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Should you change your running style if you have Achilles tendinopathy?

Very likely not. There is one definite exception that I’ll discuss later in this article, but on the whole the evidence suggests that a carefully graded strength training and load management programme is far more important. The research has not found any strong link between Achilles tendinopathy and altered running mechanics.



There is weak evidence that, for some runners, over-pronation at the ankle and foot may contribute to them developing Achilles tendinopathy. This is, however, best addressed through strength training in combination with assessing their running shoes and possibly prescribing supportive insoles.


High breaking forces when running may cause a problem and too be honest this is a variable that is worth addressing as it has also been indicated as possibly playing a role in other injuries e.g. runner’s knee.


High breaking forces are mainly caused by over-striding when you run. When you overstride your heel makes contact with the ground in front of your body, acting as a “break” which causes large forces in your legs. The easiest way to improve this is by:

  • Leaning slightly forward from your hips so that your centre of gravity falls in front of your body (not slouching!)

  • concentrate on hitting the ground more or less straight underneath your centre of gravity

  • and increasing your step rate or cadence a bit.

I also demonstrate it in this video:



On the whole we find that our runners do really well if they strengthen their Achilles tendons properly and then use a graded return to full running training. Our bodies are all different and it’s therefor no surprise that we all have slightly different running patterns. We tend to naturally select the pattern that uses the least amount of energy (is the most efficient) and that’s another reason why we don’t, unless absolutely necessary, mess with someone’s running style.



The exception to the rule


Did you perhaps switch to a forefoot running style or barefoot running just before your Achilles tendon got injured? In that case, your running style may have been to blame for your injury.


Switching from heel strike or midfoot strike to a more forefoot strike pattern places a lot more strain on the Achilles tendon and can lead to overload and injury if you try and make the change too quickly. When trying to make the switch, people often end up running on their toes rather than following a flowing forefoot strike pattern which increases the strain on the Achilles even more.


If this is the case, switching back to your normal running style may help your Achilles to recover. But if you’re deadest on making a change to a more forefoot strike or barefoot running, I would advise that you consult a physio or running specialist who can provide you with a strength training programme and very graded running programme. This will allow your Achilles and calf muscles to adapt to the increased forces without causing them to overstrain.


This does not apply to people whose natural running style is to run on the front of their feet. If you’ve always naturally run like that, your Achilles and calf will be used to it and there is really no need to change your running style.


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

Best wishes

Maryke


About the Author:

Maryke Louw is a chartered physiotherapist and holds an MSc in Sports Injury Management. You can follow her on LinkedIn, Facebook, Twitter or Instagram.




References:

  1. Altman, A. R. and I. S. Davis (2016). "Prospective comparison of running injuries between shod and barefoot runners." British Journal of Sports Medicine 50(8): 476-480.

  2. Barton, C., et al. (2016). "Running retraining to treat lower limb injuries: a mixed-methods study of current evidence synthesised with expert opinion." British Journal of Sports Medicine 50(9): 513-526.

  3. Lorimer, A. V. and P. A. Hume (2014). "Achilles tendon injury risk factors associated with running." Sports Medicine 44(10): 1459-1472.

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