How do I treat Achilles tendonitis?
Treat Achilles tendonitis with heel-drop eccentric calf raises (3 sets of 15 twice daily), reduced mileage for 2-4 weeks, ice after running, and shoes with a higher heel drop (10mm+). Most cases resolve in 6-12 weeks. Never continue hard running through Achilles pain — it can progress to rupture.
Achilles tendonitis (or tendinopathy) is inflammation or degeneration of the large tendon connecting your calf to your heel. Symptoms include morning stiffness in the back of the heel, pain at the start of runs that warms up then returns after, and tenderness 2-6 cm above the heel. Causes include sudden mileage increases, switching to low-drop or minimalist shoes, running hills, weak calves, and tight hip flexors changing your stride. Treatment protocol: (1) Eccentric heel drops are the gold standard — stand on a step with heel hanging off, raise up with both feet, then lower slowly on the injured side to below step level. 3 sets of 15, twice daily, for 12 weeks. Research shows 80% of cases respond to this alone. (2) Switch to shoes with higher heel drop (10-12mm) during recovery to reduce Achilles load. (3) Reduce running volume by 30-50% for 2 weeks, avoid hills and speed work. (4) Ice for 15 minutes after running. (5) Foam roll calves daily. (6) Don't stretch the Achilles aggressively during the acute phase — it can worsen things. Most cases resolve in 6-12 weeks. Red flags: sudden sharp pain, inability to stand on tiptoes, or a popping sensation means possible rupture — go to ER. Chronic cases (6+ months) may need PRP or shockwave therapy.