Achilles Strain with Uphill Walking, Hiking and Running

I have to be honest, Achilles issues seem to be pretty poorly managed in many orthopaedic offices and PT clinics. It’s not that the exercises prescribed are wrong. It’s that the mechanism (or reason) for the problem in the first place is poorly understood therefore the root of the problem isn’t reconciled. This often means the problem returns leaving the client frustrated and at a loss.

There are a handful of especially common mechanisms for Achilles problems, one being uphill walking, running and hiking. In this blog I will shed light on how and why the Achilles might be irritated with this activity and, more importantly, what you can do about it. 

The Mechanism

I’ll give the technical terms for those who subscribe to the geeky camp first, then I will break it down with pictures and layman’s verbiage.

Technical mechanism: Repeated deep ankle dorsiflexion under load resulting in excessive cumulative eccentric loads to the calf and Achilles tendon.

Layman’s mechanism: The ankle being repeatedly loaded in a deep flexed position puts an excessive amount of cumulative “pulling” loads through the calf and Achilles tendon.

This is the deep flexed (dorsiflexed) position I am speaking of…

Think of it as a calf stretch under load. Over and over and over.

Is this to say that this is always bad? Of course not. If you have adequate strength/endurance in the calf and your tendon is sturdy enough for the amount of uphill activity you are doing, you can handle this position just fine. The problem is, most people don’t. So the tissues cannot withstand the cumulative “pulling” load and start to get real upset.

The Remedy

There are two things that you can do to avoid injuring your Achilles with uphill activities.

1.     Strengthen your calf and Achilles.

There are countless different calf strengthening exercises to choose from so take your pick. I will say this—be sure that you work up to doing some on one leg AND do some variations in sitting so the knee is bent. Being able to lift your full body weight with a single calf 25-30 times is a good target to work towards. Just be sure that you spend several weeks on two legs building up your calf condition before going single leg – otherwise you’ll have a hard time walking the next day. Doing sitting variations is important because it removes the contribution of the biggest calf muscle, the gastrocnemius, thus targeting the deeper calf muscles a bit better.

2.     Limit the amount of ankle bend/dorsiflexion you sink into when moving uphill.

In short, keep your heels off the ground as you make your climb. The steeper the climb, the higher your heels will need to be. Check out the photo below to see what I mean.

This will decrease the “pulling” load on the calf and Achilles. It will also make your calves burn a TON. A great way to build strength but you may fatigue out pretty quickly, which is another reason why doing calf strengthening as a weekly routine is helpful.

To understand this strategy a bit better, check out the video below:

Pretty simple, huh? As always, don’t hesitate to reach out should you have any questions about this topic!