Achilles tendonitis
Achilles tendonitis is pain in the tendon at the back of your heel. The “Achilles tendon” is the tendon that attaches the calf muscles (gastrocnemius and soleus) to your foot. This tendon is especially prone to injuries due to its poor blood circulation. Fresh blood flow is how our body heals from microtraumas. With its poor blood flow the Achilles tendon is not able to heal from small injuries as the rest of our body. This means that small injuries you might not even notice can add up until all of a sudden you have a lot of pain in this tendon. Although it is a common injury, it can be quite debilitating!
What can I do?
In a nutshell, the two most important things to do are 1) strengthen your calf muscles, and 2) stretch your calf muscles. However, there are a lot of caveats before we can jump into the specifics.
Where specifically is your pain?
If your pain is in the middle of the tendon, there is a better outlook for recovery because this part of the tendon has better blood flow than other regions of the tendon. This is called mid-portion tendonitis.
If your pain is located at the bottom of the tendon where it attaches to your heel bone, you will need to be more gentle with how you progress your exercises. This region of the tendon can be more touchy. This is called insertional tendonitis.
Stretching
Use a gentle calf stretch: stand in front of a wall and step one foot back. The leg behind you is the one that will get a stretch, keep your knee straight and your heel on the ground. Shift your weight toward the wall (you can use your hands for support), until you feel a gentle stretch in your calf. Hold this stretch for 45 seconds and do it on both legs. Do this at least 3x/day.
Strengthening
When you are working on strengthening, it is important that you know whether you have mid-portion or insertional tendonitis. If you have mid portion tendon pain it is ok to do heel raises off the edge of a step or book. However, if you have insertional tendon pain please do your strengthening exercises on the floor, this is more gentle on the lowest part of the tendon where insertional pain occurs.
Here is a place to get started strengthening your calves. Do these exercises daily:
Circulation exercises (move foot up and down) 10x ea way
Two-legged heel rises standing on the floor, 3x10-15 reps
One-legged heel rises standing on the floor, 3x10-15 reps
Sitting heel rises, 3x10 reps
Eccentric heel rises standing on the floor, 3x10 reps (go up fast and slowly lower to the floor)
After about two weeks of doing the first phase, progress to these exercises. Keep doing them daily:
Two-legged heel rises standing on edge of a step, 3x15 reps
One-legged heel rises standing on edge of a step, 3x15 reps
Sitting heel rises, 3x15 reps
Eccentric heel rises standing on edge of a step, 3x15 reps
Quick rebounding heel rises, 3x20 reps
After about 4-6 weeks, you should be noticing an improvement in how your Achilles tendon is feeling. If the pain in your tendon is too stubborn to treat with these strategies, send me an email at rrubino@snowyrangept.com and I would love to talk with you about the additional techniques I can use to help decrease your pain!