- is an overuse injury common in runners who increase training too quickly
- Early treatment prevents the condition from becoming chronic
- Most cases respond to conservative treatment—rest, proper shoes, and physical therapy
- Ignoring Achilles pain can lead to tendon rupture
What Is ?
is inflammation of the Achilles tendon—the thick band of tissue connecting your calf muscles to your heel bone. It's the largest and strongest tendon in your body, but it takes a beating during running.
Every time your foot pushes off the ground, your Achilles tendon handles forces up to eight times your body weight. Do that thousands of times per run, week after week, and you understand why runners are prone to this injury.
At Central Florida Foot & Ankle Institute, is one of the most common running injuries we treat. The good news: with proper care, most runners return to full activity.
Types of
Noninsertional
This type affects the middle portion of the tendon, usually 2-4 inches above the heel. It's more common in younger, active runners. The tendon fibers develop small tears and begin to break down, swell, and thicken.
Insertional
This affects the lower portion of the tendon where it attaches to the heel bone. It can affect anyone, even people who aren't very active. Bone spurs often develop at the insertion point, adding to the pain.
What Causes in Runners?
Too Much, Too Soon
The number one cause is increasing training intensity or volume too quickly. Your muscles may adapt faster than your tendons. The classic mistake: jumping from 10 miles per week to 25 miles because you're excited about a new race.
Tight Calf Muscles
Tight calves put extra strain on the Achilles tendon. If you can't easily flex your ankle 10-15 degrees past neutral, your calf muscles are likely too tight.
Worn-Out or Wrong Shoes
Running shoes lose their support and cushioning over time. Shoes that don't match your gait or foot type also contribute to Achilles problems. Check out our guide to choosing running shoes.
Running Surface and Terrain
Sudden changes in running surface—like going from treadmill to trails—stress the tendon differently. Hill running, especially up hills, is particularly demanding on the Achilles.
Weak Calves and Hips
Weakness in the calf muscles or hip stabilizers forces the Achilles to work harder to compensate.
Age
Tendons become less flexible and more susceptible to injury with age. is most common in runners over 30.
Biomechanical Issues
, high arches, overpronation, and other structural abnormalities change how forces are distributed through the Achilles.
Symptoms: What Does Feel Like?
Early Warning Signs
- Mild ache in the back of the leg or above the heel after running
- Stiffness in the tendon area, especially in the morning
- Tenderness when you squeeze the sides of the tendon
Progressing Symptoms
- Pain that starts earlier during runs and takes longer to fade
- Thickening or swelling of the tendon
- Pain climbing stairs or walking uphill
- Stiffness that lasts throughout the day
Severe Symptoms (Get Help Immediately)
- Sudden, sharp pain in the back of the ankle
- Popping or snapping sensation
- Inability to push off or walk normally
- Significant swelling or bruising
These may indicate a partial or complete tendon rupture—a medical emergency requiring prompt treatment.
When to See a Sports Podiatrist
Don't run through Achilles pain. See a specialist if:
- Pain doesn't improve after a few days of rest
- Symptoms are getting worse
- The tendon is visibly swollen or thickened
- You can't complete your normal activities
- You felt a pop or sudden pain during activity
At Central Florida Foot & Ankle Institute, we see runners at all levels—from beginners training for their first 5K to ultramarathoners logging 100+ miles weekly. We understand you want to keep running. Our goal is to get you back on the road safely.
Treatment Options
At-Home Care (RICE Protocol)
Rest: Reduce or stop running. Cross-train with low-impact activities like swimming or cycling. Ice: Apply ice for 15-20 minutes several times daily, especially after activity. Compression: Use a compression bandage to reduce swelling. Elevation: Raise your foot above heart level when resting.Physical Therapy
Specific exercises are highly effective for :
Eccentric exercises (lowering your heel off a step) are the gold standard. Research shows they promote tendon healing better than other exercise types. Calf stretching reduces tension on the tendon. Strengthening exercises for the entire kinetic chain—calves, hips, and core—address underlying weaknesses.Footwear Modifications
- Heel lifts reduce strain on the Achilles
- Shoes with good heel-toe drop (10-12mm) decrease tendon stress
- Replace worn-out running shoes
Orthotics
Custom or over-the-counter orthotics correct biomechanical issues contributing to the problem.
Advanced Treatments
For stubborn cases, we offer:
MLS Laser Therapy: Accelerates healing at the cellular level, reduces inflammation, and relieves pain without medication. Shockwave Therapy: Uses acoustic waves to stimulate blood flow and healing in chronic tendonitis. PRP Injections: Concentrated platelets from your own blood promote tissue repair.When Surgery Is Needed
Most responds to conservative care. Surgery is reserved for:
- Cases that don't improve after 6+ months of treatment
- Severe tendon degeneration
- Tendon ruptures
Prevention: Keeping Your Achilles Healthy
Follow the 10% Rule
Never increase weekly mileage by more than 10%. Your tendons need time to adapt to training loads.
Warm Up Properly
Start each run with 5-10 minutes of easy jogging or brisk walking. Cold tendons are injury-prone tendons.
Stretch and Strengthen
Daily calf stretches and regular eccentric strengthening exercises should be part of every runner's routine—especially if you've had Achilles problems before.
Replace Shoes Regularly
Running shoes lose their support after 300-500 miles. Track your mileage and replace shoes before problems start.
Listen to Your Body
Pain is a signal. Mild Achilles discomfort that doesn't resolve after a warm-up means it's time to back off and evaluate.
Cross-Train
Incorporate non-running days with swimming, cycling, or strength training. Your Achilles needs recovery time.
Running in Central Florida: Climate Considerations
Florida's heat and humidity create unique challenges:
- Stay hydrated: Dehydrated muscles and tendons are more prone to injury
- Run during cooler hours: Early morning runs are easier on your body
- Choose proper socks: Moisture-wicking materials prevent blisters that can alter your gait
- Watch for uneven surfaces: Florida's mixed terrain—from sand to concrete—requires attention
Get Back to Running
is frustrating, but it's treatable. The key is addressing it early before a minor issue becomes a chronic problem—or worse, a ruptured tendon.
At Central Florida Foot & Ankle Institute, we combine advanced diagnostics with proven treatments to get runners back on the road. Whether you need gait analysis, custom orthotics, or cutting-edge therapies like MLS laser treatment, we're here to help.
📞 Schedule an appointment today and take the first step toward pain-free running.