If you’re dealing with stubborn Achilles pain, you’re not alone.
Achilles Tendinopathy is one of the most common injuries in running—and also one of the most misunderstood.
You might’ve been told to stop running. Or to do a bunch of stretches. Or that you just need “better shoes.”
But here’s what the evidence (and our clinical experience) tells us:
The solution isn’t to stop loading the tendon. It’s to load it better.
The Achilles tendon is incredibly strong—pound for pound, one of the strongest tendons in your body.
But it’s also stubborn. It doesn’t respond well to rest alone. And it often doesn’t love inconsistent training spikes.
The irony? Most runners dealing with Achilles pain are incredibly consistent.
But “consistent running” isn’t the same as “consistent tendon loading.”
We see this all the time.
Runners come in with solid mileage, a good strength routine, and still—Achilles pain that just won’t go away.
Why?
Because the tendon needs load right at the site of the injury. Not adjacent areas. Not just the glutes and core.
It needs progressive, heavy, direct loading of the calf and feet in particular. And it needs to be dosed properly.
Passive treatments (like ice, massage, or even some forms of PT) may give temporary relief.
But they don’t change the tendon’s capacity. They don’t make you more resilient.
They don’t get you back to training at 100%.
What does?
We get this question a lot.
It depends—but in many cases, yes, running can and should continue during rehab.
If the pain improves as you warm up, stays mild at worst (2–3/10), and doesn’t cause a limp or major gait change, it’s likely safe to keep running.
You might need to back off intensity, frequency, or volume for a bit, but full rest is rarely necessary.
We’ve helped runners return from Achilles issues to everything from 5Ks to 100-milers.
The common thread? They didn’t wait until things were “quiet.” They trained through it intelligently.
It’s easy to fall into fear-based decisions when something hurts.
To chase passive treatments. To pull back too much.
Or to push through without the right plan.
But the solution lies in that sweet spot: enough stimulus to create change, not so much that it causes a setback.
That’s where the real work is and where long-term progress lives.
If you’re dealing with Achilles pain, you don’t need to figure it out alone.
Whether you work with us or another running specialist clinician, make sure you’re getting more than symptom relief…
make sure you’re building back your strength, your capacity, and your confidence.
-Kelton Cullenberg, PT, DPT