What should you do when Achilles tendon pain comes back after you thought it was better?
That is the big question in this episode of the Doc On The Run Podcast.
This episode comes from a real strategy call with a runner who had Achilles tendinosis for years. She had treatment, got better, returned to running, completed half marathons, and then the Achilles pain started coming back again.
The problem was not that she had done nothing. In fact, she had tried a lot: PRP, physical therapy, heel drops, inserts, lasers, Graston and other treatments.
But when the Achilles pain came back, the real issue was not simply choosing the next treatment. The real issue was figuring out how severe the problem actually was, what was making it worse, and what information she needed to make the fastest safe plan back to running.
When runners get injured, we often start looking for the one thing that will fix it.
Maybe it is physical therapy. Maybe it is PRP. Maybe it is a different shoe. Maybe it is a supplement, peptide, laser, injection, or some new treatment someone mentioned online.
But the problem is this: if you change five things at once and then you get worse, which one caused the problem? And if you change five things at once and then you get better, which one actually helped?
That is why a runner with recurring Achilles pain has to become much more systematic.
The fastest path back to running does not come from guessing. It comes from tracking real information.
In this call, the runner was asked to start getting very specific about pain and tenderness, including:
Those numbers matter because they help you determine whether the tendon is tolerating activity or whether the activity is making the injury worse.
In this case, the runner had been able to return to running and complete half marathons. But while training for a hilly half marathon, one hill workout seemed to bring the Achilles pain right back.
The runner herself believed the problem probably would have returned over time anyway, but that the hill workout accelerated it. That is an important clue.
If you can identify a specific variable associated with an increase in symptoms, you can remove that variable, measure what happens, and eventually determine when and how to reintroduce it.
One of the central lessons from this strategy call is that recovery should be based on the information coming from the injured tissue and the runner, rather than simply following an arbitrary timeline.
How much does it hurt? What activity causes the symptoms? What happens afterward? What happens the next morning? Those pieces of information can help determine when it is appropriate to increase loading and move into the next phase.
The goal is not to rush blindly. The goal is to use real information to decide when to add the next safe step.
Recovering from an injury is tedious. Tracking pain, modifying workouts, avoiding known triggers, measuring tenderness, doing rehab exercises, and adjusting activity is not fun.
But having a meaningful goal can help. During the strategy call, we discussed choosing a race far enough into the future that it could become a meaningful target.
A race on the calendar gives you a reason to do all of the tedious work involved in recovery. Instead of simply trying to “get better,” you have a specific goal you are working toward.
If Achilles tendon pain came back, do not just ask: “What treatment should I try next?”
Start by asking better questions:
The better your information, the better your strategy can be.
If you want to get on a strategy call like the one you heard in this episode, go to DocOnTheRun.com and click on the “Talk To The Expert” tab.
You can block my calendar for a 10-minute strategy call where we can work through the strategy and figure out what you should do next to get back to running as quickly as possible.
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