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The Achilles tendon is one of the most robust yet vulnerable parts of the athletic body. Sitting at the junction between the calf muscles and the heel, it plays a critical role in walking, running, and jumping. When it’s working well, we hardly notice it. But once injured, the Achilles can quickly sideline even the most seasoned athletes.

Physiotherapist Alison Rose helped me to understand the complexity of Achilles issues and shared some practical advice for staying injury-free. (You can listen to the conversation HERE)

Why the Achilles Matters

The Achilles tendon is a thick, fibrous band that connects the calf muscles (gastrocnemius and soleus) to the heel bone. It acts like a spring—absorbing impact and helping to propel us forward with each stride. “It deals with an enormous load,” Rose explains. “Particularly in running, where the repetitive impact and stretch-shortening cycle challenge its resilience.”

Common Culprits Behind Achilles Pain

Achilles pain isn't always what it seems. While terms like tendinitis, tendinosis, and tendinopathy are often used interchangeably, Rose notes that true tendinopathy is typically the accurate diagnosis—though sometimes the issue lies not in the tendon itself but in adjacent structures like the fat pad, bursae, or nerves.

Cyclists tend to suffer less due to the non-weight-bearing nature of the sport, but triathletes who run off the bike often experience problems. Stiff cycling shoes, hip tightness, and altered running mechanics all play a role. “You’re going from a fixed position to a dynamic one,” Rose says. “That transition can wreak havoc if your body isn’t prepared.”

The Ageing Athlete and Injury Risk

Older athletes face a double challenge: declining muscle strength and less resilient tendons. “Your muscles are designed to protect your tendons,” Rose says. “If they’re weak, the tendons take more of the load.” She sees more full or partial Achilles ruptures in people over 50, often during sports like five-a-side football or squash. These injuries typically happen without warning but are often preceded by unnoticed weakness or stiffness.

Hormonal changes in women, especially around menopause, can further affect connective tissue health, while joint laxity from previous pregnancies may place additional stress on the Achilles.

Prevention Over Cure

The good news? Achilles injuries aren’t inevitable. According to Rose, consistent preventative habits make a world of difference.

Mobility and Strength Work: Regular stretching of the gastrocnemius and soleus muscles, deep toe flexor work, and exercises to maintain ankle mobility are foundational. Calf raises—both bent and straight leg—are essential to build tendon resilience.

Foot and Balance Training: Skipping drills (when pain-free), single-leg balance work, and using a tennis ball under foot can help maintain foot health and proprioception.

Posture and Biomechanics: Poor hip mobility or thoracic stiffness can change how your foot lands, increasing stress on the Achilles. A full-body assessment can reveal hidden issues. “If the upper body isn’t rotating properly, the force cascades down to the feet,” Rose explains.

Footwear Matters: Not every shoe suits every foot. Hard carbon cycling shoes or minimalist running shoes might exacerbate problems for some. Trial and error, combined with biomechanical feedback, is key.

Load Management: Training errors—too much volume, intensity, or poor recovery—are common triggers. Avoiding rapid spikes in training load is essential. And don’t forget recovery: poor sleep and a highly processed diet may increase inflammation and reduce tendon repair capacity.

The Elite Edge: Consistency

Elite athletes don’t just train hard—they train smart. Regular physiotherapy, strength work, and movement assessments keep them consistent. As Rose says, “Physio isn’t just for fixing injuries—it’s for preventing them.”

For the rest of us, daily habits—just like brushing your teeth—can make a big difference. Two or three minutes of calf work after a run, a few mobility drills in front of the TV, or a weekly check-in with a professional can keep us moving pain-free for longer.

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Five Key Takeaways

1. Achilles injuries aren't inevitable – With proper strength, mobility, and load management, you can avoid chronic Achilles pain and even ruptures.
2. Footwear and biomechanics matter – Shoes that don't match your movement patterns can cause or exacerbate Achilles issues, especially if you're transitioning from cycling to running.
3. Strengthen both muscles and tendons – Focus on calf strength (eccentric and isometric work), foot mobility, and skip drills to support tendon health and performance.
4. Older athletes need a tailored approach – Ageing affects muscle mass and tendon resilience, so strength training, balance work, and adequate recovery become even more important.
5. Injury prevention is a habit, not a chore – Daily mobility work, calf raises, and occasional professional assessments can keep your Achilles—and your running—strong and pain-free.

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