Running Injury Prevention Achilles Tendonitis Symptoms, Prevention, and Treatment By Christine Luff twitter linkedin Christine Many Luff is a personal trainer, fitness nutrition specialist, and Road Runners Club of America Certified Coach. Learn about our editorial process Christine Luff Reviewed by Reviewed by Michael Lau, PT, DPT on June 30, 2019 facebook twitter linkedin instagram Michael Lau, PT, DPT, CSCS, is a licensed physical therapist, strength and conditioning coach, and co-founder of The Prehab Guys. Learn about our Review Board Michael Lau, PT, DPT Updated on March 11, 2020 Print Pixelfit / E+ / Getty Images Table of Contents View All Table of Contents Symptoms Causes Prevention Treatment Achilles tendonitis is an injury that occurs when your Achilles tendon, the large band of tissues connecting the muscles in the back of your lower leg to your heel bone, becomes inflamed or irritated. Symptoms The signs and symptoms of Achilles tendonitis often develop gradually. You'll feel pain and stiffness in your Achilles (back of your ankle), especially when you first get out of bed or after sitting down for a long period of time. The inflammation is commonly at the most narrow point of your tendon, just above your heel. The pain sometimes lessens as you do a warm-up run, and may even disappear as you continue running. But once you stop, the pain returns and may feel even worse. You may also notice a crackling or creaking sound when you touch or move your Achilles tendon. There may also be mild swelling or a small bump on your tendon. Depending on how long you've been experiencing these symptoms, you may not have swelling. You may also notice thickening of your Achilles tendon, which is known as Achilles tendinopathy. Causes When you place a large amount of stress on your Achilles tendon too quickly, it can become inflamed from tiny tears that occur during the activity. Achilles tendonitis is often a result of overtraining or doing too much too soon. Excessive hill running can contribute to it. Flattening of the arch of your foot can place you at an increased risk of developing Achilles tendonitis because of the extra stress placed on your Achilles tendon when walking or running. You're more at risk for Achilles tendonitis if you're inflexible (especially in your calf muscles) or if you overpronate (feet roll inward when your run). It may also be caused by a sudden or hard contraction of your calf muscle, such as when you're sprinting. Higher BMI is another risk factor. Changes in shoewear (such as switching to a minimalist shoe), or changing running style (transitioning to a forefoot strike pattern running on the balls of your feet) can also contribute to Achilles tendonitis risk. Common Running Injuries Prevention Be especially careful and don't overdo it when you introduce speed training or hill training into your regimen. Don't do a hard workout two days in a row. Strengthen your calf muscles with exercises such as toe raises. Especially if you wear a minimalist shoe, work on strengthening your intrinsic foot muscles as well. Work low-impact cross-training activities, such as cycling and swimming, into your training. If you're just getting started with your training, be sure to stretch (especially your calves) after running, and start slowly, increasing your overall weekly mileage by no more than 10 percent per week. Treatment Use the R.I.C.E method of treatment when you first notice the pain. Although rest is a key part of treating tendonitis, prolonged inactivity can cause stiffness in your joints. You should definitely take a few days off from running, but make sure you move the injured ankle through its full range of motion and perform gentle calf and ankle stretches to maintain flexibility. If self-care doesn't work, it's important to get the injury treated because if the tendon continues to sustain small tears through movement, it can rupture under excessive stress. Your doctor may suggest a temporary foot insert that elevates your heel and may relieve strain on the tendon. Other possible treatments include special heel pads or cups to wear in your shoes to cushion and support your heel, or a splint to wear at night. Physical therapy may also help allow the tendon to heal and repair itself over a period of weeks. Is It Okay to Take a Week Off From Running? Was this page helpful? Thanks for your feedback! Whether you're looking to run faster, further, or just start to run in general, we have the best tips for you. Sign up and become a better runner today! Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Fit uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. American Academy of Orthopaedic Surgeons. Achilles Tendonitis. Updated June 2010. Klein EE, Weil L, Weil LS, Fleischer AE. Body mass index and achilles tendonitis: a 10-year retrospective analysis. Foot Ankle Spec. 2013;6(4):276-82. doi:10.1177/1938640013489343 KidsHealth from Nemours. Achilles tendonitis. Updated May 2019. Sussmilch-leitch SP, Collins NJ, Bialocerkowski AE, Warden SJ, Crossley KM. Physical therapies for Achilles tendinopathy: systematic review and meta-analysis. J Foot Ankle Res. 2012;5(1):15. doi:10.1186/1757-1146-5-15