Tendonitis is a common challenge for runners, characterized by discomfort and irritation in connective tissues. It often results from the repetitive stresses of running. This article explores the nature of tendonitis, its risks, and outlines a path toward recovery and a safe return to running.
What is Tendonitis?
Tendons are robust, fibrous tissues that connect muscles to bones, facilitating movement and providing stability. Tendonitis occurs when these tissues become irritated or inflamed, often from repetitive stress like consistent impact during running. Factors contributing to its development include sudden increases in mileage or intensity, improper running form, or wearing worn-out or unsupportive footwear.
Common types of tendonitis affecting runners include Achilles tendonitis, impacting the tendon connecting the calf muscles to the heel bone, and patellar tendonitis, often called “runner’s knee,” affecting the tendon below the kneecap. Iliotibial (IT) band syndrome, involving a thick band of tissue along the outside of the thigh, is another frequent concern. Posterior tibial tendonitis, affecting the inner ankle and arch, can also develop from overuse.
Why Running with Tendonitis is Risky
Continuing to run with tendonitis can significantly worsen the condition. The repetitive stress of running on an already inflamed tendon intensifies irritation, potentially leading to chronic discomfort. This ongoing strain can disorganize collagen fibers, leading to tendinosis—a degenerative condition involving structural changes and weakening of the tendon tissue, unlike the primary inflammation of tendonitis.
Persisting with running through pain delays healing and prolongs recovery. Overloading a weakened tendon increases the risk of a partial tear or even a complete rupture. While a full rupture is less common during typical running, the risk escalates with untreated, degenerated tendons.
Healing and Returning to Running Safely
Recovery from tendonitis begins with relative rest, which is generally more beneficial than complete inactivity for tendon health. Initial management often involves the RICE protocol: Rest, Ice, Compression, and Elevation, typically applied for the first 24 to 72 hours following injury or an acute flare-up. Ice helps reduce inflammation and pain, while compression and elevation manage swelling. Avoiding activities that aggravate the pain is part of this initial rest phase.
Seeking professional medical evaluation from a doctor or physical therapist is important for an accurate diagnosis and tailored rehabilitation. A structured physical therapy program will likely involve manual therapy and progressive exercises to gradually load the injured tendon. These exercises often include eccentric training, where the muscle lengthens under tension, and strength training for supporting muscle groups like the calves, glutes, and core, which improve biomechanics and reduce tendon stress.
A gradual return to running is crucial to prevent re-injury, beginning with a combination of walking and jogging at a comfortable pace. Runners should incrementally increase their duration and intensity, generally by no more than 10-30% per week, allowing the tendon to adapt. Listen to your body; continued running is usually acceptable if pain remains at a low level (5/10 or less), improves during the run, and returns to baseline within 24 hours, without a worsening trend week-to-week.
Addressing underlying biomechanical issues and ensuring proper footwear are significant components of a safe return to running. Worn-out shoes or those lacking adequate support can contribute to tendon strain. A professional gait analysis can identify movement patterns that place excessive stress on tendons, allowing for corrective strategies. Incorporating warm-up routines and cool-down stretches before and after runs further supports tendon health and flexibility.