The Ultimate Runner's Guide to Achilles Tendon Injuries (2022)

The Ultimate Runner's Guide to Achilles Tendon Injuries (1)

John Davis

This is most likely an article you don’t want to read.Here’s why:Yourachilles probably already hurts when running. It achilles may feel sore during your run, be creaking after your run, and feel tight and stiff as you walk around. Every day you have that sinking feeling that something is wrong, you wonder“should I run or is it time to stop running till it heals?”.Achilles tendon injuries can be stubborn, painful and depressing. If you’re reading this, then you likely have one. Luckily, we’re here to help, and not just by telling you to ice your achilles and rest.This guide will explain why achilles tendon issues occur, and what you can do to limit the time it takes to heal it if you are suffering from achilles tendon aching, soreness after a run, creaking, or heel pain.The Achilles tendon is the thickest and strongest tendon in your body, connecting your calf muscles to the back of your heel.Virtually all of the force generated when you “toe off” the ground during running is transmitted by the Achilles, and this force can be as much as three times your body weight. And the faster you run, the more strain you put on the Achilles tendon.As such, it’s prone to injury in many runners, but particularly those who do a lot of speed training, uphill running, or use a forefoot-striking style. Achilles tendon injuries account for 5-12% of all running injuries, and occur disproportionately in men.This may be because of the faster absolute speeds men tend to train at, or may be due to other biomechanical factors.Achilles tendonitis (or achilles tendinitis as it is actually known in the medical world) typically starts off as a dull stiffness in the tendon, which gradually goes away as the area gets warmed up. It may get worse with faster running, uphill running, or when wearing spikes and other low-heeled running shoes.If you continue to train on it, the pain in the tendonwill be more sharp and you will feel it more often, eventually impeding your ability even to jog lightly.About two-thirds of Achilles tendonitis cases occur at the “midpoint” of the tendon, a few inches above the heel. The rest are mostly cases of “insertional” Achilles tendonitis, which occurs within an inch or so of the heelbone. Insertional Achilles tendonitis tends to be more difficult to get rid of, often because the bursa, a small fluid-filled sac right behind the tendon, can become irritated as well.The Ultimate Runner's Guide to Achilles Tendon Injuries (2)

The common causes ofAchilles tendonitis in runners

Here’s the deal:The causes of Achilles tendonitis all appear to be related to excessive stress being transmitted through the tendon. Weak calf muscles, poor ankle range of motion, and excessive pronation have all been connected with the development of Achilles problems.The upshot is that all of these factors, plus training volume and so on, result in damage to the tendon.

While the term “tendonitis” implies that inflammation (-itis) is the root cause of the problem, in fact, the true cause is real, physical damage to the fibers of the Achilles tendon itself.

Much like a bungee cord is made up of tiny strands of rubber aligned together, tendons are comprised of small fiber-like proteins called collagen. Pain in the Achilles tendon is a result of damage to the collagen. Because of this, treatment options should start with ways to address this.

How can Itreat my achilles tendon pain?

For a long time, researchers and doctors muddled about trying to address roulette factors like calf strength & tightness, ankle range of motion, and pronation, assuming that the Achilles tendon would heal itself once these factors were corrected.Unfortunately, it seems that the thick tendons of the body do not heal as rapidly or completely as we’d like.The cause of this seems to be the collagen fibers:When a tendon is damaged, collagen fibers are ruptured. The body is able to lay down new fibers to replace the damaged ones, but it does so in a rather disorganized way. The new collagen fibers look much like a mess of spaghetti when viewed on a microscope, in contrast to the smooth, aligned appearance that healthy tendon fibers have.Unfortunately, it gets worse:While we might propose that runners do calf stretching to loosen up their calf muscles and increase their ankle range of motion, this often does more harm than good—tugging aggressively on the damaged tendon fibers is much like pulling on either end of a knotted rope.

Instead, the main objective in treating Achilles tendon injuries should be healing the damaged tendon. The exercise of choice is the eccentric heel drop, which has an impressive research pedigree backing its use.

How does the eccentric heel drop help my achilles get better faster?

The strength protocol consists of two exercises: a straight-kneed and a bent-kneed eccentric heel drop.The protocol calls for three sets of fifteen heel drops, both bent-kneed and straight-kneed, twice a day for twelve weeks.Standing on a step with your ankles plantarflexed (at the top of a “calf raise”), shift all of your weight onto the injured leg.Slowly use your calf muscles to lower your body down, dropping your heel beneath your forefoot. Use your uninjured leg to return to the “up” position. Do not use the injured side to get back to the “up” position!The exercise is designed to cause some pain, and you are encouraged to continue doing it even with moderate discomfort. You should stop if the pain is excruciating, however.Once you are able to do the heel drops without any pain, progressively add weight using a backpack. If you are unlucky enough to have Achilles tendon problems on both sides, use a step to help you get back to the “up” position, using your quads instead of your calves to return up.What’s the bottom line?The eccentric exercises are thought to selectively damage the Achilles tendon, stripping away the misaligned tendon fibers and allowing the body to lay down new fibers that are closer in alignment to the healthy collagen in the tendon.This is why moderate pain during the exercises is a good thing, and why adding weight over time is necessary to progressively strengthen the tendon.

This is most likely an article you don’t want to read.Here’s why:Yourachilles probably already hurts when running. It achilles may feel sore during your run, be creaking after your run, and feel tight and stiff as you walk around. Every day you have that sinking feeling that something is wrong, you wonder“should I run or is it time to stop running till it heals?”.Achilles tendon injuries can be stubborn, painful and depressing. If you’re reading this, then you likely have one. Luckily, we’re here to help, and not just by telling you to ice your achilles and rest.This guide will explain why achilles tendon issues occur, and what you can do to limit the time it takes to heal it if you are suffering from achilles tendon aching, soreness after a run, creaking, or heel pain.The Achilles tendon is the thickest and strongest tendon in your body, connecting your calf muscles to the back of your heel.Virtually all of the force generated when you “toe off” the ground during running is transmitted by the Achilles, and this force can be as much as three times your body weight. And the faster you run, the more strain you put on the Achilles tendon.As such, it’s prone to injury in many runners, but particularly those who do a lot of speed training, uphill running, or use a forefoot-striking style. Achilles tendon injuries account for 5-12% of all running injuries, and occur disproportionately in men.This may be because of the faster absolute speeds men tend to train at, or may be due to other biomechanical factors.Achilles tendonitis (or achilles tendinitis as it is actually known in the medical world) typically starts off as a dull stiffness in the tendon, which gradually goes away as the area gets warmed up. It may get worse with faster running, uphill running, or when wearing spikes and other low-heeled running shoes.If you continue to train on it, the pain in the tendonwill be more sharp and you will feel it more often, eventually impeding your ability even to jog lightly.About two-thirds of Achilles tendonitis cases occur at the “midpoint” of the tendon, a few inches above the heel. The rest are mostly cases of “insertional” Achilles tendonitis, which occurs within an inch or so of the heelbone. Insertional Achilles tendonitis tends to be more difficult to get rid of, often because the bursa, a small fluid-filled sac right behind the tendon, can become irritated as well.The Ultimate Runner's Guide to Achilles Tendon Injuries (3)

The common causes ofAchilles tendonitis in runners

Here’s the deal:The causes of Achilles tendonitis all appear to be related to excessive stress being transmitted through the tendon. Weak calf muscles, poor ankle range of motion, and excessive pronation have all been connected with the development of Achilles problems.The upshot is that all of these factors, plus training volume and so on, result in damage to the tendon.

While the term “tendonitis” implies that inflammation (-itis) is the root cause of the problem, in fact, the true cause is real, physical damage to the fibers of the Achilles tendon itself.

Much like a bungee cord is made up of tiny strands of rubber aligned together, tendons are comprised of small fiber-like proteins called collagen. Pain in the Achilles tendon is a result of damage to the collagen. Because of this, treatment options should start with ways to address this.

How can Itreat my achilles tendon pain?

For a long time, researchers and doctors muddled about trying to address roulette factors like calf strength & tightness, ankle range of motion, and pronation, assuming that the Achilles tendon would heal itself once these factors were corrected.Unfortunately, it seems that the thick tendons of the body do not heal as rapidly or completely as we’d like.The cause of this seems to be the collagen fibers:When a tendon is damaged, collagen fibers are ruptured. The body is able to lay down new fibers to replace the damaged ones, but it does so in a rather disorganized way. The new collagen fibers look much like a mess of spaghetti when viewed on a microscope, in contrast to the smooth, aligned appearance that healthy tendon fibers have.Unfortunately, it gets worse:While we might propose that runners do calf stretching to loosen up their calf muscles and increase their ankle range of motion, this often does more harm than good—tugging aggressively on the damaged tendon fibers is much like pulling on either end of a knotted rope.

Instead, the main objective in treating Achilles tendon injuries should be healing the damaged tendon. The exercise of choice is the eccentric heel drop, which has an impressive research pedigree backing its use.

How does the eccentric heel drop help my achilles get better faster?

The strength protocol consists of two exercises: a straight-kneed and a bent-kneed eccentric heel drop.The protocol calls for three sets of fifteen heel drops, both bent-kneed and straight-kneed, twice a day for twelve weeks.Standing on a step with your ankles plantarflexed (at the top of a “calf raise”), shift all of your weight onto the injured leg.Slowly use your calf muscles to lower your body down, dropping your heel beneath your forefoot. Use your uninjured leg to return to the “up” position. Do not use the injured side to get back to the “up” position!The exercise is designed to cause some pain, and you are encouraged to continue doing it even with moderate discomfort. You should stop if the pain is excruciating, however.Once you are able to do the heel drops without any pain, progressively add weight using a backpack. If you are unlucky enough to have Achilles tendon problems on both sides, use a step to help you get back to the “up” position, using your quads instead of your calves to return up.What’s the bottom line?The eccentric exercises are thought to selectively damage the Achilles tendon, stripping away the misaligned tendon fibers and allowing the body to lay down new fibers that are closer in alignment to the healthy collagen in the tendon.This is why moderate pain during the exercises is a good thing, and why adding weight over time is necessary to progressively strengthen the tendon.

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Is there anything else I can do to speed healing?

While you are addressing the damage to the tendon fibers through eccentric heel drops, there are some steps you can take to help ameliorate some of the other contributing factors to your injury.

  • While calf tightness and ankle range of motion are legitimate concerns, I still don’t think that aggressive calf stretching is an ideal solution, because of the tugging action on the tendon. Instead, try foam rolling your calves and applying a warm water bag to the muscle (but avoid heating the tendon!).Foam rolling your calf muscles can loosen them up without tugging too much on the Achilles tendon. Just make sure you are not making the 4 most common mistakes runners make when foam rolling.
  • Read our Post on Are you doing the correct calf and achilles exercises to prevent injury?
  • You can also stretch out your shins by leaning back in a kneeling stance to aid ankle range of motion.
  • Footwear concerns should also be addressed at this point. If you have been wearing low-heeled “minimal” shoes, racing flats, or spikes, you ought to stick to more traditional shoes with a higher heel until your tendon is healthy again. Once you’ve healed up, you can gradually do some running in low-heeled shoes or even barefoot (on grass) to help accustom your Achilles to moving through its full range of motion. Poor casual footwear choices should not be overlooked too, especially for women. Some shoes can also put pressure on the back of your heel, irritating the insertion of the tendon. Generally, the closer a shoe is to looking and feeling like a “running shoe,” the better it is for your foot.
  • Doctors and podiatrist may be keen to have you try out a custom orthotic to treat your Achilles problems. While it might be worth a shot, there isn’t a whole lot of scientific evidence backing their use in this case. Orthotics don’t reliably alter pronation, and even if they do, it’s uncertain as to whether this will increase or decrease stress on the Achilles.

Outline of treatment

Conservative treatments

These are cheap, easy to perform treatments that you can do it home in your own time. You should try to do as many of these as possible each day.

  • Eccentric heel drops
  • Icing after each run
  • Heating before each run with warm water or heating pack
  • Contrast bath during the day – take two small buckets/trash cans and fill one with hot (hot bath temp) water and the other with ice water (cold enough so some ice still doesn’t melt) and put your whole leg (up to the calf) in the cold. Hold for 5 minutes and then switch to the hot for 5 minutes. Repeat 2 or 3 times, ending with cold. This helps rush blood in and out of the area, which facilitates healing
  • Don’t take anti-inflammatory like Advil or ibuprofen. These stop the body’s natural healing agents and we want as much natural healing to occur as possible.
  • Avoid excessive stretching – only very light, easy stretching until healed
  • Massage your calves with a foam roller or The Stick.
  • Heel lifts are a possible temporary solution. They restrict the Achilles’ range of motion, so can be helpful to get over the initial hump of the injury, but should be taken out after you are recovering.
  • Switch to more supportive or traditional running shoes (higher heels) during your runs and while walking around until your pain is completely gone, and avoid flats and high heels!
  • Ankle strengthening and mobility exercises.
  • Sleep in a Strassburg sock or nightsplint to gently stretch the Achilles while sleeping.

Aggressive treatments

These treatments are a little more expensive or time consuming and are only suggested for if you suffer from chronic Achilles pain or the conservative treatments are not working for you.

  • A custom orthotic might help alleviate the pain from excessive pronation. This is not a proven treatment, but for those runners who respond to orthotics, it can help.
  • Iontophoresis with dexamathasone. This is a treatment offered by physical therapists that involves propelling anti-inflammatory steroids into the tendon. You need a prescription and a physical therapist to administer the treatment, but research has shown the potential to have a positive effect on the treatment of Achilles issues.

Cross Training While Injured and During Recovery

Cross training is recommended while you’re injured and as you slowly return to running.

The best form of cross training for this injury is Aqua Jogging. Studies have shown that aqua jogging can enable a well-trained runner to maintain running fitness for up to 4-6 weeks.

Aqua jogging is a form of deep water running that closely mimics the actual running movement. Your feet don’t actually touch the bottom of the pool, so it is zero impact and safe for almost any type of injury. In my experience, the only time to avoid aqua jogging is when you have a hip flexor injury, which can be aggravated by the increased resistance of the water as you bring your leg up.Because aqua jogging closely mimics natural running form, it provides a neuromuscular workout that, in addition to aerobic benefits, helps keep the running specific muscles active. The same can’t be said for biking and swimming.The only downside to aqua jogging is that you need a pool that is deep enough to run in without touching the bottom. If you’re lucky enough to have access to a pool of this size, aqua jogging should be your first cross training choice.

Inone study, a group of ten runners trained exclusively with deep water running for four weeks and compared 5km race times pre deep water running and post deep water running.

The researchers found no statistical difference in 5k time or other markers for performance, such as submaximal oxygen consumption or lactate threshold.

Ina second study, researchers measured the effects of aqua jogging over a six week period.

This time, 16 runners were separated into two groups – one who did aqua jogging workouts and the other who did over land running.

Using the same training intensities and durations, the researchers found no difference between the groups in maximal blood glucose, blood lactate, and body composition.

It get’s better:

Research has also demonstratedthat aqua jogging can be used as a recovery tool to facilitate the repair of damaged muscles after hard workouts.

These findings make aqua jogging an important recovery tool in addition to being the best cross training method for injuries.

Need one more reason?

The calories burned aqua jogging are even higher than running on land, so if you want to avoid weight gain while you take time off from running, this is definitely the exercise for you!

Aqua Jogging Workouts For Runners

If you’re interested in aqua jogging to rehab your injury, then the absolute best way is to use one of my favorite programs,Fluid Running.

First, it comes with an aqua jogging belt and waterpoof bluetooth headphones so you have everything you need to aqua jog effectively.

Second, they have an app that pairs with the headphones so you can get workouts, guided instructions on how to aqua jog properly, and motivation while you’re actually pool running.

This has been an absolute game changer for me when I am injured.

I used to dread aqua jogging workouts because they were so boring and it took all my mental energy to stay consistent.

But, with workouts directly in my ear, it’s changed the whole experience and I actually look forward to the workouts. So much so that I now use aqua jogging as a cross training activity in the summer, even when I am not injured.

Fluid running is an awesome deal when you consider it comes with the belt (highly recommended for better form), the waterproof headphones (game changer for making pool workouts fun), a tether (to add variety to the workouts you can do) and the guided workout app (to make your cross training structure and a whole lot more interesting).

That’s why we’ve partnered with them to give you 2 additional running-specific workouts you can load into the app when you use the code RTTT .

Check out the product hereand then on the checkout page, add the code RTTT in the coupon field and the workouts will be added to your order for free.

If you’d rather do the aqua jogging workouts on your own, here are some great ideas to get you started!

Medium Effort Workouts

The Pyramid

10 minutes easy warm up – 1:00 hard, 30 seconds easy – 1:30 hard, 30 seconds easy – 2:00 hard, 30 seconds easy – 2:30 hard, 30 seconds easy, go to 5:00 in 30 second intervals and then come back down the pyramid (4:30 hard, 30 easy, 4:00 hard, 30 easy etc). Finish with 10 minutes easy cool down.

Wave your hands in the air like you just don’t care

10 minutes easy warm up, 1 minute medium (87-92% of maximum heart rate or what feels like tempo effort), 1 minute sprint (95-100% of maximum heart rate or all out sprint), 30 seconds hands in air (keep moving your legs in the running motion, but put your hand above your head), 1 minute rest, Repeat 10-15 times. 10 minutes easy cool down.

Hard Workouts

One of the difficulties of cross training is replicating those truly lung-busting, difficult workouts.

So, if you’re going to be pool running quite a bit due to injury or limited training volume, invest in a bungee cord designed for sprinters.

(Video) 10 Best Achilles Tendon Supports 2019

Tie one end of the resistance band to a sturdy object (pole, lifeguard stand, pool ladder) and bring the other into the water with you.

Put the strap around your waist and begin aqua jog away from your starting point.

You’ll begin to notice the bungee tighten and resist against you (depending on the length of your pool, you may need to wrap the bungee around the supporting object or tie it in knots to make it shorter to feel resistance).

Spend a few moments testing yourself to see how far you can pull the bungee.

This is a great challenge and a fun way to compete with yourself during an otherwise boring cross training activity.

Now for the hard part:

Pick a point on the pool wall or side of the pool that you feel stretches the bungee to a very hard sprint that you could maintain for 60-90 seconds.

This will be your “sprint” marker that you’ll use on sprint intervals (95-100% of maximum heart rate or all out sprint).

Now:

Find a point that feels like the end of a hard tempo run.

Mark this spot as your “medium” interval distance.

When you complete the hard workouts, you can use these reference points to ensure that you maintain a very hard effort.

The springboard

10 minutes easy warm up, 90 seconds easy (slowly moving out and stretching the bungee), 2 minute medium, 1 minute sprint, 1 min rest (let the bungee pull you back – this is kind of fun). Repeat 10 times. 10 minutes easy cool down.

The race simulation

10 minutes easy warm up, 90 seconds easy (slowly moving out and stretching the bungee), 5 minutes medium (focus and concentrate, just like during the hard part of a race), 30 seconds sprint, 2 minutes rest. Repeat 4 times. 10 minutes easy col down

The lactic acid

10 minutes easy warm up, 90 seconds easy (slowly moving out and stretching the bungee), 2 minutes sprint, 90 seconds rest. Repeat 12 times, 10 minutes easy cool down.

I guarantee that with the bungee, you’ll get your heart rate through the roof.

You can challenge yourself and make aqua jogging more fun by seeing how long you can stay at your maximum stretched distance or seeing how far you can push it.

Likewise, if you have a friend who is injured (or someone willing to be a good sport) you can try pulling each other across the pool for some competitive fun.

Cross training can be tough, especially when you’re injured or want to be increasing your volume faster.

However, I hope that providing a variety of workouts, either through theFluid Running app (which also makes it easier to keep track of the workout while in the water) or on your own can add a fun challenge in the pool and you can emerge from your injury with minimal fitness loss.

When can I return to running?

You can still run during this twelve-week period, but only if your Achilles does not flare up while doing so.Use warm water to heat up the tendon before you run, and apply ice afterwards, even once you’ve started feeling better. Using a foam roller and hot water packs to loosen up your calves in the morning and at night is also not a bad idea, and don’t forget to take a look at what you’re wearing in your daily life.If you have insertional Achilles tendonitis, use the modified flat eccentric heel drop exercise instead of the two variants off a step.A custom orthotic or heel lift may be helpful, but should not be a first-line treatment option.

The Ultimate Runner's Guide to Achilles Tendon Injuries (4)

(Video) Running Shoes for Achilles Pain

Is there anything else I can do to speed healing?

While you are addressing the damage to the tendon fibers through eccentric heel drops, there are some steps you can take to help ameliorate some of the other contributing factors to your injury.

  • While calf tightness and ankle range of motion are legitimate concerns, I still don’t think that aggressive calf stretching is an ideal solution, because of the tugging action on the tendon. Instead, try foam rolling your calves and applying a warm water bag to the muscle (but avoid heating the tendon!).Foam rolling your calf muscles can loosen them up without tugging too much on the Achilles tendon. Just make sure you are not making the 4 most common mistakes runners make when foam rolling.
  • Read our Post on Are you doing the correct calf and achilles exercises to prevent injury?
  • You can also stretch out your shins by leaning back in a kneeling stance to aid ankle range of motion.
  • Footwear concerns should also be addressed at this point. If you have been wearing low-heeled “minimal” shoes, racing flats, or spikes, you ought to stick to more traditional shoes with a higher heel until your tendon is healthy again. Once you’ve healed up, you can gradually do some running in low-heeled shoes or even barefoot (on grass) to help accustom your Achilles to moving through its full range of motion. Poor casual footwear choices should not be overlooked too, especially for women. Some shoes can also put pressure on the back of your heel, irritating the insertion of the tendon. Generally, the closer a shoe is to looking and feeling like a “running shoe,” the better it is for your foot.
  • Doctors and podiatrist may be keen to have you try out a custom orthotic to treat your Achilles problems. While it might be worth a shot, there isn’t a whole lot of scientific evidence backing their use in this case. Orthotics don’t reliably alter pronation, and even if they do, it’s uncertain as to whether this will increase or decrease stress on the Achilles.

Outline of treatment

Conservative treatments

These are cheap, easy to perform treatments that you can do it home in your own time. You should try to do as many of these as possible each day.

  • Eccentric heel drops
  • Icing after each run
  • Heating before each run with warm water or heating pack
  • Contrast bath during the day – take two small buckets/trash cans and fill one with hot (hot bath temp) water and the other with ice water (cold enough so some ice still doesn’t melt) and put your whole leg (up to the calf) in the cold. Hold for 5 minutes and then switch to the hot for 5 minutes. Repeat 2 or 3 times, ending with cold. This helps rush blood in and out of the area, which facilitates healing
  • Don’t take anti-inflammatory like Advil or ibuprofen. These stop the body’s natural healing agents and we want as much natural healing to occur as possible.
  • Avoid excessive stretching – only very light, easy stretching until healed
  • Massage your calves with a foam roller or The Stick.
  • Heel lifts are a possible temporary solution. They restrict the Achilles’ range of motion, so can be helpful to get over the initial hump of the injury, but should be taken out after you are recovering.
  • Switch to more supportive or traditional running shoes (higher heels) during your runs and while walking around until your pain is completely gone, and avoid flats and high heels!
  • Ankle strengthening and mobility exercises.
  • Sleep in a Strassburg sock or nightsplint to gently stretch the Achilles while sleeping.

Aggressive treatments

These treatments are a little more expensive or time consuming and are only suggested for if you suffer from chronic Achilles pain or the conservative treatments are not working for you.

  • A custom orthotic might help alleviate the pain from excessive pronation. This is not a proven treatment, but for those runners who respond to orthotics, it can help.
  • Iontophoresis with dexamathasone. This is a treatment offered by physical therapists that involves propelling anti-inflammatory steroids into the tendon. You need a prescription and a physical therapist to administer the treatment, but research has shown the potential to have a positive effect on the treatment of Achilles issues.

Cross Training While Injured and During Recovery

Cross training is recommended while you’re injured and as you slowly return to running.

The best form of cross training for this injury is Aqua Jogging. Studies have shown that aqua jogging can enable a well-trained runner to maintain running fitness for up to 4-6 weeks.

Aqua jogging is a form of deep water running that closely mimics the actual running movement. Your feet don’t actually touch the bottom of the pool, so it is zero impact and safe for almost any type of injury. In my experience, the only time to avoid aqua jogging is when you have a hip flexor injury, which can be aggravated by the increased resistance of the water as you bring your leg up.Because aqua jogging closely mimics natural running form, it provides a neuromuscular workout that, in addition to aerobic benefits, helps keep the running specific muscles active. The same can’t be said for biking and swimming.The only downside to aqua jogging is that you need a pool that is deep enough to run in without touching the bottom. If you’re lucky enough to have access to a pool of this size, aqua jogging should be your first cross training choice.

Inone study, a group of ten runners trained exclusively with deep water running for four weeks and compared 5km race times pre deep water running and post deep water running.

The researchers found no statistical difference in 5k time or other markers for performance, such as submaximal oxygen consumption or lactate threshold.

Ina second study, researchers measured the effects of aqua jogging over a six week period.

This time, 16 runners were separated into two groups – one who did aqua jogging workouts and the other who did over land running.

Using the same training intensities and durations, the researchers found no difference between the groups in maximal blood glucose, blood lactate, and body composition.

It get’s better:

Research has also demonstratedthat aqua jogging can be used as a recovery tool to facilitate the repair of damaged muscles after hard workouts.

These findings make aqua jogging an important recovery tool in addition to being the best cross training method for injuries.

Need one more reason?

The calories burned aqua jogging are even higher than running on land, so if you want to avoid weight gain while you take time off from running, this is definitely the exercise for you!

Aqua Jogging Workouts For Runners

If you’re interested in aqua jogging to rehab your injury, then the absolute best way is to use one of my favorite programs,Fluid Running.

First, it comes with an aqua jogging belt and waterpoof bluetooth headphones so you have everything you need to aqua jog effectively.

Second, they have an app that pairs with the headphones so you can get workouts, guided instructions on how to aqua jog properly, and motivation while you’re actually pool running.

This has been an absolute game changer for me when I am injured.

(Video) How I Fixed Achilles Tendonitis (It Worked For Me, No More Achilles Issues)

I used to dread aqua jogging workouts because they were so boring and it took all my mental energy to stay consistent.

But, with workouts directly in my ear, it’s changed the whole experience and I actually look forward to the workouts. So much so that I now use aqua jogging as a cross training activity in the summer, even when I am not injured.

Fluid running is an awesome deal when you consider it comes with the belt (highly recommended for better form), the waterproof headphones (game changer for making pool workouts fun), a tether (to add variety to the workouts you can do) and the guided workout app (to make your cross training structure and a whole lot more interesting).

That’s why we’ve partnered with them to give you 2 additional running-specific workouts you can load into the app when you use the code RTTT .

Check out the product hereand then on the checkout page, add the code RTTT in the coupon field and the workouts will be added to your order for free.

If you’d rather do the aqua jogging workouts on your own, here are some great ideas to get you started!

Medium Effort Workouts

The Pyramid

10 minutes easy warm up – 1:00 hard, 30 seconds easy – 1:30 hard, 30 seconds easy – 2:00 hard, 30 seconds easy – 2:30 hard, 30 seconds easy, go to 5:00 in 30 second intervals and then come back down the pyramid (4:30 hard, 30 easy, 4:00 hard, 30 easy etc). Finish with 10 minutes easy cool down.

Wave your hands in the air like you just don’t care

10 minutes easy warm up, 1 minute medium (87-92% of maximum heart rate or what feels like tempo effort), 1 minute sprint (95-100% of maximum heart rate or all out sprint), 30 seconds hands in air (keep moving your legs in the running motion, but put your hand above your head), 1 minute rest, Repeat 10-15 times. 10 minutes easy cool down.

Hard Workouts

One of the difficulties of cross training is replicating those truly lung-busting, difficult workouts.

So, if you’re going to be pool running quite a bit due to injury or limited training volume, invest in a bungee cord designed for sprinters.

Tie one end of the resistance band to a sturdy object (pole, lifeguard stand, pool ladder) and bring the other into the water with you.

Put the strap around your waist and begin aqua jog away from your starting point.

You’ll begin to notice the bungee tighten and resist against you (depending on the length of your pool, you may need to wrap the bungee around the supporting object or tie it in knots to make it shorter to feel resistance).

Spend a few moments testing yourself to see how far you can pull the bungee.

This is a great challenge and a fun way to compete with yourself during an otherwise boring cross training activity.

Now for the hard part:

Pick a point on the pool wall or side of the pool that you feel stretches the bungee to a very hard sprint that you could maintain for 60-90 seconds.

This will be your “sprint” marker that you’ll use on sprint intervals (95-100% of maximum heart rate or all out sprint).

Now:

Find a point that feels like the end of a hard tempo run.

Mark this spot as your “medium” interval distance.

When you complete the hard workouts, you can use these reference points to ensure that you maintain a very hard effort.

The springboard

10 minutes easy warm up, 90 seconds easy (slowly moving out and stretching the bungee), 2 minute medium, 1 minute sprint, 1 min rest (let the bungee pull you back – this is kind of fun). Repeat 10 times. 10 minutes easy cool down.

The race simulation

10 minutes easy warm up, 90 seconds easy (slowly moving out and stretching the bungee), 5 minutes medium (focus and concentrate, just like during the hard part of a race), 30 seconds sprint, 2 minutes rest. Repeat 4 times. 10 minutes easy col down

The lactic acid

10 minutes easy warm up, 90 seconds easy (slowly moving out and stretching the bungee), 2 minutes sprint, 90 seconds rest. Repeat 12 times, 10 minutes easy cool down.

I guarantee that with the bungee, you’ll get your heart rate through the roof.

You can challenge yourself and make aqua jogging more fun by seeing how long you can stay at your maximum stretched distance or seeing how far you can push it.

Likewise, if you have a friend who is injured (or someone willing to be a good sport) you can try pulling each other across the pool for some competitive fun.

Cross training can be tough, especially when you’re injured or want to be increasing your volume faster.

However, I hope that providing a variety of workouts, either through theFluid Running app (which also makes it easier to keep track of the workout while in the water) or on your own can add a fun challenge in the pool and you can emerge from your injury with minimal fitness loss.

When can I return to running?

You can still run during this twelve-week period, but only if your Achilles does not flare up while doing so.Use warm water to heat up the tendon before you run, and apply ice afterwards, even once you’ve started feeling better. Using a foam roller and hot water packs to loosen up your calves in the morning and at night is also not a bad idea, and don’t forget to take a look at what you’re wearing in your daily life.If you have insertional Achilles tendonitis, use the modified flat eccentric heel drop exercise instead of the two variants off a step.A custom orthotic or heel lift may be helpful, but should not be a first-line treatment option.

The Ultimate Runner's Guide to Achilles Tendon Injuries (5)

The Ultimate Runner's Guide to Achilles Tendon Injuries (6)

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(Video) Best Running Shoes for Achilles Tendonitis In 2022 - Top 10 achilles Tendonitis Running Shoes Review

References

1. Taunton, J.; Ryan, M.; Clement, D.; McKenzie, D.; Lloyd-Smith, D.; Zumbo, B., A retrospective case-control analysis of 2002 running injuries. British Journal of Sports Medicine 2002, 36, 95-101.2.
2. Marti, B.; Vader, J. P.; Minder, C. E.; Abelin, T., On the epidemiology of running injuries-the 1984 Bern Grand-Prix study. The American Journal of Sports Medicine 1988, 16(3), 285-294.3.
3. Maffulli, N.; Wong, J.; Almekinders, L. C., Types and epidemiology of tendinopathy. Clinics in Sports Medicine 2003, 22(4), 675-692.4.
4. Ryan, M.; Grau, S.; Krauss, I.; Maiwald, C.; Taunton, J. E.; Horstmann, T., Kinematic analysis of runners with Achilles mid-portion tendinopathy. Foot & Ankle International 2009, 30(12), 1190-1195.5.
5. Alfredson, H.; Pietilä, T.; Jonsson, P.; Lorentzon, R., Heavy-load eccentric calf muscle training for the treatment of chronic achilles tendonitis. American Journal of Sports Medicine 1998, 26 (3), 360-365.
6. Jonsson, P.; Alfredson, H.; Sunding, K.; Fahlström, M.; Cook, J., New regimen for eccentric calf-muscle training in patients with chronic insertional Achilles tendinopathy: results of a pilot study. British Journal of Sports Medicine 2008, 42 (9), 746-749.
7. Nigg, B., The Role of Impact Forces and Foot Pronation: A New Paradigm. Clinical Journal of Sports Medicine 2001, (11), 2-9.
8. Neeter, C.; Thomeé, R.; Silbernagel, K.; Thomeé, P.; Karlsson, J., Iontophoresis with or without dexamethazone in the treatment of acute Achilles tendon pain. Scandanavian Journal of Medicine & Science in Sports 2003, 13 (6), 376-382.

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FAQs

How do I protect my Achilles tendon when running? ›

5 Tips to Help Athletes Avoid Achilles Tendon Injuries
  1. Stretch and strengthen. Stretch your calf regularly by pulling your toes toward your shin or by standing with your heels hanging off the edge of a stair. ...
  2. Increase workouts slowly. ...
  3. Wear the right footwear. ...
  4. Rest at the first sign of pain.

What happens if you keep running with Achilles tendonitis? ›

Achilles tendonitis is a chronic inflammation of the tendon connecting the heel to the calf muscles. Because Achilles tendonitis is typically caused by repetition and overuse, running with Achilles tendonitis tends to make the problem worse, and can increase the chance of tears or tendon ruptures.

Are barefoot shoes good for Achilles tendonitis? ›

No, it will not make your injured Achilles tendon heal any faster and may even cause it to be more painful, especially if you've not worn zero-drop shoes before. When you have Achilles tendonitis, the tendon becomes very sensitive to being stretched.

How long should I stop running with Achilles tendonitis? ›

For mild cases you may be able to continue some running as long as you're able to keep it pain free. Bare in mind though that a tendon may take 24 hours to respond to load so may not hurt until the next day. If you can't find a way to run pain free then it's usually sensible to rest for a few days until you can.

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