The Ultimate Evidence-Based Guide to Overcoming Achilles Tendinopathy

For Runners, HYROX Athletes & Anyone Pushing Pace and Volume

Achilles pain is one of the most frustrating issues for runners and HYROX athletes — it lingers, flares without warning, and can stop progress dead in its tracks. The good news? Modern research has completely changed how we treat tendons, and the old “rest it until it feels better” approach has officially been thrown out.

At Return to Performance, our multidisciplinary team — physiotherapists, strength & conditioning coaches, sports nutritionists, sports doctors and mindset specialists — take athletes through evidence-based approaches that get them not only pain-free, but performing better than before.

What Actually Causes Achilles Tendinopathy? (What the research shows)

Achilles issues rarely come from one single moment — they develop because your tendon isn’t currently strong enough for the load you’re asking it to handle.

The biggest contributors for runners/HYROX athletes:

  • Sudden spikes in running volume

  • Hard sessions placed too close together

  • Reduced strength or power in the calf complex

  • Poor load management

  • Reduced tendon capacity from previous injury

  • Insufficient fuel (nutrition) to support training and tendon recovery

Tendons respond to progressive, heavy loading — not rest, and not stretching alone.

The Three Things Every Athlete Needs to Do:

1. Strengthen the calf complex (heavy, slow loading)

Evidence consistently shows that the gold standard is a progressive loading programme targeting:

  • Soleus (your endurance calf muscle)

  • Gastrocnemius (your power calf muscle)

Your tendon needs high mechanical load to remodel — bodyweight heel raises aren’t enough.

2. Address the root cause, not just the pain

We assess:

  • Running mechanics

  • Training structure

  • Strength asymmetries

  • Plyometric tolerance

  • How your nutrition and sleep affect tendon recovery

This is why the S&C and nutrition input is just as important as the physio component.

3. Build back to high-speed, high-force loading

Most runners/HYROX athletes skip this stage — and that’s why symptoms return.

This phase includes:

  • Hopping progressions

  • Jump/sprint mechanics

  • Force absorption work

  • Return-to-run and return-to-race planning

Why RTP’s Approach Works

Tendons need load, strategy and consistency, not “quick fixes.”

Our remote programmes combine:

  • Physio assessment

  • S&C progressive loading plans

  • Nutrition support for tendon healing

  • Sports medicine oversight (when needed)

  • Mindset coaching to help you stay consistent during rehab

It’s the same methodology used with world-class athletes — now made accessible to serious runners and HYROX athletes anywhere in the world.

If You’re Struggling With Achilles Pain

You don’t need to “wait it out” or reduce your training goals for the season.

We specialise in helping runners and hybrid athletes return stronger than pre-injury.

Apply for our Achilles Rehab to Performance programme here.

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Why a Multidisciplinary High-Performance Team Beats “Just Physio” — And Why It Matters for Your Results