Falls Creek: Tackling Tendons

Falls Creek is renown to be a hot spot for distance runners, from the recreational enthusiasts to the elite athlete. It not only encompasses unique trails, hills and rugged surroundings, but an environment for altitude exposure and near perfect running temperatures. All of these factors make for an ideal training location.

However, with high enthusiasm for athletic improvement often we hear patients describe increase in training volumes, changes in intensity and first time exposure to uneven ground. With this can come tendon pain, especially in the Achilles.

Tendon pain/symptoms can affect runners of different ages, under different loads and with varying degrees of symptoms. This can ultimately affect the runners capacity to function confidently.

5 tips to help reduce the risk of developing Achilles tendon pain at falls: 

  1. Ensure good base level of strength (achieved though an S&C program – Running specific)
  2. Avoid unloading and reloading too rapidly.
  3. Keep training load consistent on a weekly basis.
  4. If reloading after a break, increase in activity must be slow and progressive.
  5. Monitor symptoms in the tendon, especially the next morning after running. Tendons take some time to tell you whether they were happy with the session you completed. This can tell you a lot about how it’s coping with your running progression. (If it “worsens” it’s simply saying it was too hard)

If pain is identified, consulting a stride physiotherapist in regards to putting a management plan in place, can enable the athlete to continue exercising at a safe and appropriate level.


If you suspect you have developed some tendon pain (your tendon aches, pain stays isolated, gets better with loading “warms up” but worsens with increase in speed) here are some key tips to help you manage your symptoms:

  1. Make a plan with your stride physiotherapist to address load management.
  2. Find an appropriate baseline level of activity that the tendon can handle.
  3. Incorporate some isometric exercises (holds) that targets the affected tendon – recommended dose is 5×45 sec holds with 2 mins recovery between reps (repeat 3-4 x daily).
  4. Introduce some slow/heavy loaded exercises when the tendon is slightly less painful – e.g. seated or standing calf raises – 3×8 with 3:3 ratio (3xweek).
  5. Avoid rubbing or stretching the tendon at any stage (this compresses the tendon which it won’t like).
  6. If sore, avoid consecutive running days

As a physiotherapist that works with high level runners, Achilles tendon pain is a common presentation. It is important to recognise as a runner that the key ingredients for tendons is patience and persistence. Too often I find patients presenting claiming that exercise intervention hasn’t worked. The common factor in this patient group is that they have tried rushing the return to running.

I can completely understand that time away from the chosen activity can be frustrating however, patients who do extremely well are the ones who understand their pathology, have a plan in place and have been given an individualised program over an appropriate time that allows for tendon adaptation.

Todd Anderson








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