Achilles Tendinopathy: What Runners Should Do
The Achilles hates rest and hates too much load. Progressive rehab is the middle ground that gets runners back to full mileage. Here is what actually works.
How to recognise it
Morning stiffness and pain at the back of the heel, easing with warm up and returning after a run. Often preceded by a spike in training volume or a switch to hillier routes.
The evidence based rehab plan
Heavy slow calf raises, done both straight and bent knee, three sets of fifteen reps every second day. Pain up to a moderate level during the exercise is acceptable as long as it settles within 24 hours.
Adjust the training, do not stop
Reduce running volume, avoid hills and speed work temporarily, and keep pain within an acceptable range during and after runs. Complete rest usually delays recovery.
Return to full training
Gradually reintroduce hills and speed work over several weeks. Continue calf loading twice weekly indefinitely to protect the tendon long term.
Related physiotherapy services
Frequently asked questions
Should I get a scan?+
Not usually. Achilles tendinopathy is a clinical diagnosis. Scans come in for high suspicion of a tear or unusual presentations.
Are eccentric calf raises the only exercise?+
No. Modern rehab uses heavy slow resistance combining eccentric and concentric loading, which is at least as effective.
Can dry needling help?+
Yes, for the surrounding calf muscles. It is a useful adjunct, not a standalone fix.
Medical disclaimer: this article is general education and does not replace a personal assessment. If your pain is severe, worsening, or accompanied by numbness, weakness or loss of bladder or bowel control, seek care promptly.
Book with N S Physiotherapy
In clinic in Eco Park, Centurion, or home visits across Centurion and Midrand.
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