Why Does My Achilles Tendon Hurt When I Run?



Are you starting to feel soreness in the back of your ankle with running? Does it feel stiff when you wake up in the morning or at the start of your run? Are you wondering, why does my achilles tendon hurt when I run?



In this episode I cover all of the myths and provide you with the latest research on what Achilles Tendonitis is and how you don’t need to stop running to overcome this very common running injury! 


This is Part 1 of this topic where I will go over exactly what Achilles Tendonitis is. Next week in Part 2, I will discuss the treatment and prevention of this injury! 



Click below to see the live video from our Healthy Runner Facebook Group…

Listen to the Podcast Episode during your next run!


This week I answer the most common questions about this condition including : 

  • What is Achilles Tendonitis
  • What causes Achilles Tendonitis
  • What are the symptoms of Achilles?
  • Do I need an MRI to diagnose Achilles Tendonitis?
  • What would a medical provider do on exam?

Let’s get into it with the blog!


1. What is Achilles Tendonitis?


Achilles Tendonitis is a very common condition among runners where they start to experience some pain in the tendon that runs along the back of the leg and into the ankle. Remember that “-itis” means inflammation, so there’s inflammation occurring in this tendon!




This is the largest tendon in the body. It runs from the bottom of your calf muscle, all the way to your heel bone where it inserts! When you walk, run, climb stairs, and stand on your tip toes, you’re using this tendon! The Achilles Tendon is very strong and can withstand great stresses. However, the tendon can also be prone to overuse and degeneration issues which leads to this pathology of Achilles Tendonitis.


The tendon can become irritated and inflamed which then causes pain. An individual with Achilles Tendonitis may notice pain in the mid-portion of the tendon, about 2 inches above the heel bone or there may be pain where the tendon inserts at the heel bone.


2. What Causes Achilles Tendonitis?


Achilles Tendonitis occurs from repetitive stress to the tendon. As stated previously, the Achilles Tendon can handle a lot of stress – but when too much is done too soon, or too much load is placed on the tendon over and over, it can become irritated.


Other risk factors that may lead to Achilles Tendonitis include:


  • Improper Training Progression with a rapid increase in speed, mileage and uphill running.
  • Tight calf muscles can can pull too much and put extra stress on the Achilles.
  • You may have an extra bone growth where the Achilles Tendon attach on the heel. This is called a Bone Spur and it can cause inflammation and pain.
  • Decreased total lower extremity strength can lead to higher stresses on the Achilles due to compensations. Strength work is KEY for this reason! Activation of shin, thigh, calf, and hip muscles (especially those glutes) is going to be super important!
  • Rapid change in footwear with less shock absorption or with a heel drop can lead to added stress on the Achilles.
  • Being a Forefoot Striker. Running on your toes can lead to increased stressors on your Achilles.


3. What are the Symptoms of Achilles Tendonitis?


There are MANY different symptoms associated with Achilles Tendonitis. Some of the most common symptoms include:


  • Pain and stiffness along the Achilles Tendon in the morning
  • Pain along the tendon or back of the heel that worsens with activity
  • Severe pain in the Achilles area the day after exercises
  • Thickening of the tendon
  • Bone Spurs
  • Swelling that is present all the time and gets worse with activity




Hearing or feeling a “POP” in this area is a much more significant injury. The pop, or feeling of being shot in the back of the heel, is an Achilles Tendon Rupture (or torn Achilles). See your doctor immediately if you think you may have torn your tendon.




4. How is Achilles Tendonitis Diagnosed?


A medical provider will look for the following signs during an exam to determine if an individual has Achilles Tendonitis…


  • Swelling along the tendon or the back of the heel
  • Thickening or enlargement of the Achilles Tendon
  • Bony spurs at the lower part of the tendon at the back of the heel (this is insertional tendonitis)
  • Point tenderness on the tendon
  • Pain in the middle of the tendon
  • Pain at the back of the heel
  • Limited Range of Motion in the ankle – specifically decreased ability to flex your foot
  • Strength Assessment
  • Heel Raises that increase pain


In next weeks episode we will discuss treatment and prevention of this pathology… stay tuned and subscribe to our YouTube Channel and Podcast so you can stay in the loop!!


In the video version of this episode, I also mentioned our brand new high touch coaching program…

SPARK Back Coaching Program.  To learn more about this program click this link to jump on a 30 min strategy phone call: https://calendly.com/duanescotticoaching/30-minute-strategy-session


This episode, our 60th episode (can you believe it?!) is sponsored by UCAN energy! UCAN nutrition is powered by superstarch and it delivers that steady long lasting energy without the spike and then the crash.


Since you are part of our healthy runner community, you will get 15% off all of your orders at ucan.co.  Just use the code HEALTHYRUNNER during checkout when placing your order.  Go ahead and give ucan a try, trust me…you won’t regret it



You can listen to all the information in this episode on the Healthy Runner Podcast…available wherever you get your podcasts!



Here is what other runners are saying about the podcast



Thank you (running friends) for taking the time to read and I hope you enjoy the podcast episode!

Warmest regards,


– Duane


Duane Scotti, PT, DPT, PhD, OCS



⚡️ SPARK Physical Therapy and the Healthy Runner Podcast  Helping Active Adults Be Able To Run Without Aches and Pains So You Can Feel Good About Yourself Again…

[Even If You Don’t Think You Are A Runner]

If you are a runner and frustrated with your nagging aches and pains and have been told to stop running, we can help you.


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