Can I Run a Marathon with Achilles Tendonitis?

To provide an indication of when the answer may be "yes" and when it's probably a "no", sports physio Steph Davies discusses the cases of two of her patients who each attempted to run a marathon with Achilles tendonitis. One finished with a PB, the other had to pull out during the race.
🌟Need more help with your injury? You’re welcome to consult one of the team at TMA online via video call for an assessment of your Achilles injury and a tailored treatment plan: www.treatmyachilles.com
📽️Other videos you may find useful:
▶️ How to Prevent Achilles Tendonitis when Marathon Training: • How to Prevent Achille...
▶️ Running With Achilles Tendonitis: • Running With Achilles ...
▶️ Achilles Tendonitis - When is it OK to Run with Achilles Pain? • Achilles Tendonitis - ...
📚Chapters:
00:00:00 Introduction
00:00:29 Achilles tendon overview
00:01:42 The demands of a marathon
00:02:44 So ... Can I run a marathon with Achilles tendonitis?
00:03:24 Case study 1: Success story
00:04:35 Case study 2: Could not finish race
00:06:06 What is the risk of tearing my Achilles?
00:08:16 How we can help
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References:
Cook, J. L., and Craig R. Purdam. "Is tendon pathology a continuum? A pathology model to explain the clinical presentation of load-induced tendinopathy." British journal of sports medicine 43.6 (2009): 409-416.
Lemme, Nicholas J., et al. "Epidemiology of Achilles tendon ruptures in the United States: athletic and nonathletic injuries from 2012 to 2016." Orthopaedic Journal of Sports Medicine
6.11 (2018): 2325967118808238.
Lorimer, Anna V., and Patria A. Hume. "Achilles tendon injury risk factors associated with running." Sports Medicine 44 (2014): 1459-1472.
Rabello, Lucas Maciel, et al. "Running a Marathon-its influence on Achilles tendon structure." Journal of Athletic Training 55.2 (2020): 176-180.
Silbernagel, Karin Grävare, et al. "Continued sports activity, using a pain-monitoring model, during rehabilitation in patients with Achilles tendinopathy: a randomized controlled study." The American Journal of Sports Medicine 35.6 (2007): 897-906.
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[@bev9708]

MANY thanks for this, it's the clearest I've ever heard it explained!

[@TreatMyAchilles]

You're very welcome!

[@zerogravity6990]

I also finished a marathon last year in spite of having insertional achilles tendinopathy. I could barely walk in spring with 9/10 bursitis pain but managed to get back into training in summer, mostly thanks to your tips. During marathon in autumn it was only 2/10 pain. You guys are wonderful! 👍💓

[@TreatMyAchilles]

Thanks for sharing!

[@ashleystauber684]

what were the main exercises you did to help it?

[@zerogravity6990]

Hello! At first I took complete rest and did heel drops but it made things even worse. Then I switched to heel raises and foam rolling my calves two times per day. Instead of running I did cycling, fast walking and core training. When my pain level was ok I started running again, quite slowly with an emphasis on upright posture. I used shoes with a high heel drop and increased it even more by putting heel lifts in them. Oh, and I cut out the heel cap on my right shoe.

[@matthewdropco]

Thanks!

[@TreatMyAchilles]

You're welcome!

[@Asd12370]

Just ran the Gold Coast Marathon with Achilles tendinitis. You can do it. You don’t notice it after a couple of km. But it definitely did some more damage to it - my Achilles tendon is way more swollen now and stiff. Will now need to rehab it properly.

[@TreatMyAchilles]

Thanks for sharing and best wishes for a speedy recovery!

[@cristianrecabarren5891]

Thanks for the amazing content. One question, when the case study with Heel raise and hop test are OK it is a 3 sets of 10 reps or just one? how normally would be the that protocol test? thanks you!

[@TreatMyAchilles]

I'm not 100% clear on what you're asking. The number of reps is determined by the reason for why you are testing it - e.g. is it to check if a person is ready to start plyometric training, then 10 may be enough. If it is to see if they can run, then number 1 is if they have actually done enough strength training e.g. can do their strength work with 10 or 20% of bodyweight added + have they completed a full plyometric workout that consists of different types of hops and jumps - this varies but can be in excess of 100 hops (but this is built up to over several weeks). And all of this can also be influenced by the patient - some older patients just don't react well to any plyometric workouts and do a very slow shuffle run - for them simply easing back into running without plyo work may be the best option.

[@tristanlenczner]

Hey thanks for the great video. Do you have any expertise with Peroneal tendinitis? The tendon on the outside of my right foot underneath my ankle hurts as i ramped up my marathon training. Very stiff in the mornings and clicks when i run too far. Have a marathon in May and really want to solved this issue.

[@TreatMyAchilles]

Here's our video (from our other Channel) on peroneal tendonitis. Hope you find it helpful! kzbin.info/www/bejne/g6PSdYCdeaaagM0

[@earthquakemagoon2505]

Hello Steph! I have an issue where treatment exercises have gone well and the Gastro & Solius are nice and strong. But, I still have a fair bit of tenderness to the touch of my mid-Achilles where the injury is. Is this normal? Should I back off some as I'm at the point of getting started in doing light bouncing? I have full ankle motion and no stiffness in the morning or discomfort when walking. Thank you!

[@TreatMyAchilles]

In our experience the tendon stays tender to touch and squeeze long after the injury has recovered and the person is safe to return to sport, so you don't have to worry about that. The more important signs are how it feels in the morning and with activities and it sounds as if yours is doing very well there.

[@evadebruijn]

🙏

[@jtortiz5605]

I had Achilles surgery 20 yrs ago. Can I run a marathon? Some times it does hurt when I train

[@TreatMyAchilles]

Yes, you can run a marathon but it is important that you make sure you also do strength training for your Achilles and take a very long time to slowly build up to marathon distance so that you give your Achilles enough time to build the strength needed for running such long distances. If you wanted help with your training plan and advice on how to strengthen your Achilles, this is something that our team of physios can help you with via video call. The best physios on the team to help with this are Steph, Kevin, Barry or Alison. You can read more about how the online consultations work here: www.treatmyachilles.com/treatment-packages

[@alugotisatishreddy8684]

Hi Mam, I have been suffering from insertional tendonitis from 2 years. Physiotherapy is not giving great results for me should i go for injections.

[@abbisalmi1948]

Consider shockwave therapy it helped me. But what helped more is known that caused the problem. Also exercises are necessary even with shockwave therapy. Treat My Achilles are great and highly recommended.

[@davidolson558]

I have had insertional Achilles tendonitis for about 1 1/2 years. I think that I put too much load ony body. I've done physical therapy and I'm a lot better. 25 minutes of stretches and exercises everyday in the morning and I'm ok. I do plan to run again after losing 20 lbs

[@TreatMyAchilles]

Shockwave can make a big difference for insertional Achilles tendonitis so that may be an option before injections. Also, it may be worth checking if you are actually doing the right exercises - if you wanted help with that, it is something our team can do via video call. Your can read more about that here www.treatmyachilles.com/

[@plengrongpi8241]

I am surgery after 6 month but still my achilles tandon very tight what to do?

[@TreatMyAchilles]

Strength training is usually the best way to get rid of the tightness from surgery - I can't comment on what the right exercises are for you because I don't know your situation - your physio will be able to help you with that.

[@WishToSightRead]

So, I'm practising for a 4 mile, during running my achilles doesn't bother me at all, it's only the next morning that it's rather irritated. After walking around a bit, it's more or less ok and after doing calf exercises even better. Can I continue running with this reaction?

[@TreatMyAchilles]

Here's our video with advice on that: kzbin.info/www/bejne/mJ-rgaiOo991Z7s

[@drezzy10]

Hi I’m a basketball player that’s been suffering with insertional tendinopathy for over a yr, was wondering if a compression sleeve or brace would be recommended

[@TreatMyAchilles]

Compression braces and sleeves doesn't really work for Achilles injuries - In order to recover they require a period of reduced load (relative rest) + a carefully graded strength training plan. You can read more about what treatments work and what doesn't work here: www.treatmyachilles.com/post/achilles-tendonitis-treatment-what-works-what-doesn-t-work-and-what-makes-it-worse

[@plengrongpi8241]

How to my achilles tandon tight become flexible

[@TreatMyAchilles]

I'm not 100% sure what you mean, so will provide 2 answers: 1. If your Achilles is painful and feeling tight, then it is likely injured and this video will help you understand the treatments: kzbin.info/www/bejne/fmLRl5qLZsagrMk 2. If your calf muscles and Achilles is simply tight from exercise, then doing calf stretches will help - but stretches may make it worse if it is injured - so make sure you get it assessed to understand what is the correct solution.

[@davidolson558]

One thing missing from these videos is weight loss in healing the Achilles tendonitis

[@TreatMyAchilles]

You're right - I have added it to our list to do.

[@davidolson558]

@@TreatMyAchilles thank you!

[@commonwealthedison5346]

No.