Today on the Doc On The Run podcast, we’re talking about which is worse for your Achilles tendon, running hills or running stairs.
This episode comes from a question sent in by a runner who was listening to the Doc On The Run podcast, and he wanted to know which is worse for my Achilles tendon, running hills or running stairs? And so this is somebody who had an Achilles tendon issue and was recovering and getting back to running and he’s been back to running, he’s doing better, he’s running without any pain, but he wanted to incorporate some strength training in the form of either hill repeats or running stairs, and this is a completely reasonable thing to do. Running hills and running stairs is one of the fastest ways to develop strength as a runner, but it can put a lot of stress and strain on your Achilles tendon.
The way that I think about this is that when you think about the mechanism of injury, the way that you actually rupture or completely tear your Achilles tendon, that we know has to be the most stressful thing for the Achilles tendon because it could cause it to rupture. So the way that works is you have to do several things all at the same time in order to actually really put the maximum amount of stress on your Achilles tendon.
First thing you have to do is you have to dorsiflex your foot or pull it upward away from the ground in order to put a lot of stress on it and so step one when you’re going to try to rupture your Achilles tendon is to basically run. If you’re running uphill for example, you have to do several things. You have to pull your foot up to get it flat onto the ground but that has a really dorsiflexed position where it’s pulled way up away from the ground and way toward your shin. At the same time of course to get your leg up on the hill in front of you, you have to bend the knee.
What that does is it unlocks the gastroc or big beefy part of the Achilles tendon and it only engages the soleus part. That actually allows you to dorsiflex or pull your foot up even further, so then when you plant your foot on the hill and you lean your knee forward toward the hill, and then you get ready to push off, you’re putting a huge amount of stress on the Achilles tendon where the back of the Achilles is stretched around the back of the heel bone under maximum tension.
Then the final piece of that equation to break the tendon is to actually pronate forcibly. So if you plant your foot on the hill, your knee is bent and then you get ready to fire that Achilles tendon and you’re changing direction and you twist as you push off, that will actually pull the Achilles tendon enough that it can rupture. So when I think about that and I think about this question, we know that it’s going to be more stressful to run up hills, that’s a given. But the first thing is that the one piece of that equation you could avoid is twisting. So if you’re running up hills and you’re changing direction, that is incredibly risky and I would not recommend that under any circumstances because it’s not worth the risk.
But if you’re running uphill and you’re not changing direction but your foot is still planted on the hill, it’s still really putting a lot of stress and strain on the Achilles tendon. If you run on stairs, when you think about the amount of dorsiflexion or the movement toward your shin in order to plant your foot on the surface and then push off to move up to the next step, well if you’re on a flat step, you’re actually not dorsiflexing as much. For that reason alone, you are a lot less likely to I think rupture your Achilles tendon, injure the Achilles tendon, or apply excess stress and strain to a recovering Achilles tendon if you’re running on stairs as opposed to hill repeats.
So in San Francisco, there is a place, the Fillmore Steps. It’s a very, very steep street and it’s one of these iconic places in San Francisco. We know that the Fillmore Steps, it’s so steep that there is a sidewalk that is sloped the slope of the hill, and then there are actually stairs cut into the sidewalk right next to it.
Sometimes I see runners running on the steps and sometimes I see them running on the sidewalk. Running on the sidewalk on that hill is the exact same angle but it’s riskier because your foot is in more of an acute angle, but that is the thing that you could really avoid. So if you’re running on the Fillmore Steps and you’re actually on the steps and not on the sidewalk next to the steps, that is safer.
So in terms of which is safer, well if you think about the Achilles tendon and the amount of stress and strain applied to the Achilles tendon when you’re running uphill, it is safer to take the stairs.