There’s a notion among runners that achilles tendonitis is a condition that can be ignored and ran through.  Although the pain caused by the injury does subside once you get into your run, it’s not a sign that the injury can or should be ignored.  The familiar heel pain on your first few morning steps will be a constant reminder that the problem persists.  The pain goes away once you start running as the blood flow to the working calf muscles increases.  However this effect is lost very quickly on cooling down.  Even stopping for a few minutes stretching will result in the heel pain coming back again.

The condition can be effectively managed with a combination of gastrocnemius and soleus stretching, and eccentric calf loading.  Calf raises are a concentric calf action and contrary to some advice will result in a worsening of the tendonitis.  Early intervention with achilles tendonitis prevents the progression to achilles tendinosis – a more serious condition, where tendon degeneration has begun.

Although tendonitis or tendinosis doesn’t lead directly to rupture of the achilles tendon, imaging studies of ruptured achilles tendons do reveal, in the vast majority of cases, some underlying, pre-existing tendon degeneration.   Read more on achilles tendonitis.