In this blog, we shall go over the key steps to follow to help your Achilles pain be gone for good.

Step 1: Understanding and Managing Tendon Overload

Achilles tendon injuries typically start in the “reactive” phase due to overload. This occurs when you place too much strain on your tendon. This can happen suddenly for example after an intense workout (like doing 200 box jumps in a CrossFit session) or from accumulated strain over time (such as increasing a basketball player’s training frequency).

Load Tolerance and Rest

When people hear “rest,” they often think it means completely avoiding the gym. Complete rest can be counterproductive for tendon injuries. Tendons follow the principle of “use it or lose it.” Completely resting can lower your tendon’s load tolerance and make future injuries more likely once you resume activity.

However, continuing to push through pain can worsen the injury and cause structural changes in the tendon. The key to recovery is balanced load management. Start by listing exercises that exacerbate your symptoms and those you can perform without pain. By identifying and modifying the movements causing pain, you can adjust your routine to aid the healing process.

Activities that heavily load the tendon for example jumping or sprinting should be temporarily replaced with low-impact exercises such as squats and deadlifts. As your tendon heals, gradually reintroduce the activities that previously caused discomfort.

Avoid Stretching the Achilles Tendon

Contrary to common belief, stretching the Achilles tendon should be avoided during rehabilitation. Stretching can increase compressive loads on the tendon, worsening pain. Instead, focus on improving ankle mobility with soft tissue mobilisation techniques for example in the clinic we use Active Release Techniques frequently to treat this issue.

Using Heel Raises

Heel raises in shoes can help manage certain types of Achilles tendinopathy by reducing tendon compression. While helpful for some, heel raises are not substitutes for proper strengthening exercises.

Step 2: Creating a Rehab Plan

Exercise is the best treatment for tendon pain. Strengthening the tendon and increasing its load-bearing capacity is key to recovery.

Phase 1: Isometric Exercises

Isometric exercises, where the muscle contracts without joint movement, are excellent for reducing pain and maintaining strength. Isometrics can help decrease pain for up to 45 minutes and improve strength. For Achilles tendon injuries, partial heel raises performed in a standing position can activate the calf muscles and load the tendon. Aim for 5 sets of 45-second holds, performed 2-3 times daily. Isometrics should be challenging, contracting the muscle at 70% of its maximum capacity. This will help restore the tendon’s load tolerance and prepare you for the next phase.

Phase 2: Strength Training with Isotonics

Tendinopathy rehabilitation aims to enhance the tendon’s ability to bear loads. After initial pain reduction with isometrics, progress to isotonic exercises involving eccentric and concentric muscle contractions. Exercises like standing calf raises and seated heel raises should target both the gastrocnemius and soleus muscles. Perform these exercises slowly and with heavy weights, focusing on good technique.

Additionally, introduce exercises that have some impact involved, such as box jump landings, to gradually reintroduce the tendon’s spring-like function. Begin with low-impact landings and progressively increase intensity as tolerated.

Phase 3: Plyometric Training

Before starting plyometrics test your strength with double-leg and single-leg heel raises and assess your ability to perform single-leg hops pain-free. The goal of this phase is to reintroduce the tendon’s role as a spring. Begin with double-leg pogo hops and short light running sessions, gradually increasing volume and intensity.

Start with two to three sessions per week, allowing for rest days in between. As you progress, incorporate higher-level plyometric activities like squat jumps, skipping and single-leg hops. Gradually increase frequency and intensity based on your tendon’s response.

Final Thoughts

The rehabilitation process for tendon injuries requires patience and careful progression. Listen to your body, make gradual adjustments, and seek professional guidance when needed.

Contact the clinic today on 0578678904 or book now.

Yours in Health

Lawlor Clinic: Spine & Sport, Portlaoise, Laois