The Runner's Guide to Achilles Tendinopathy

[@waynehadley1999]

I'm 60 years old, been a runner since primary school, rugby player, swimmer, waterpolo and triathlete since 1986, sprint, 70.3 and IM distances. Over the past 8 years I've struggled with recurring achilles tendonitis, did loads of rehab, PT etc. each time, did all the usual exercises. The big change for me was switching from 10-12mm heel-toe drop shoes to 4-5mm, this is counter to the conventional wisdom that you need a higher heel-toe drop if you have recurring AT. Symptom free and mileage heading up to normal over the past 12 months. I also think the other factor to improvement came when I added plyometrics to my rehab (once I was pain free with isometric, eccentric and concentric exercises and passive stretch).

[@mwdaniel]

Interesting. I had to switch to 10-12 mm drop shoes (Brooks Stealth), they have been the only shoe that has removed the pain and aggravation enough to help the recovery, to the point I can walk barefooted without pain (for the most part)......after over a year and half. Tried the 5-7mm drop Hoka Bondi route and could never find relief. ALso for work, I started wearing Red Wing boots that had a higher drop. Now, after watching this, I will begin the heavier load, lower rep work.

[@dallasdevries9421]

low drop stuff is what kicked my issue off to begin with...defintely aggravates it...would love to go to a zero drop again...not sure its in the cards

[@applerunner1184]

Just wanted to let everyone know that Matt is spot on based upon my experience - I am about 15 months on from a bad Achilles problem which I picked up during a race. I could barely walk. It didn't really start improving until I was able to do single leg calf raises with a deficit. Heavy weight (I am now up to 150 lbs). 5 reps per set, 3 sets. I just smashed my half PB with zero achilles pain! It does take a while, so be patient.

[@kylestreeter6569]

What's "a while". Just curious. I've had symptoms for about 6 months and started rehab immediately. Still having symptoms and wondering when I can expect to feel normal again.

[@applerunner1184]

@@kylestreeter6569 I was running after about 3 months with symptoms. I had to tape gel pads to my heel and remove shoe heel counters to prevent friction. I was not symptom free until 9-12 months. The real progress in the rehab came from progressing to heavy single leg heel drops twice a week. I mean heavy - to failure (5-8 reps, 3 sets). Increasing the weight on a regular basis. Then I started doing the same weighted heel drops with a deficit. Start small initially and then build up over time. After a while, performing heel drops became the “medicine” for pain. I always felt better after!

[@Mattbh119]

2 yrs off n on most annoying injury / issue

[@applerunner1184]

I was running after about 3 months with symptoms. To get symptom free took about 9-12 months. Heavy weight to failure. Then with a drop. I use a smith bar at the gym and put a weight on the floor to provide a deficit. Key is to keep on progressing the weight and the deficit. Keep going beyond pain free symptoms as it is still healing when no pain. I still do it for maintenance purposes…

[@andybrown9190]

Can I ask, did you still doing running whilst carrying out your strengthening exercises.

[@BowflexWorkouts]

Wow, this was so informative! I thought I had a full recovery from my Achilles Tendinopathy and backed off the rehab a few months ago & now it's flaring up again. I stopped when the pain went away. Sounds like that's a common mistake and I know better now. Thank you so much for taking the time to record this video!

[@runningfortherestofus7812]

That was a really great episode. I’m a masters runner who has struggled in the past with this. I’ve been doing one legged calf raises just with body weight so I’m going to try going heavier. I actually benefit more from these topics than the shoe reviews. Please keep making more of these. Question; does it help to do both straight and bent leg calf raises to work both soleus and gastroc?

[@mcfarvo]

AFAIK straight leg hits both just fine, whereas you may be missing out when seated, so use both or just the standing/knee-extended CR lifts

[@jeffloflin6316]

Age 63, 25 trail races over 3ish years. Yep achilles issues from the start. One is great the other in rehab. This information is very accurate. Great video!! The main reason I've made it through is my Physical Therapist, Erika, who is up to date on achilles issues.

[@james3856]

I must have listened to over 100 videos on Insertional Achilles Tendinopathy. This is by far the best video I have seen. Thank-you for sharing the rich knowledge from your doctoral studies on this subject. I have run the Boston Marathon for 7 years in a row trying to get under 3 hours and have come within a couple mins. But I have been plagued with insertional Achilles issues on most of my hard and long runs. I am able to bear heavy loads with heal drops, but have never continued for more than short periods of time. I have just put up with it. I have noticed an interesting thing though. I recently tried shoes with support and the pain is gone. I love minimalistic shoes to make me faster. I would love to go back to my low drop lighter shoes with no pain. I'm going to try easing into heavy weights for a year and see what it does. Note to author: if you're interested in talking sometime, it may be an interesting case for you due to my Master's level of intense training. I would still like to get under 3 hours in the Boston Marathon. I am 61 years old.

[@fernandezjose205]

I truly appreciate your help! As a new runner, I've been dedicated to intense training for about 5 months, achieving some notable milestones, including PRs and a half marathon. Notably, I started with a 36-minute 5k and have progressed to an impressive 19:37 5k within this relatively short period. However, during a 10k run, I experienced Achilles pain, possibly linked to my Nike race day shoes and rigorous training. As of right now the discomfort surfaces at paces below 9 min per mile, but I can manage with slow runs, walking, and calf exercises. Despite this, I can't help but worry about potential tears, given my past experience with a meniscus tear from MMA when I was younger. I'll continue to run slow and incorporate weight training exercises. Thank you for sharing your knowledge and valuable information!

[@SteveLinGuitar]

Thank you so much! I'm 42 and last week experienced my first Achilles tendonitis. Stumbled on your channel after watching a bunch of stuff and can't thank you enough. This was caused by badminton -- lots of footwork in lunging and jumping--lots off explosive movements. I'm very happy that the message is that all of this can be remedied and improved.

[@nznige]

im 46 and have had it bothering for me about 3 years, I was doing long distance slow trail runs and playing tennis, I think its the tennis doing it, so frustrating its stopping me running another 50km atm

[@rdnatasha]

I'm also a badminton player and going through the same since 1 year :( although I'm 24 and have playing for 12 years, I used to be so pain free :(( admittedly I have always been really bad with warming up and cooling down hhaha, it's catching up to me now. Curious as to whether your achilles tendonitis is in your left or your right? Mine is left, I wonder if it's footwork related.

[@TheCyclingCardio]

Awesome..now I need to rehaul my lower body program…my plantar fascitiis, achiles, and sacrolumbar (due to squats) is compromising my training

[@brentg2792]

Great information, thanks. As a 47 year old ultra runner I’ve been battling high hamstring tendinopathy in both legs for last 6 months and my left achilles just started acting up. Been lifting but not with enough purpose or close enough to failure. Excited to try the heavy 3-5 sets/reps.

[@armanimckoy2168]

Im using this info to help with skateboarding.

[@sumguy9687]

Great info. I’m 58 and have been having achilles problems for a while now. Been concentrating on eccentric heel drops per the Alfredson protocol. Just started adding weight with a 20lb dumbbell about a month ago. Gotten back into run/walking and so far so good. Also using shoes with a higher heel drop.

[@johnmclean9498]

Mat - huge thank you for this. This is very helpful- I will be switching to your protocol of heavier weight and low reps more frequently. Keep doing the great content - and have fun chasing the kids 👍

[@cedric_v]

What the .. Been having so much stiffness in my achilles last months but was always afraid to load heavy with the calf raises. Decided to give it a go with 13kg and the stiff is like totally gone after doing 4 sets with 5 reps. Guess weight idd was the key to all this Awesome video this !!!

[@guinevereshort3811]

I have been crippled with bilateral insertional tendinopathy for 24 months now. This video has given me hope that there is light at the end of the tunnel. Weights and habit. It's that habit-forming I worry about. But Thank you. It was really informative.

[@Marc-dk8vw]

Congrats Dr Matt (I know you are still working on PhD, but you will do it.)

[@samadhistrength]

Really solid topic. Any tips for how to handle a calcific insertional tendinopathy vs a mid range? I have a background in barbell strength training which kept me completely injury free for the first 3 years of dedicated running at 37 years old. Got slammed with the achilles issue and the low rep, super heavy eccentric work is literally the only thing that makes it feel better. Good to hear that research is saying the same! Strong follow on this channel💪

[@SirThomas1212]

Anyone can pu any activities any day but the consistency is the most hardest to keep. An informative session on the topic for runners, thank you Dr. Matt. Now you can run and destroy some shoes. 🎉

[@jaakkoperala5772]

Just wanted to say this was a super useful episode! I've been dealing with Achilles pain for 4 years and only a few months ago I noticed the lumps in both of my Achilles. I've done strength training for calves, but I should've used more weight. I'll put it back to being my top priority again - let's see how things evolve.

[@michaelhaney1357]

This was timely. My DPT helped me get through Berlin and Chicago while dealing with this. I was typical, as the issue was over a year old before we got together. Spent the last 6 weeks getting things settled down while building strength and have just started adding weights. Now I’ll try upping the weight and lowering the reps. I should start jogging in another couple weeks. Mentally, I was already resigned to not running all out until at least the summer. Thank God I can still get VO2 max and anaerobic work in on the bike. Really appreciate the in depth talk.

[@JHornsby89]

This is really fascinating, I injured my Achilles in 2018... Had to take time off, 6 months later did strength training. Lots of heavy KB calf raises etc. 3 months later voila! Gone!... or so I thought. I then trained and after most speed sessions my Achilles would "flare up". Couple of easy runs, gone... Fast forward 2024, in really good running shape (highest most consistent block of running in a long while). Finished my long run and bam! It's back. Well interesting to know, I never really "fixed" the tendinopathy in the first place. Back to strength training I go...

[@sirbustasirbusta8099]

So did you stop strength training and then when it flared up?

[@JHornsby89]

@sirbustasirbusta8099 given that was a few months ago. What I did was back volume off again, strength trained with lots of calf raise variation and general strength stuff. I've now picked my running volume up, put 1 speed session in a week, kept strength in 3x a week and I am experiencing no pain. But I'll keep the strength and calf exercises in even though the pain has gone. As the video states its a long time to fully restrengthen the achilles.

[@andynth33]

great episode. is there any examples of the one leg kettle bell calf raise that you recommend?

[@Dr.Warren]

As a fellow PhD, congratulations on finishing up!!! I tore my Achilles this past winter training for a marathon. I've completed an Ironman and several marathons so I was used to the training volume. Six weeks in a boot, 10 weeks PT, and I am currently on my "return to running" program. It's a combination of walk/run should be 100% running this fall. This is great information. Keep up the good work.

[@IvanaNovcic]

Would you avoid foamrolling calfs while having Achilles tendinipathy? Thank you.

[@LancePeterman]

Great stuff, Matt. The calf strength training in particular was helpful. Hopefully some black friday sales on kettlebells :)

[@matthewtait]

This video is fantastic, thank you!

[@skateata1]

Everything in this videos makes sense. My route always included up and down hills. I also play roller derby so my ankles go through a lot. I noticed abig improvement when i added strength training to my routine and an actual warm up.

[@nigelb8007]

Great vid

[@bjornpersson1172]

Thanks for a great episode! A friend recommended it to me. I’m desperate to get back to running after two years of not running. Rest didn’t help, nor did body weight eccentric heel raises. Will definitely try this! What I don’t get is how to do them without support, with a kettle bell in each hand. Is that on flat ground then? Cause it seems hard on a step up board. Anyone, please go ahead and reply.

[@travisharrisphotography]

Great info! Thank you!!

[@treythompson3083]

This is a very informative video. I have been dealing with this issue for over a month.

[@DoctorsofRunning]

Thanks for watching! Hope this video was helpful to your recovery.

[@Bettie_Noir]

Thank you for this. I am 56 and I have been suffering from Achilles tendinitis and Tennis Elbow for several months and the pain is awful. Does taking collagen help improve tendons in addition to the exercise? Thank you again.

[@StreamCrossingRunner]

SO helpful- I’ve been suffering from this and this is so helpful!

[@DoctorsofRunning]

Thanks for watching!

[@wendymackenzie7771]

@DoctorsofRunning what strength would you recommend for bilateral insertion achillies tendinopathy. TIA. Great video BTW

[@danieljozefczyk7869]

This is so true I used to struggle with my knees in my 20s and now it's my calfs being 42 thank you this is interesting

[@fahadghabesh3053]

Thank you for this video! It's been incredibly helpful for my Achilles tendon I can already see improvement Keep up the great work!

[@erinmalette7276]

I do these calf raises for post tib. Would suggest loading heavy as well? Light weight high rep hasn’t helped.

[@chrisconrad4521]

I’ve had Achilles tendonopathy for 2 years. In my last year of middle distance running, I had to get cortisone shots in both ankles 3 times over the year. I wish this video was made earlier but better late than never!

[@darrenogrady7797]

Thankyou Doc. Covering the lifestyle risks such as alcohol as well as "banging on" about aging factors made me sit up and listen. We can't stop aging and there's no chance of stopping having a tickle so that's it. Back to biking ! I'm kidding 🤣 A Brilliant intro with research science pouring out of your brain thankyou for the enlightenment, staying fit over 50 is like a whole new meaning to growing up I can assure you and you could also add a hint of addiction to the love of being fit and the joy of trail running as one of the big hurdles in treatment. It really bites not being able to "just run" and it's a huge mental aspect of recovery. Patients and faith in the process of healing. Eccentric strength tendon development is there an acronym for that ? ATEST SP4AG Achilles Tendon Essentric Strength Training. SLOW Program 4 Age Groupers 😅 You rock thanks again...

[@michaelcaricoo]

Jokes on you thumbnail, I always panic

[@DoctorsofRunning]

🫠

[@emirgokcen1906]

This was great, thanks a lot. I have been suffering from Archilles Tendinopathy since 2018 due to high running load back then. It has never been fully healed. Long term mindset is the key as you suggested which is I did not do much. Need to stick strength training for long term.

[@intosite7279]

Really insightful! Have seen so many videos and read so many articles that mention the same exercises but always only mentioned heavy weights without specifics, which isn't helpful. 5 max reps weights is so much better indicator

[@maewalker]

This was really helpful. I'm a younger runner, and my physio thinks I might have a tendonopathy--not it's not in my Achilles (tho I have had some calf pain), it mostly tends to have some sharper pain thru my anterior medial calf/peri-shin area (which I'm not even certain has a tendon there...). Trying to find strength exercises that work for that I'm finding tricky. It's not on the shin itself, so I feel like a splint or stressie is pretty unlikely. I know I have struggled with hip strength for a long time, so maybe that's an area I need to address better too 😅

[@emf6621]

I've struggled with Ach. Ten. (AT) for more than a year now. I have reduced my running and done many heel raises, but the tendon keeps getting sore to the touch after activity. I'd be very interested to hear how you'd interpret that symptom - soreness in one spot when the tendon is palpated.

[@timowen5741]

That was extremely informative and sadly I fit the classic demographic. I now realize that I’ve had Achilles tendon issues for a long time but running “steadily” they have just about been under control (well no pain or swelling) recently I’ve slowly added some speed work and yesterday during an easy 10km the pain started. As soon as I’m back to normal walking I’ll try the method prescribed and will be, for once, patient. I’m 61 and a keen triathlete so hopefully cycling will still be okay and obviously swimming

[@gdm9488]

Got minor tendinopathy pain and doing calf raises and can do slow running with low pain, I've been dealing with it a month or so, so early in healing. I know you mentioned no faster running early on but how much would a 10k race in a couple of weeks set you back? Mid-late 20s m

[@yourloved6741]

I have been running about 4 years and just developed what looks like a lower bursitis and tendonitis. I have not been diagnosed but it’s the lower part of my heal. I don’t have any pain but it’s red and irritated. My question is this, should I only do Eccentric on the ground??? Or, slow Concentric & eccentric? Up & down. I read that going up could cause irritation to bursitis?? Thanks for incredibly video! Going to start to strengthening ASAP.

[@richardrivera7591]

Suffering from Achilles Tendon issue right now....going on 4 months.....pain after running and can hardly walk afterwards. Pain is just above the heel. BTW, I'm 59 yoa male and was running about 35-45 miles a week.

[@FeelgoodThreads]

@doctorsofrunning I’m in month 6 of rehabbing an Achilles rupture. When do you recommend I start loading heavy? Right now I’m only doing single leg calf raises with body weight.

[@cosmicsea666]

Do you have any insights into scraping the muscles and tendons? I went through some rehab for this particular issue, and they focused a lot on scraping. I'm not developing discomfort again as a 51-year-old runner and have found that scraping helps relive the stiffness and discomfort while I'm not running.

[@ivankrga8817]

@DoctorsofRunning Pros and cons of calf stretching for people with Achilles tendinopathy?

[@DoctorsofRunning]

Unless your calf muscle is actually limited in its flexibility, stretching not recommended for Achilles Tendinopathy

[@ivankrga8817]

Thanks for the feedback.@@DoctorsofRunning

[@veecord9863]

Why not?

[@pabloromar7413]

@@DoctorsofRunningstretching is recommended litteraly everywere on the internet and my doctor in Switzerland showed me the « stanish » protocole wich contains stretching everyday. Can you explain yourself a bit more ?

[@sublimity59]

Hi thanks for the great video. One important question - do I run on the same day as strength training? If so, before or after the strengh training?

[@DoctorsofRunning]

Recommend checking our strength training episode for these answers: kzbin.info/www/bejne/d6Oxn6qpg86Yi9ksi=e0tygO6H2bzb14qg

[@giuseppec8134]

In the context of what you discuss in the video (namely, strenghtening, load management and recovery) can you also advise on the impact of the drop in running shoes when trying to recover from Achille's tendinitis a/o tendinopathy. With the view of picking more forgiving shoes to deal with Achille pain (a/o tendinitis) I've just purchased a pair of Topo Atmos, after some deliberation against the Glycerin 21 and the Ghost Max (booth featuring a higher drop, despite the lower drop Brooks claim for the Ghost Max). My thinking choosing the Atmos is that if I need to increase the drop I can always add a heel lift to them. My choice has mostly been the result of me being no longer able to tolerate pointed shoes like those from the traditional brands. To give you some background, about a year ago I found relief from some metatarsalgia through using lower drop and foot shaped shoes (namely Topo for my running and Altra for my walkings). I got rid of my metatarsalgia, and built good resilience and strenght in my running, with few 10ks and half marathon joyfully run by following a well structured routine for a number of months and including long, speedy, tempo and recovery sessions for a total of, let's say, 40/50 miles per week. I probably abused from using my Altra Escalante 3 during a two-week holiday when I did some running (which I hadn't done before), which included some unplanned hills, and lot of barefoot walking on the beach. As a result, I believe, back from holiday, when resuming my usual running I started experiencing an increasing pain in my Achille. Although this prevented me from going back to my pre-holiday routine I have somehow managed to do some running since (let's say 4 miles three time a week) and some strenghtening routine of the like you discussed in your videos. Based on the pain, which I understand is not necessarily a good indicator, it seems to be improving. I am a mid foot-forefoot stryker, slightly overweight (85 kg and 180 cm) and 46 of age (fit and healthy). Although I had not payed attention to this before, I've realised that my most congenial drop height has always between 4-6 mm. Most recently, and following my metatarsalgia, I have developed low tolerance to higher drops (8mm+). Thanks!

[@markuscg1]

I have issues with my Achilles. I wanted to be in your study but didn’t qualify due to some other hip issues. 😢 I’ve noticed that a certain statin (which many of us over 50 are on) caused my Achilles tendon and plantar fascia to get really tight and cramp quite a bit when at rest. I know statins can cause myopathy but surprised at the issues I was having. I’m trying a different statin now.

[@adamdonahue4617]

Best shoes for this?

[@everett1326]

This video is super informative, thank you for the in-depth explanation! I was surprised that stretching wasn't mentioned at all. If someone is experiencing achilles tendinopathy/tendonitis, are there any benefits to stretching the calf/area or have you found that there isn't as much of a benefit relative to strength training and load balancing?

[@DoctorsofRunning]

@@everett1326 typically tendinopathies do not respond well to stretching. Most research suggests not doing that unless there is limited motion. The best responses from the research and clinically have been from load balancing and appropriate strength work to help remodel the tissue and improve the ability to tolerate stress.

[@kdub3562]

Very helpful and gained some additional info that I was not aware of

[@ahmedhentati598]

Thanks for the awesome rehab guide! Very informative video. What would you recommend as the top exercise for tibialis posterior tendinopathy please ?

[@jvizzle3141]

Incredibly helpful (and hopeful) video - I’m committing to putting in the work to finally put this issue to bed … You mentioned your grip: I’d highly recommend a quality weightlifting strap (versa gripps are really great) to remove your grip as a limiting factor in your calf training … There’s a time and place for grip training, but it shouldn’t impede your target muscle training! Straps are a staple in bodybuilding because back training is otherwise almost always grip-limited…

[@m.topfer]

Do you have some tips for stability when doing calf raises and having weights in both hands? Currently my setup is heavy backpack (30-40kg) with 10kg dumbbells but I have hard time with front-back stability when I'm trying to go down very slowly and controlled. Thus I prefer to use just one dumbbell and use the other hand for stability. But I didn't try many times to use both dumbbells - probably it is just a matter of training (and also heavier dumbbells instead of backpack might help - lower center of gravity). Could you be more specific about follow up exercises regarding plyometrics? I can quite easily get back to running (trail running, cca. 70km/w mileage, decent speed ~3:30min/km, no problem with speedwork) but I'm having really hard time to get from there to be able to do team sports with sudden changes in directions - like ultimate frisbee. What would be some demanding exercises that could make me ready for such sports?

[@applerunner1184]

Yeah - I had the same issue. I got the most benefit by 1) increasing the weight and 2) adding a deficit. My solution for 1) was to go to the gym and perform the calf raises using a bar with weights - the bar is attached to a frame at each end so stability is not an issue for me. I use a weight on the floor to provide a deficit.

[@luiseduardoharobarchin3063]

I am a bit late into this video, but would you have any suggestions in terms of shoes that can actually reduce the risk of developing these tendinopathies?

[@boldlygoing_nowhere]

Great stuff!! Confused on one comment: At 25:38 he advises lower weight, higher reps for loading, strengthening, change tissues. At 26:31, he says higher weight, lower reps for tissue changes. Then says hes up to 75 reps on something. Just wondering which is the recommendation?

[@DoctorsofRunning]

@@boldlygoing_nowhere that’s me screwing up. High weight, low reps make far more significant tissue changes in tendons

[@boldlygoing_nowhere]

@@DoctorsofRunning thank you!!! super enjoyed this episode and appreciate you putting it out there the people.

[@zacharysmith5982]

Hi Matt! You specified 3-5 reps 3-5 sets for the heavy lifting movements, but I’m wondering: what would you prescribe for the Plyometric movements? I know you said explosive, quick recoil jumping is best, but what sets/reps would you program? Thanks!

[@Jarrod723]

Is there a simple strength training plan you recommend for runners that include principles like slow heavy resistance training and other important practices?

[@CreemoreTorch]

Much appreciated.

[@Kledis]

Are the same principles valid even with Haglund's?

[@Ginguredrunner]

What do you suggest for someone that has arthritis in both big toes (which makes calf raises difficult sometimes). I'm also wondering if you think it's ok to keep running if you wake up in the morning with stiffness? The pain is there but not unbearable.

[@davidpruden1736]

I had both my big toes fused due to arthritis. I now run in stiff carbon plated shoes as they protect my toes and can roll over the top of my big toes (as opposed to ankle rolling out to get around the big toe). Best thing ever from my perspective, and means you can get back to running and calf raises without much issue.

[@BenitoR2]

​@@davidpruden1736 What's your plated dhoe of choice for this? Thanks

[@angelakle6576]

I have a really bad flat foot on the left. Could that mess with my achilles tendon? It hurts on the inside of the back of my ankle when I get up from my couch. I am overwight.

[@MargieLodovico]

what do you recommend for footwear at home and at work? does heal drop shoes necessary,thanks

[@sjm2347]

Any single exercise / 20 min session recommendation for IT band? Is the rec for fascia similar? My IT band went from tight to totally unable to run in mile 23 of a road 50k. Four weeks later and still pain, even just walking sometimes. Past PT for issues always put me on the 3x10 rep low/no weight stuff, which takes an hour, but at least included calf raises, single-leg squats, RDLs - also a lot of glute work. 🤷‍♂️

[@parkernovakovic9806]

What heavy eccentric / weightlifting exercises should I do for posterior tibialis tendinopathy?

[@davidg5584]

Thank you

[@Bypassrunner13]

As someone with tendinopothy and a haglunds. I still run ultras on it but have been told I need to wear orthotics. I’d rather stay on a program of strength and avoid the orthotics. Do you feel that I do in fact need to wear a corrective measure for this ?

[@harry800]

Would you recommend seated calf raise or standing

[@jordanberumez5983]

What’s the likelihood of getting a tear or rupture from running with tendinopathy? My job requires me to be very active with long runs, fast runs, rucking and many other physical activities. I don’t have the luxury to avoid these activities for 9 months. I was told you can’t really tear or rupture from running, it just upsets the tendon.

[@QronoZ713]

Hi Matt, great video. I have a hard time to understand what "heavy" is. I'm problem the strongest in my calf, by far among my running friends yet still I have tendonitis in my Achilles. Something doesn't add up for me.

[@QronoZ713]

Like, I'm doing 3-4 × 10 Double leg 120 kg Smith machine lifts, full ROM.

[@pelaubscher]

Can you clarify? Re-read your text. Thanks

[@QronoZ713]

@@pelaubscher According to Matt, and the research, having a deficit in strength in the calf is associated with achilles tendon pain. I've had lower leg issues for quite some time, a couple of years. During those years I've built my calf strength really well, I'm lifting the heaviest I've ever done. Still, I managed to get achilles "tendonitis" while running maybe half the mileage I used to. Among my friends, I'm by far the strongest in the calf lift exercise, yet we run the same (or they run more) and they are not injured. I have a hard time wrapping my head around all of this, it feels like there's some missing pieces here. Like, the other day I saw a video of Kara D'Amato doing calf raises with like a 5 kg weight, and she runs 160 km/week. Meanwhile I get injured running 100 k/w, while being able to lift 120 kg x 12.

[@girtsstromcinskis1173]

Hi i have stiffnes in archellies when i run but, when i do calf rases with one leg it is sharp pain in archelles, wath should i do? It all started a few days ago

[@applerunner1184]

I had a bad achilles issue caused by a heel spur (see my post above) and I am now fully recovered. You need to start easy and slowly increase the load. Start with two leg calf raises, then do single leg, then single leg with weight, then single leg with weight and deficit. Then rinse and repeat with more weight. Stick with it and be patient - it takes up to 9 months to fully recover. One thing that I did for a while was to tape gel pads to the back of my heel to prevent the shoe counter from rubbing against the heel. For some shoes, I even had to cut out the heel counter.

[@angelakle6576]

And what do you mean by, "loading this thing"?

[@angelakle6576]

ok it is hurting when i get up and then if i walk on it, it isnt hurting if i walk.

[@simont6439]

Great video! But I think your claim of higher reps being ineffective is not accurate. After all, the Alfredson protocol is based on 3×15 reps, twice a day, 7 days/week, for 12 weeks, and has shown great results on Achilles healing, both insertional and mid-portion. That is more frequent though than what you suggest. Would be interesting to see a study comparing these protocols.

[@DoctorsofRunning]

@@simont6439 the current evidence suggests that heavy slow resistance training has better long term outcomes than the eccentric protocols. This may have to do with the fact that tendons respond/remodel best to stimuli that is higher intensity and lower rep. Similar to their response to plyometrics. I should have clarified that higher eccentrics are not ineffective, but the current research has suggested there are better ways. -Matt

[@thewarrenbuffettspreadsheet]

Do you know if I should not to the calf raises with a deficit if I have insertional achilles tendinitis?

[@simont6439]

@@thewarrenbuffettspreadsheet You should do only a flat ground calf raise. Either eccentric only, or concentric & eccentric. If you drop below horizontal you'll compress the insertion point with the tendon which irritates it. For protocol google 'New regimen for eccentric calf-muscle training in patients with chronic insertional Achilles tendinopathy: results of a pilot study'

[@cristian-adrianfrasineanu9855]

Does a higher LSS in Stryd mean the tendon is getting healthier again due to increased stiffness and energy release?

[@miroslavmiskuf3459]

cool video 👍

[@ehougen82]

"I picked this up from Cal State Fullerton, one of the PhDs down there." It's Andy Galpin isn't it? Just say it haha

[@chrisconrad4521]

What should I do on the days between weight calf raises?

[@sunnek]

44yrs old.not a runner.occasionally play football and cricket.have had issues with knees recently developed Achilles tendinitis.how do I treat it.pain is severe.therapist is giving ultrasound,IFT and laser treatment.should I wear orthotics.but mostly wear flip flops.how do strengthen muscles?what exercise should I do.pls help .in lot of pain but have to go around with usual work and travel.

[@jeronico2000]

I don’t heared anything about forefoot stability, ankle mobility, myofascial release of calves , toe yoga, general stiffness in hamstrings , running shoes ? 😮

[@bluesque9687]

What are the best shoes to avoid Achilles issues?

[@Landshark928]

In general the ones with higher drop, also give attention to stability otherwise your tendon needs to perform under lateral stress

[@jj..200]

Cuanta carga se debe soportar en cada una de las 3 series 20? 30? 40kg? Gracias Un saludo

[@jj..200]

Mas carga ?

[@kizarumelon2477]

COMMENT SECTION: PLZ SAY WHETHER U HAVE MID SECTION OR INSERTIONAL ACHILLES TENDON PAIN. -one u need to do dorsiflextion. The other u do not want dorsiflexsion (ankle dropping below toe angle).

[@vinzactive]

Can someone with achilles tendinopathy still do his regular running routine while completely healing the specific tendon?

[@DoctorsofRunning]

@@vinzactive yes as long as the symptoms are manageable! Don’t be afraid to modify your training if you need. I’ve been able to train through mine and rehab it! -Matt

[@vinzactive]

@@DoctorsofRunning thanks Matt! Great help

[@mcfarvo]

If you're not lifting/resistance/strength training, then you are missing out!

[@iainstatham]

Can someone define 'sore'? I can deal with the pain as i warm into a run. It hurts sometimes for a few moments when I'm walking. But it's mostly okay, unless i touch it. So long as i don't touch or poke the tendon it's okay mostly.

[@thatswhatisaidbunnybread.5317]

Did you say you use 75 lbs in each hand???

[@davidannett1616]

Thank you so much. Ive been struggling with this since 18 when i started college running. Here i am at 31 and still have bad flare ups. What do you think about a sleeping sock to keep it in a stretch position? About grastin? Strength is on the menu, but i want to train between now and then too!

[@thewarrenbuffettspreadsheet]

I am fairly strong and I can do like 30 single leg calf reps with 75lb kettlebell. I dont have a gym. How can I list so heavy that I only manage 5 reps?

[@QronoZ713]

Smith machine or leg press

[@Thepianoman77]

Can I hire you as my Physiotherapist? I promise my insurance will pay you 😂

[@Thepianoman77]

What all of us knew you were gonna say.... Strength training and progressive loading 😭

[@DoctorsofRunning]

@@Thepianoman77 true!! The key is at least 9 months of progressive loading BUT high weight low rep!!

[@Thepianoman77]

@@DoctorsofRunning I will do my best! Mine is definitely Achilles tendonopathy, but I guess not bad enough yet, and hopefully never. Still able to do 40-70 mile weeks. Gonna see my primary this week also, for this and other routine things. Maybe a PT or physio referral as well. Do you have suggestion for a strength training routine (to do along side marathon training plans)? I’ve been trying to do leg strength at least once a week. But I want something with a bit more substance, but that also fits for marathon training goals, if that makes sense.

[@andreitarkovsky3214]

any casual viewers can tell me (stumbled upon channel) does he sell shoes too?

[@DoctorsofRunning]

@@andreitarkovsky3214 we do not sell shoes or any product. Matt certainly does not. This is the now published research from his PhD.

[@vaato5059]

[@evadebruijn]

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