Calling all runners and weekend warriors alike all need to know how to take care of themselves.  By living an active lifestyle and having health goals to train for longevity we can’t let nagging injuries get in our way.  Considering the miles runners log it’s no surprise lower leg injuries like achilles tendonitis and tendinopathy occur. This blog will teach you the difference between the two and what’s an effective approach for treatment and why many runners tend to miss the mark on getting rid of this injury. 

 Let’s paint a picture, your buddy in your running group mentions he has Achilles Tendonitis and another member in your morning running group says they have Achilles Tendinopathy.  Both have heel pain and some tenderness along their heel and calf muscles. The two calf muscles unite into one band of tissue, which becomes the Achilles tendon at the low end of the calf.  

So, what’s the difference?

Here’s a quick anatomy lesson before we find out the difference. Tendons connect muscle to bone.  Your Achilles tendon connects your calf muscles (gastrocnemius and soleus muscle) to your heel (calcaneus bone) as seen in the photo below. 

Tendonitis vs Tendinopathy 

• Tendonitis is a term for tendon pain based on inflammation of a tendon, usually more acute in nature.
• Tendinopathy is a generalized term for chronic tendon problems. 

A keyword in these descriptions is acute (new) versus chronic (consistent stress over a long period of time).  Many people presenting with an Achilles Tendonitis had a recent increase in their training volume, intensity or duration of runs.  Now picture having those symptoms and then trying to “run through it” without a smart and individualized plan to address the underlying causes to develop this injury, that’s where Achilles Tendinopathy comes into the picture.

 Most runners and weekend warriors believe doing some stretching, massage, foam rolling will make their symptoms resolve...where in actuality there’s research indicating that those modes for treatment are actually NOT effective.  They may provide pain relief momentarily, but they will not resolve your symptoms for good.  And let’s be honest-as much as we may think a quick fix is the answer, we can feel more frustrated when you’re held back from your fitness goals and training due to an annoying sensation at your Achilles. 

So, what’s a runner to do?

STRENGTHENING.

What do we mean by strengthening? This word can mean a lot of things to individuals. Specifically for the tendinopathies we want to load the tendon with strengthening, even if it’s a little painful during.  If you think of a pain scale 0 (low) and 10 (high), when completing these exercises under control and in a safe manner, a score of 4-5/10 can still be beneficial for recovery.  The key is it needs to stay at this same level or less after and next day, if symptoms increase that provides more information that you overloaded the muscle and tendon during those exercises and then you can dial it back.  

Recovering from an injury and training safely doesn’t need to be something you have to master on your own. Find a trusted physical therapist or coach to guide you through the appropriate exercises such as graded eccentric loading, form and dosing for the best results. 

There are many factors that can be changed depending on symptoms and fitness goals from speed, ROM and resistance.  Here are a few general examples of exercises and progressions for restoring the tensile capacity of the tendon to promote resilience and recovery.

• Position: Start by sitting in a chair, then long sitting on the ground, incline, then standing
• Involvement: Start with both legs and transitioning to a single leg will allow for more specific strengthening
• Range of Motion: Partial to full range of motion if possible
• Speed: Slow and progress to fast
• Resistance: This can vary a lot depending on the person from starting with light resistance to a band and eventually adding weight. We’d recommend working with a trusted physical therapist to get the right plan for you and your situation.

Heel Raises - Knees Straight

Heel Raises - Knees Bent

Now you know the difference between tendonitis, tendinopathy and in actuality what you SHOULD be doing for treatment to take care of your body and give those nagging symptoms a big wave “bye, bye!” for good. Try out the exercises and remember, recovery from injuries whether they were from a day ago or something you’ve been struggling with for a decade, it takes consistency and dedication to the process to see lasting change. At Inside Out, we care about you and your goals. We’re in this for the long haul with you, we get it.  We know what it feels like to not be able to train or live the way you want to. We understand and are eager to help guide you, and fellow runners to a life of resiliency and away from the nagging injuries. 

If you’re still not getting the progress you want as you work towards your goals, or if you have pain or injury that you’re trying to work around, we can help! We help busy and active individuals live strong and confident lives.  We do this through comprehensive packages that include 1-on-1 in-person or virtual sessions sessions, remote exercise programming and mobility programming, and nutrition coaching that is customized to you.

Don’t wait to live your best life, we’d love to help you reach your goals and be a part of your transformation!

Most people don’t know how to stay healthy and fit without getting hurt. At Inside Out Strength and Performance we provide a clear plan to get you in the best shape of your life, without getting injured, so that you can be active and confident that you’ll feel your best for years to come.

We help North County San Diego’s active adults and runners dealing with pain or injury get back to living a pain-free, strong, and confident life.

We are the Strength Docs who help active adults and runners live a strong, confident, and pain-free life. Fill out our contact form here to get a clear plan and get started.

This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider like a physical therapist with any questions you may have regarding a medical condition.