressing this issue with appropriate shoes or orthotics, along with strength training for foot and ankle stability, can significantly help.
Prevention Tips for Achilles Tendon Health
Achilles issues can be avoided with a consistent approach to strength and flexibility training. Here are some evidence-based strategies for prevention:
Strengthen Your Calf Muscles: Incorporate eccentric calf raises three times a week to target the Achilles tendon’s resilience. Strengthen the foot’s arch and work on hip abduction and rotational control exercises to keep your entire kinetic chain aligned.
Maintain Flexibility in the Hips, Spine, and Ankles: Limited mobility in these areas can compromise running form and load distribution. Make sure your hip flexors are not too tight, as this can restrict hip extension. Regular thoracic spine mobility exercises and ankle flexibility drills will also keep your lower body moving efficiently.
Build a Sustainable Training Schedule: Pushing through fatigue or stress only heightens your injury risk. Listen to your body and don’t be afraid to adjust your schedule when needed to avoid overload.
Already Dealing with Achilles Pain?
If you’re struggling with Achilles tendinopathy, don’t lose hope. The RUNsource app, available in the Apple and Google Play stores, offers comprehensive rehab programs developed by running medicine experts to guide you through recovery. For immediate steps, consult a physical therapist who can perform a gait analysis, recommend targeted strengthening and mobility exercises, and advise on the best footwear for your needs. Plus, on our website, you can download a free guide with expert tips to improve your performance and prevent injury.
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