Achilles Pain in Runners: Why It Keeps Coming Back (and What to Do About It)

Have you ever asked yourself:

    •    “Why is my Achilles sore in the morning?”

    •    “Why won’t my Achilles tendon pain go away?”

    •    “Is this tendinitis or something else?”

If so, you’re not alone — Achilles pain is one of the most common and frustrating overuse injuries in runners. It can come on gradually or after a hard effort, and it tends to linger if not managed properly.

While classic advice usually includes rest, stretching, or icing, these strategies often fall short for chronic or stubborn cases. So let’s break down why your Achilles pain might not be going away — and what you can do to actually fix it.

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1. You might be dealing with Achilles tendinopathy — not tendinitis

Most cases of Achilles pain in runners aren’t actually due to inflammation (tendinitis), but rather a condition called tendinopathy. This involves small-scale degeneration and thickening of the tendon, which can build up over time with repetitive stress.

The takeaway? It’s not about “calming inflammation” — it’s about gradually restoring strength, structure, and load tolerance.

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2. You’re either underloading the tendon — or overloading it too quickly

Tendons heal through progressive loading — not through complete rest. But runners often fall into two traps:

    •    Doing too little: Prolonged rest leads to further weakening.

    •    Returning too fast: Jumping back into training flares things up again.

Instead, try a middle ground:

    •    Begin with isometric exercises (like heel raises held for 30–45 seconds)

    •    Progress to slow, heavy calf strengthening

    •    Eventually layer in plyometrics and running drills

Each phase builds tolerance for the next. If you skip steps, symptoms often return.

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3. You’re stretching more than you’re strengthening

Most runners instinctively start stretching their calves when their Achilles flares up. But when it comes to Achilles tendinopathy, stretching alone isn’t enough — and sometimes it can even aggravate things.

The priority should be strength, especially in the soleus, your deeper calf muscle. This muscle does a lot of the work during running — especially during mid-stance — and it often gets overlooked in rehab.

Add exercises like:

    •    Bent-knee calf raises

    •    Eccentric heel drops

    •    Weighted slow reps

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4. Your running shoes or gait mechanics may be contributing

Achilles load is influenced by both footwear and biomechanics. If you’ve recently:

    •    Switched to lower-drop shoes (like racing flats or zero-drop trainers)

    •    Increased your volume or hill work

    •    Changed running surfaces (track, trails, treadmill)

…you might be placing more strain on the tendon than it can currently handle.

Also, mechanics like overstriding, excessive heel drop, or reduced hip extension can increase load on the Achilles. If pain keeps recurring, a gait analysis may be worth considering.

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5. You don’t have a structured return-to-run plan

Taking time off is often the first thing runners do — but rest alone doesn’t rehab a tendon. What you really need is a step-by-step plan to rebuild strength, reintroduce plyometrics, and return to running gradually.

A smart approach should include:

    •    Pain-guided loading (a little discomfort is okay)

    •    Strength training 2–3x/week

    •    Careful volume and speed progression

    •    Ongoing tendon monitoring for 8–12+ weeks

If you keep flaring up every time you try to increase mileage or intensity, chances are your load progression needs adjusting.

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Final thoughts

Achilles pain can be persistent, but it’s not permanent. With the right diagnosis, progressive strength work, and a structured return-to-run strategy, most runners can make a full recovery and get back to training pain-free.

If you’re stuck and unsure where to start, feel free to reach out or schedule an appointment at StrongCore Chiropractic and Performance.

Click here to book appointment!

Dr. Andres T. De La Cruz, D.C., CCSP, CSCS

Doctor of Chiropractic

Certified Chiropractic Sports Practitioner

Certified Strength and Conditioning Specialist

DoctorDeLaCruzDC@gmail.com

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Disclaimer:

The information in this blog is intended for general educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult with a qualified healthcare provider before beginning any new exercise, mobility, or treatment program. If you have specific questions about your health or a medical condition, please contact your healthcare provider or schedule an appointment at StrongCore Chiropractic and Performance.