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Achilles pain training errors: Not enough R&R

Updated: Jun 2, 2022

Training Error Series:


Research has shown that training error is the main cause of about 80% of the overuse injuries, like Achilles tendinopathy, that runners get. You have to analyse your training and fix possible flaws or you may find that your Achilles problem continues despite doing all the right exercises and treatments. In this blog I explore why rest and recovery are important factors to consider as part of injury prevention / treatment and need to be factored into your weekly programme. This is the second article in our Training Error Series where we look at Boom & Bust Cycles, Rest and Recovery, Weekly Mileage and Training Intensity.

Not allowing enough Rest and Recovery in your training programme is a very common training error that can cause Achilles pain but also stop your Achilles tendon injury from recovering.

In this blog:

  • Why do we need rest days?

  • Rest also includes sleep

  • What can I do to factor R&R into my week?

Why do we need rest days?

When we run we cause changes or adaptations in our bodies. Running gives an endurance stimulus to our body so it starts to adapt and get fitter to allow us to keep progressing and running further with more ease. These adaptations need time to occur.

When we run we also put load through our joints, muscles and tendons – one of which is our Achilles tendon. These also go through natural adaptations to allow us to take more load and do more exercise.

I will focus now on the Achilles tendon that is made of collagen. To keep collagen healthy our body is in a permanent cycle of laying down new healthy collagen fibres and removing the waste products and parts that the body no longer needs.

When exercise is of a too high intensity or volume compared with how quickly this recovery cycle can lay down new healthy collagen fibres, we get out of balance and that’s when pain or problems can occur. Rest days allow our Achilles tendons and the rest of our bodies to stay in balance and to adapt so that we become better and fitter in our chosen sport or activity.

Rest also includes sleep

Sleep is probably the best recovery tool we have. It’s important to us physically and cognitively – there’s a reason why sleep deprivation has been used as a torture technique!

The recommended amount of sleep per night for a healthy adult is 7-9 hours, but athletes may need 9-10 hours. Both sleep extension (sleeping for longer periods at a time) and napping has been shown to lead to improvements in sporting performance. provides expert online physiotherapy treatment for Achilles Tendon Injuries. Follow the link to learn more.

What can I do to factor R&R into my week?

Our recovery load needs to equal our activity load. A good start can be to look at your training programme and schedule rest days pre and post high intensity days.

Here are some evidence based sleep strategies if you struggle with sleep:

  • Training more means you need to sleep more, therefore changing your bedtime needs to be a factor.

  • Daytime napping, even just 20-30 minutes, reduces the effects of sleep deprivation.

  • Maybe changing the time of day you train e.g. late night training or early morning training could mean you go to bed earlier or get up later.

  • A regular sleep routine is important e.g. a regular bedtime or wake up time.

  • Limit lie-ins on a day off to within an hour of normal wake up time.

  • Sleep hygiene is important if you struggle with sleeping. Think about avoiding caffeine, alcohol and nicotine in the hours prior to bed.

  • Wind down more by getting less blue light from devices or doing fewer stimulating activities an hour before bed.

  • Learn coping strategies for anxiety and worry because it can affect sleep e.g. relaxation or guided imagery techniques.

  • Create a comfortable bedroom environment that is cool, dark and quiet. Using ear plugs or an eye mask may also help.

When designing or tweaking training programmes I always take into account my patients’ weekly mileage, symptoms (including how they respond over 24 hours), exercise intensity, other weekly activities that they have to do e.g. work and childcare as well as the periods they allow for recovery. All of this combined allows me to design a tailor made programme that keep them training whilst also rehabilitating their Achilles problem.

Let me know if you have any questions. Need more help with your Achilles injury? You can consult us online via video call for an assessment of your injury and a tailored treatment plan.

Best wishes


About the Author:

Alison Gould is a chartered physiotherapist and holds an MSc in Sports and Exercise Medicine. You can follow her on LinkedIn, Facebook, Instagram or Twitter.


  1. Bird, Stephen. (2013). Sleep, Recovery, and Athletic Performance: A Brief Review and Recommendations. Strength and Conditioning Journal. 35. 43-47.

  2. Bonnar, Daniel, et al. "Sleep interventions designed to improve athletic performance and recovery: a systematic review of current approaches." Sports medicine 48.3 (2018): 683-703.

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