Managing Achilles Tendinopathy and Calf Strains for Ultra-Endurance Athletes

Ultra-endurance athletes push their bodies to remarkable limits, but with the high demands of long-distance training and racing come unique challenges. Achilles tendinopathy, calf strains, and persistent calf tightness or fatigue are common issues for athletes in this category. At The Foot Studio, we believe in empowering athletes to overcome these challenges with a blend of the latest treatments and expert guidance and not accepting this as just “normal”. There’s a lot that can be done to help manage these conditions and optimise performance—and it all starts with a thorough, holistic assessment.

Why a Comprehensive Assessment Matters for Achilles and Calf Issues

Many athletes with Achilles or calf pain might be tempted to treat the symptoms, but at The Foot Studio, we encourage looking at the full picture. Conditions like Achilles tendinopathy or chronic calf tightness often result from issues elsewhere in the body. For example, a restriction in your ankle joint or limited range of motion in your big toe can create strain higher up, forcing your calf and Achilles tendon to compensate. A thorough assessment will uncover these underlying causes, allowing us to tailor an effective treatment plan.

Treatment Options to Address Achilles Tendinopathy and Calf Strains

With a clear understanding of your biomechanics and unique needs as an athlete, we can recommend a combination of therapies designed to promote healing, reduce strain, and improve function in your Achilles and calf muscles. Here’s an overview of some of the most effective treatments for ultra-endurance athletes.

1. Photobiomodulation Therapy: Enhancing Recovery with Light Therapy

Photobiomodulation therapy (PBMT), also known as high-power laser therapy, uses targeted light to reduce pain, improve blood flow, and accelerate healing at the cellular level. For ultra-endurance athletes, PBMT can be particularly beneficial in managing both Achilles tendinopathy and calf strains, as it encourages tissue repair while reducing inflammation and fatigue.

This non-invasive treatment requires no downtime, allowing athletes to maintain their training schedules with minimal disruption. PBMT is a valuable addition to recovery routines, providing support for both acute injuries and chronic conditions by speeding up the body’s natural healing process. PBMPT is usually combined with strengthening exericses to get the full potential.

2. Radial Pressure Wave Therapy (Shockwave Therapy): Stimulating Tissue Healing

Radial pressure wave therapy (RPWT), or shockwave therapy, uses acoustic waves to stimulate cellular repair and improve blood flow in affected areas. Shockwave therapy is particularly effective for treating chronic tendinopathies, as it helps to promote healing and reduce pain by increasing circulation and targeting micro-damage within the tendon.

For ultra-endurance athletes experiencing chronic Achilles issues, RPWT provides a powerful solution that supports tissue recovery without the need for invasive procedures or extended rest. It can be an ideal option for athletes looking for a highly effective therapy that keeps them moving. Again, combined with strengthening exericses.

3. Strengthening and Stretching Exercises! Building Resilience in the Achilles and Calves

Exercise therapy is at the heart of managing Achilles and calf issues effectively. Targeted exercises help strengthen the muscles, tendons, and ligaments around the ankle and calf, reducing the likelihood of strain and promoting resilience.

At The Foot Studio, we guide athletes through exercises that are customised to address specific needs. A programme combining flexibility, strength, and dynamic movement is essential for athletes who need to balance power with endurance.

4. Taping and temporary offloading Techniques: Temporary Support and Offloading for Healing

Taping can provide essential, temporary support during high-mileage training or racing, allowing athletes to manage pain and prevent further injury while maintaining their training load. There are a number of effective taping techniques that are particularly effective for Achilles tendinopathy and calf strains, as they help offload strain from the tendon and muscles, improving alignment and providing stability.

Temporary taping offers the dual benefit of supporting the injured area while enabling healing and strengthening to occur. By reducing direct strain on the Achilles or calf, taping allows athletes to maintain their training volume with reduced risk, reinforcing the benefits of other treatments in the recovery plan. At The Foot Studio, we tailor specific taping methods for each athlete, ensuring optimal support without compromising their range of motion.

5. Choosing the Right Footwear: Supporting and Strengthening the Achilles Tendon

Footwear is a fundamental part of managing Achilles and calf issues. Ultra-endurance athletes benefit from shoes that offer optimal support, cushioning, and stability to reduce impact and prevent excessive strain on the Achilles and calf muscles. For some individuals, this might initially mean choosing shoes with a higher heel pitch (a heel lift in the shoe) to reduce tension on the Achilles tendon during recovery.

However, for long-term strength and resilience, transitioning to a lower heel drop may be beneficial. Lower drop shoes encourage the Achilles tendon to work more naturally, which strengthens it over time. At The Foot Studio, we work with athletes to assess their footwear needs and develop a gradual transition plan, enabling them to safely move to a lower drop shoe as their tendon strength improves. The right footwear, combined with a strategic plan, can make a significant difference in supporting performance and preventing re-injury. This strategy is usually more of a longer term plan over a 12-18 month period and beyond.

6. Orthotics: Customised Support to Address Biomechanical Needs

For athletes dealing with chronic Achilles or calf issues, custom orthotics can be a game-changer. Orthotics are designed to support and align the foot in a way that reduces strain on the calf muscles and Achilles tendon, helping to alleviate pain and prevent further injury. Orthotics can correct biomechanical issues, ensuring that the load is more evenly distributed across the foot and leg.

Custom orthotics from The Foot Studio are crafted to fit each athlete’s specific foot shape and running style. By addressing any underlying alignment issues, orthotics provide support that goes beyond standard footwear, helping athletes achieve better performance while reducing strain on their Achilles and calves.

Empowering Your Performance with a Proactive Approach

Achilles tendinopathy, calf strains, and muscle fatigue don’t have to stand in the way of your endurance goals. With a comprehensive assessment and a combination of science-backed treatments, you can strengthen your calves, prevent injuries, and keep pursuing your ultra-endurance ambitions with confidence. At The Foot Studio, we are here to help you optimise your training and recovery, providing expert guidance tailored to your needs as an ultra-endurance athlete.

ALaura 🌿