How Runners Can Solve a Sore Achilles Problem

Many runners are familiar with the burning sensation that accompanies Achilles tendinopathy. What starts as a dull ache soon grows into a fiery pain, quickly evaporating any chance of a successful workout.

One might even say it’s every runner’s Achilles Heel (sorry, I couldn’t resist).

But Achilles tendinopathy is actually quite common—and luckily, it’s usually fairly easily to treat (unlike IT Band Syndrome, which is often trickier and more stubborn). It’s important to know that there’s no such thing as Achilles tendinitis, which must include inflammation because of the ‘itis’ suffix.

“The Achilles tendon is incapable of swelling (the bursae—a tiny sac of fluid between the Achilles and heel can swell, but that’s different),” according to Jay Dicharry, a physical therapist and biomechanics expert at Rebound Physical Therapy in Bend, Ore. “We should call the injury Achilles tendinopathy. Basically, the tendon is weak and dysfunctional, and thus compromised.”

Therefore, treatment includes strengthening and correcting the function of the Achilles tendon. There are two stages of Achilles tendinopathy treatment: the acute stage and the rehabilitation phase.

The Acute Stage of Achilles Tendinopathy

The first phase of treatment begins as soon as the injury starts and usually lasts about 1-3 days. The goals during this stage are to reduce pain and manage any swelling around the Achilles tendon.

This is when the standard RICE (Rest, Ice, Compression, Elevation) treatment is very helpful. Runners with a painful Achilles tendon should stop running, ice the painful area, use compression socks, and elevate the leg for 10-15 minutes 1-2 times per day.

Wearing shoes with a slightly higher heel-toe drop can also reduce the stress on the tendon. Spending time barefoot or in zero-drop shoes can further irritate the tendon, so it’s best to give the Achilles more support during this phase of treatment.

This approach can help you manage the early pain signals from the injury but it probably won’t heal it outright. There needs to be a much more specific treatment plan after the acute phase of the injury.

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