Achilles injuries in runners

Dealing with running achilles injuries

Achilles problems are common to runners and may stem from overtraining, inflexibility, incorrect running shoes, or poor biomechanics. Here's the guide to avoiding achilles injuries and what to do should you sustain one.

Achilles injuries are notoriously slow healers since the achilles has a poor blood supply. Soft tissue injuries like a pulled hamstring can clear up in weeks, while an achilles injury can take months.

Problems with the achilles often start when there is some twisting of the achilles tendon due to poor biomechanics of the lower legs. This twisting puts undue strain on the achilles area and thus weakens it causing tiny tears to the tendon. The often produces swelling and a feeling of creaking in the achilles itself.

Creakiness is the most common achilles injury and can be cured most of the time, if it is caught early enough. This is called achilles tendonitis and is caused by inflammation of the achilles tendon itself or its covering sheath. The main causes of achilles tendonitis are overuse and injury.

Signs and symptoms of achilles running problems 

Overuse injury. Pain may be felt before and after running, but generally eases off during the actual running. If ignored, then over time, the pain can become more constant, often throbbing, making running near impossible. After a prolonged period of inactivity, such as sleeping at night, there may be severe stiffness in the achilles, making it difficult first thing to come downstairs.

Overuse injuries to the achilles may be caused by the following

  • Overtraining, or a change in training methods.
  • Inappropriate running footwear.
  • Tight muscles, especially in the calf area.
  • High impact or repetitive activities.
  • Underlying foot problems.
  • Unaccustomed activity, for example: the first run after time off.

Traumatic injury. Pain usually has a sudden onset, just above the heel. This may change to a constant dull pain, usually felt when overstretching the damaged soft tissue. There may be some swelling and heat around the tendon after the injury and movement may be limited, with an inability to walk normally, run, stand on tiptoe or pull the foot up.

If you suspect serious injury and you are unable to walk or put your foot on the ground, or if the pain gets worse, then seek medical advice.


Treating an achilles injury using the P.R.I.C.E technique


Protect the injured tendon for the first couple of days, either with a protective covering or a small heel raise in the shoe to rest the tendon in a shortened position and prevent overstretch.


Rest the injured achilles and give any inflammation a chance to settle down.


Use a covered ice pack on the injured area. Use for 10 to 15 minutes. Remember not to apply the ice directly to the skin as ice can burn.


Apply some pressure to the ankle with a compression bandage to reduce any swelling.


If there is any swelling, keep the foot up and this will help the fluid to drain away.

Compression may not be necessary if the injured leg is elevated. From the second or third day, start to gently exercise the injured tendon. Start to walk as much as discomfort allows. You may feel a stretch, but at no time must this be painful.

Over the next few days as symptoms subside, start gentle stretches to the achilles tendon. Increase the speed of walking and gradually introduce jogging. Build up to running as improvement allows.

Finally check your running shoes and make sure they are not overly worn and that they are suitable for your running gait. The type of running shoe you have can make a massive difference to your chances of picking up an achilles injury. This is why it is is of vital importance to get your shoes from a specialist running shoe retailer.

For some runners, the heel tab in their trainers may be a source  of soreness if it is rubbing on the achilles area. By making cuts in the heel tabs you can release some of the pressure that is being exerted on the achilles. Most people won’t need to do this as it only affects around 10 per cent of achilles sufferers.

It is important not to make the cuts too long, as this can cause more problems than it solves. All you are trying to do is reduce the pressure exerted from the heel tab onto your achilles. Start with a cut in the middle of the tab and go down no more than 1cm. Around six to seven small cuts will be ideal, but if you want to test this out, start with around three and see how this feels. You should notice a difference immediately when you run, as the rubbing on the achilles should have stopped.

Another possible solution to your achilles problem is to visit a biomechanist or podiatrist to get your feet assessed for possible orthotic inserts, which will correct any abnormalities in your running gait.

Achilles injuries can be frustrating and take a fair amount of time to heel. It is important to act upon any discomfort in the achilles area, not to ignore it, and the problem will only worsen until you eventually break down. By being cautious about it and taking steps you can prevent an achilles niggle becoming a long-term achilles injury or even a full on achilles rupture.

Comments (2)

  • TonySmith2 'Couldn't be more in agreement about the achilles being a real slow healer. didn't really know the reason why, but now I'm enlightened. My daily penance is a series of stretches to help alleviate my problems.'

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  • RuddysMarathonEffort 'Ditto. I injured mine in Feb 08 but continued training and ran Edinburgh Mara in May. Result achilles knackered! Don't make my mistake, stop when you get injured! Feb 09, still not running!! Slow healer!'

    Report as inappropriate

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