The Runner’s Guide to Achilles Tendonitis Prevention & Recovery
Affecting 10-15% of runners, Achilles issues demand targeted rehabilitation to maintain tendon elasticity and prevent chronic degeneration.
3-Phase Rehabilitation Protocol
Acute Phase (0-2 weeks)
- Relative rest (cross-train if pain-free)
- Ice massage 5min every 2 hours
- Compression sleeve during day
- Night splint in mild dorsiflexion
Recovery Phase (2-6 weeks)
- Eccentric heel drops (3×15 daily)
- Soft tissue mobilization
- Gait retraining if needed
Return-to-Run (6+ weeks)
- Walk-run progression program
- Continued strength work
- Biomechanical assessment
Essential Eccentric Exercises
| Exercise | Progression | Sets/Reps | Frequency |
|---|---|---|---|
| Double-leg heel drops | Flat surface → step | 3×15 | Daily |
| Single-leg heel drops | Bodyweight → weighted | 3×10 | Every other day |
| Eccentric slant board | 30° → 45° incline | 3×8 | 2x/week |
Long-Term Prevention Strategies
Biomechanical Adjustments
- 4-8mm heel-to-toe drop shoes
- Cadence increase to 170+ steps/min
- Midfoot strike pattern
Strength & Mobility
- Calf raises with slow eccentrics
- Ankle dorsiflexion mobility work
- Posterior chain strengthening
Red Flags Requiring Medical Attention
- Morning stiffness >30 minutes
- Swelling that doesn’t improve
- Audible “pop” with sudden pain
- Difficulty walking on tiptoes
Clinical Insight: A 2023 British Journal of Sports Medicine study found runners who completed 12 weeks of eccentric loading reduced Achilles pain by 72% compared to stretching alone.
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