Published on: 10-Aug-2026
You rest the shin splints. They fade. Six weeks into your next training block, they’re back. Same story with the Achilles that grumbles every spring, or the heel pain that meets your first steps out of bed.
If that’s you, it’s usually not your shoes or your form. The tissue taking the load down there never got strong enough to handle the mileage you keep asking of it. Rest calms the symptom. It doesn’t build the capacity. So the moment you ramp up again, you’re right back where you started.
Here’s the good news. The fix is boring and cheap, and it works. You build strength in your lower legs and feet so they tolerate the pounding instead of breaking down under it.
Why the same injuries keep coming back
Running is repetition. Every mile is thousands of steps, and every step sends force up through your foot, ankle, calf and Achilles. Those structures are built to absorb and return that force. But only up to a point.
When you add distance or pace faster than your tissue can adapt, you cross that point. The calf and the small muscles inside your foot fatigue, then get overloaded and start to complain. Shin splints, Achilles tendinopathy and plantar fasciitis are among the most common ways that overload shows up in runners. Different names, same root cause: demand outran capacity.
Rest drops the demand. It does nothing for the capacity. That’s why so many runners get stuck in the flare-up-and-recover loop for years. To get out of it, you have to make the tissue stronger than the sport.
Where the strength actually needs to be
Two areas matter most.
The first is your calf complex, the gastrocnemius and soleus that run down the back of your lower leg into the Achilles. This is your main shock absorber and your main push-off engine. A strong calf takes load off the shin and the Achilles tendon directly.
The second is the set of small muscles inside your foot, the intrinsics. They hold your arch and control how your foot meets the ground. They also keep your ankle stable when you’re on one leg, which in running is always. Weak intrinsics let the arch collapse and the load dump onto your plantar fascia and shin.
Strengthen both and you’re loading exactly the tissues that fail first. That’s the whole idea.
The three drills that do the heavy lifting
You don’t need a gym or fancy kit. You need a step near a wall, and about ten minutes three days a week.
Begin with heavy-slow calf raises. Stand with the balls of your feet on the edge of a step, heels hanging off. Rise up slowly over three seconds and lower over another three. Pause at the top of each rep. Slow is the point. It’s the load and the tempo that build tendon strength, not speed or bounce. Start with both legs, two sets of ten. As it gets easy, shift toward single-leg raises, then add weight in a backpack. Do these off a step so your heel can drop below the toes and load the calf through its full range. Slow, heavy calf loading helps stubborn Achilles pain, and the same work builds the tolerance that keeps it away.
Next is single-leg balance. Stand on one foot. That’s it to start. Hold for 30 seconds, barefoot on something soft. When it’s easy, close your eyes or stand on a cushion. Fit it in while you brush your teeth. Balancing on one leg lights up your ankle stabilisers and your foot intrinsics at the same time, and it trains the control you need every time your foot lands mid-stride.
Last is toe and arch work. Two simple ones. Toe spreading: sit down, try to fan your toes apart and hold, ten times. Towel scrunches: put a towel on the floor and drag it toward you using only your toes. Then short-foot: without curling your toes, gently pull the ball of your foot back toward your heel so your arch lifts a little, and hold for five seconds. These wake up the small muscles most runners have let go quiet.
How to load it without flaring up
The calf complex and the small intrinsic muscles of the foot absorb and return load with every stride, so they are the tissues that fail first when mileage climbs faster than they can adapt. Add the load gradually with those drills and you build the tolerance that keeps the same injuries from coming back. Adding a little load each week matters far more than doing a lot in one session, which is where most people go wrong.
If you would rather work from a set of therapy drills rather than assemble your own, refer to a publication that covers physical therapy guidance on strengthening the feet, calves and ankles, with toe, arch, calf-raise and balance moves with sets and holds for each.
Physical Therapists and exercise Physiologists can also assess your foot mechanics and gait and build a strengthening program around what they find, which is worth doing if pain keeps returning no matter what you try.
Start small. One flare-up won’t undo months of consistent loading, but skipping weeks will. Add a little each week and let the tissue catch up to the sport.
Frequently Asked Questions
How long before this actually helps? Give it eight to twelve weeks of consistent work. Strength and tendon changes are slow. You’ll often feel steadier on one leg within a couple of weeks, but the injury-proofing takes a couple of months.
Can I do this while I’m still sore? Usually yes. Strengthening a grumpy tendon is often part of the fix, not something to avoid. A useful rule: pain up to about a 3 out of 10 during and after is fine, as long as it settles by the next morning. If it spikes or lingers, ease off and get it looked at.
Do I keep running while I build strength? In most cases, yes, just hold your mileage steady rather than climbing while the tissue adapts. If a specific injury is flaring hard, back the running off for a bit and let the strength work lead.
Barefoot or shoes for the balance drills? Barefoot on a firm floor is best for balance and foot work. It lets your foot muscles do their job instead of the shoe doing it for them.
Is one leg weaker than the other a problem? It’s common and worth fixing. Single-leg calf raises and balance holds will show you the gap fast. Do a few extra reps on the weaker side until it catches up.
The post Why do the Same Running Injuries Keep Coming Back? appeared first on Sports Medicine Weekly By Dr. Brian Cole.