Injury Prevention

How To Use Strength and Conditioning Effectively for Achilles Injury Prevention

There are some common mistakes athletes make when using strength training to prevent Achilles injuries.

As a triathlete it can seem like the odds are stacked against you—particularly when there’s evidence to show you are likely to sustain an overuse injury at some stage, disrupting the quality and continuity of your training and performance. In fact, one study reported 75% of triathletes experienced at least one overuse injury in five years. And among the most common of those is the dreaded Achilles injuries, characterized by everything from tendonopathy to a rupture.

Fortunately, there are a number of scientifically supported measures you can take to not only reduce any previous Achilles injuries, but to also minimize the risk of getting any issues in the first place. The challenge in triathlon has been to get your head (and your time) around the idea that prevention beats cure, which is understandably difficult when your training schedule is already busy with swim, bike, and run.

Here we will focus on how strength training can help with Achilles injuries, which to date is often poorly understood and poorly applied, limiting its benefit to you as a triathlete. But there are some fast and effective ways to apply strength and conditioning realistically into even the most busy of schedules—for injury prevention and performance improvements.

Achilles Injury Prevention: It’s the Muscles, Not the Tendon

When it comes to Achilles injuries, the actual culprits of your problems likely exist elsewhere. Tendons are always joined to a muscle and, in more recent years, it’s been shown that if the calf muscles are trained to be stronger, then Achilles pain and problems decrease. A reason this works is that the greater strength of the connected muscles reduces loading on the tendon and reduces the subsequent problems, which cause the tendon to react with pain in the first place.

More broadly, though, we also observe that in most circumstances Achilles problems in triathletes exist alongside running gait issues. For examples, overstriding and excess heel or toe striking are often evident, and could suggest these positions load the Achilles excessively and increase injury risk. Researchers have demonstrated runners with Achilles injuries often have their center of mass less forward when their foot strikes the ground and subsequently produce less forward force.

For this reason, strengthening beyond the calf muscles could positively influence your running gait and minimize injury, as there is evidence to show lack of leg strength correlates with Achilles injury. Strength training your calf muscles, as well as additional leg and hip muscles, is also key for triathletes to prevent future problems.

Achilles Injury Prevention: Load Them As They Lengthen

While it’s well-known that using eccentric strength training to load your calf muscles as they lengthen helps minimize Achilles problems, the vast majority of approaches to this are conservative and outdated, limiting the benefits to athletes. These are some of the common things athletes do wrong in their calf strengthening protocols:

  • Too high frequency in eccentric strength training (e.g. daily)
  • Training only one area of the calf
  • No progressive overload
  • Relying too much on volume
  • Not valuing the importance of strength training elsewhere in your body

That means if you’re going to use a strength-based approach to minimize and prevent Achilles injuries and issues, then you need to adjust the common practices and techniques—ie. how you do your eccentric calf raises and calf drops. Based on the science, evidence, and our experience, we suggest innovating your strength training in these ways:

  • Quality vs. quantity: To optimally develop strength requires recovery—which means avoiding daily strength for your Achilles exercises, instead limiting them to 2-3 times per week.
  • Use both straight and bent knee calf raises: Both your gastrocnemius and soleus muscles attach to Achilles, yet it’s often only the former that we focus on. Use these two exercises to ensure both muscles are strengthened instead.
  • Progressively overload: Without progression in your strength training each week your body will not develop optimally. Load or volume needs to be adapted weekly and increased—not just keeping at three sets of eight reps, for instance.
  • Load beats volume: While anecdotal, we find adding load rather than repetitions is the most effective way to progress each week, an approach promoted by world leading tendon expert Gill Cook (approx. 2.5-5kg increases per week, from your initial load of an exercise).
  • Hips and legs are just as important: Knowing that certain gaits could be the underlying cause of Achilles problems, the need to strengthen other muscles to correct this is imperative—i.e. gluteal, hamstring, and quadricep muscles. See our other article for more detail on running form.

This strength training approach uses one of the most proven methods to resolve and prevent Achilles injuries, while still managing your training load and swim-bike-run volume. It’s key to consider the influence this approach can have not just
on Achilles injuries, but also on improving your performance. This is where genuine strength and conditioning can address both performance improvements and injury prevention. With the time demand on triathletes, this is critical—and supports specific injury prevention, in addition to positive performance variables, such as power and economy.

Dave Cripps holds a Masters degree in sport science and is an accredited strength and conditioning coach in the U.K. He’s currently the Director of TriTenacious, a leading online strength and conditioning resource for triathletes, and Coalition Performance, one of the U.K.’s most successful private physical fitness training facilities.