My name’s Tony, and I ruptured my Achilles tendon earlier this year. It was the first major injury of my life, and one that tends to strike suddenly. In the six months since, I’ve met many people who’ve gone through the same rough ride. I’ve been documenting my rehab and post-surgery training on Instagram with the tags #findyourtrainablemenu and #achillesgate2020. Still, I thought a deeper look at how Achilles ruptures happen and how to prevent them could help more people. So my colleagues Dr. Bo Bobenko and Shane McLean shared their insights to cover exactly that, and I added a few thoughts of my own along the way. I hope you find it useful.
Measures to Strengthen & Prevent Achilles Injuries
Tendons—those tissues that connect muscle to bone—don’t usually get the spotlight, but they’re essential. The Achilles tendon is the thickest and strongest tendon in the body, linking the calf muscles to the heel. It transmits the big forces produced by the calf to enable walking, running, jumping, sprinting, and more. It can handle enormous loads—up to about ten times body weight—but it’s also responsible for a lot of high-load movements, and it doesn’t always signal trouble until something goes wrong.
There are several types of Achilles injuries besides tendonitis. Here’s a quick overview:
– Achilles tendon tears: often sudden and dramatic, with a pop and pain that travels up the leg.
– Tendinopathy: degeneration of the collagen fibers in the Achilles, with increasing heel pain, stiffness, swelling, and sometimes a grinding sensation.
– Tendonitis: acute inflammation of the tendon, with morning pain and stiffness, pain that worsens with activity, and more pain the day after exercise. It comes in two forms—insertional (where the tendon attaches to the heel bone, often with bone spurs) and noninsertional (fibers in the middle of the tendon).
– Tendinosis: non-inflammatory degeneration from repetitive strain without proper healing, often tied to tight Achilles or calf muscles and sometimes heel spurs.
Activities that can trigger Achilles tears include fast starts, sudden stops, or pivots in activities like running, gymnastics, dance, football, baseball, softball, basketball, tennis—and even more unusual pursuits can factor in. Tears tend to happen when you push off and lift rather than when you land. Here’s a sense of the data:
– About 90% of injuries come from acceleration or deceleration movements.
– 15–20% of men report heel pain or tendinopathy before injury.
– Roughly half of those who rupture have had some tissue degeneration beforehand.
– Tears often occur within about 30 minutes of moving around, and many ruptures happen suddenly with degenerative changes already present.
For example, Tony’s tear was linked to an aggressive eccentric loading pattern (the “jump back start”) combined with load management gaps and then sprinting again. And yes, there was an element of bad luck, especially during a period when I hadn’t been doing much plyometrics.
Big picture with tendon pain modulation
– Central nervous system (CNS) response: The CNS is excellent at adapting to pain and protecting us, but this can make tendon health tricky—damage can exist without pain.
– Load management and exposure: Controlling tendon loads is arguably the single most important factor for tendon health. It can feel daunting to track loads, but better load management reduces injury risk. Think of a wall that’s cracking—you don’t just keep hammering away; you patch and reinforce it, gradually.
How to prevent Achilles tears
– Increase the variety of loads you place on the tendons. If you’re not training for a specific sport, focus on preserving the tendon’s natural role: absorbing and transferring forces efficiently.
– Include movements like pogo jumps and heel taps, and weave tendon loading into your daily prep routine.
– Use a long-term loading plan with multiple angles and tempos. A common approach is heavy slow resistance: four seconds eccentric, three seconds concentric, planned over about 12 weeks, with solid research backing the idea.
– A reminder worth keeping: “We start dying when we stop jumping.”
– Assessment can help, but there’s no single gold standard. Some clinicians gauge pain tolerance with manual pressure on the tendon to monitor progress, though this isn’t universally supported by research.
– Easy tendon-loading options if you haven’t loaded the tendon recently: calf raises with full range of motion, lifting quickly and lowering slowly, aiming for about 20 reps per leg as a baseline to detect asymmetries and overall deficits.
– Plan for increasing activity tolerance: a safe rule is roughly 10% more volume per week. Also remember the idea that we often overestimate what we can do in a month and underestimate what we can achieve in a year.
– Exercise isn’t everything; diet matters too. Reducing stress, getting quality sleep, and eating well supports tendon health, with supplements playing a supplementary role. Vitamin C is important for collagen synthesis, aiding tendon strength. Vitamin A supports tissue formation and immune function, and Vitamin E has anti-inflammatory properties that may help tendon healing. Evidence on diet and tendon health is still evolving, so treat supplements as add-ons rather than the foundation.
I’ve used collagen-related products to support healing, because some formulations are designed to promote collagen synthesis in tendons and ligaments. But the core focus should be real, high-quality food, good sleep, and smart loading. If you want to know what I’ve personally used, I’ve leaned on a combination of collagen supplementation and other supporting nutrients, while keeping the nutrition side as the priority.
Wrapping up
Tendon tears can strike without warning and don’t care how fit you are. One moment you’re ready to move fast, and the next you’re on the ground. Before engaging in risky tendon activities, make sure you warm up properly, load the tendon appropriately, and look after stress, sleep, and nutrition. As Tony’s experience shows, there are no guarantees. Do your best to prepare so you don’t hear the pop from hell.
And yes, I didn’t do something flashy like wrestle a T-Rex or jump from a helicopter—this happened while sprinting, which felt both anticlimactic and brutally honest.
