Doctors of Running Podcast · Doctors of Running

#275 The Latest Research on Achilles Tendon Injuries

·1 hr 11 min·4 clips

A healthy tendon is "like a basketball with good air," while an injured one needs much more energy to bounce.

The episode opens with a reunion. Nathan introduces Dr. Karin Cybernagle as a longtime connection from the University of Delaware, and the conversation begins on that warm, familiar note before shifting into clinical detail. The topic is Achilles tendon injuries. From there, the discussion focuses on what it means for runners, with Karin stressing over and over that the first step is getting the diagnosis right before anyone starts chasing a rehab plan. There is no quick fix. Instead, the conversation keeps returning to how the tendon needs loading to recover, and how the load that helps tissue adapt is different from the fast, high-speed stress of running. Strength matters. The group explains that heavier strengthening is the slower stimulus that can help the tendon recover over time, while training load still has to be managed so the athlete has room to adapt. They keep it practical. Karin talks about seeing someone who knows running injuries and Achilles tendinopathy well, because that clinician can sort out differential diagnoses, measure deficits, and decide what the next step should be. A training diary comes up. That is part of how the panel thinks about balancing work and recovery, since a tendon does not respond to one good run but to a pattern of stress, rest, and gradual change. The conversation also acknowledges that Karin can sometimes consult by email or Zoom. Even so, she argues that an in-person evaluation is the better call when the diagnosis is still uncertain or the problem keeps coming back. The comparison lands. Just as a runner may need guidance to train well, an Achilles rehab plan can benefit from another set of eyes, especially when the athlete has stopped the exercises and then flared again after returning to running. The episode keeps coming back to patience. Feeling better for a few days is not the same thing as the tendon having fully adapted, and the panel uses that point to warn against reading too much into short-lived improvement. The closing takeaway is steady rather than flashy. If you are trying to come back without guessing, the show gives a clear, runner-specific framework for diagnosis, strengthening, load management, and the slow work of getting the tendon to catch up.

As heard by us

A grounded look at Achilles rehab that favors diagnosis, loading, and patience over shortcuts.

The conversation treats Achilles problems with uncommon patience. Dr. Karin Cybernagle keeps returning to diagnosis, loading, and the basic question of whether the issue is truly Achilles tendinopathy before rehab starts.

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Why you'd press play

If your Achilles is flaring and you want a sober reset, this is worth your time.

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