Repetitive uphill running A greater amount of upward or dorsi-flexion of the ankle is required for the foot to clear the ground when running uphill. This results in greater stretch and stress on the Achilles tendon. This increased speed must be controlled by the eccentric contraction of the calf muscle group. That is, the calf muscles must contract strongly whilst lengthening. This can result in breakdown of the connective tissue component of the muscle, which includes the Achilles tendon.
Excessive pronation involves increased internal rotation of the tibia.
It is believed that this action of the tibia wrings out the Achilles tendon causing micro tears. The compromise to the blood flow to the tendon also considerably delays the healing process. Optimally, ice should be applied for 10 minutes every hour and should never be applied for more than 15 minutes at any one time. If using ice, it should be wrapped in a damp towel to avoid skin damage. An experienced Physiotherapist should be consulted at this stage, to ensure minimal further damage to the tissues and minimal disruption to the injured runners training.