Achilles Tendonitis – Exercises to Heal and Strengthen Your Tendon
Today's video covers the primary exercises we use in physical therapy to treat achilles tendonitis or tendinopathy. Not only do these exercises work to reduce pain, but they will also strengthen the tendon and the two calf muscles (gastrocnemius and soleus).
Achilles tendinopathy describes a condition in which the tendon that connects the calf muscles to the heel bone (calcaneus) becomes irritated, resulting in pain and limited function.
Achilles tendinopathy can be subdivided into two categories based on the location of symptoms. These two subdivisions include mid-substance and insertional variations. Pain associated with mid-substance tendinopathy is experienced several centimeters above the heel bone, whereas, insertional pain is experienced at the calcaneus.
The management of both types is very similar where appropriate loading, through the use of calf raises, serves as the intervention of choice. The major difference when implementing the calf raise is that individuals with insertional tendinopathy will initiate calf raises on the ground and only progress to a raised surface when tendon irritation has reduced.
So, based on this information here is the progression:
1. Isometric Holds - raise up on both legs, shift body weight over to the painful side and hold for 30-45 seconds. Perform 4-5 repetitions daily.
2. Eccentric Contractions - raise up on both legs and slowly lower down on the painful side. Perform 3 sets of 15 slow repetitions every other day. Insertional cases should stay on the ground during this phase.
3. Full Calf Raise - perform the full calf raise on the painful side. 3 sets of 15 reps every other day.
For the soleus calf raise, aim to complete 3 sets of 15 repetitions.
Reference: Malliaras P, et al. Achilles and patellar tendinopathy loading programmes : a systematic review comparing clinical outcomes and identifying potential mechanisms for effectiveness. Sports Med. 2013.
Today’s video covers the primary exercises we use in physical therapy to treat achilles tendonitis or tendinopathy. Not only do these exercises work to reduce pain, but they will also strengthen the tendon and the two calf muscles (gastrocnemius and soleus).
Achilles tendinopathy describes a condition in which the tendon that connects the calf muscles to the heel bone (calcaneus) becomes irritated, resulting in pain and limited function.
Achilles tendinopathy can be subdivided into two categories based on the location of symptoms. These two subdivisions include mid-substance and insertional variations. Pain associated with mid-substance tendinopathy is experienced several centimeters above the heel bone, whereas, insertional pain is experienced at the calcaneus.
The management of both types is very similar where appropriate loading, through the use of calf raises, serves as the intervention of choice. The major difference when implementing the calf raise is that individuals with insertional tendinopathy will initiate calf raises on the ground and only progress to a raised surface when tendon irritation has reduced.
So, based on this information here is the progression:
1. Isometric Holds – raise up on both legs, shift body weight over to the painful side and hold for 30-45 seconds. Perform 4-5 repetitions daily.
2. Eccentric Contractions – raise up on both legs and slowly lower down on the painful side. Perform 3 sets of 15 slow repetitions every other day. Insertional cases should stay on the ground during this phase.
3. Full Calf Raise – perform the full calf raise on the painful side. 3 sets of 15 reps every other day.
For the soleus calf raise, aim to complete 3 sets of 15 repetitions.
Reference: Malliaras P, et al. Achilles and patellar tendinopathy loading programmes : a systematic review comparing clinical outcomes and identifying potential mechanisms for effectiveness. Sports Med. 2013.
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Ive recently had an achilles tendon repair on my right leg. Im 7 weeks post op but havent started physio. Im just scared of defaulting. But is it wise to stay this long without physio?
Thanks, Ryan Gossling
Hello ! I have insertional tendonitis and my therapist gave me eccentric exercise to do on stairs. Is it good for me to do on stairs??? And how do i relax my tight calf muscle??plz Help?
I have pain lower down near the bone, I can stand on it but if I walk on it normally I can feel significant irritation. After doing some of this exercises, how do I know when I can walk on it normally? (it's been 3 days since I walked on it because it kept getting worse the more I walked on it)
I’m still confused which I do for insertion Achilles’ tendon
My pain is gone with these esxercises, huge thks. But the lump still there (mid support achilis ten) and gets painpul even when i weara shoe, how to ghet rid of that lump?
Would you stretch at all or only strengthen?
Nice!!! Thanks for sharing doc 🙏🏻
Thanks for this video. How many weeks would you leave between each phase of rehab ? Or is it solely based on the individual? Also with this type of injury could it be cause by a muscle imbalance causing the pelvis to tilt forward ? Maybe tight Plantar Fasciitis and tight glutes? Would it be worth while l working on them and also starting the first phase of rehab? I am a Sports Massage Therapist and really have been learning alot from your videos. Thank you. ✌️
Those soleus raise machines at gyms are so hard to come by yet they’re so useful.
Can I still start with these if I have swelling? I have done many things and insertional achilies does not go away. Been 10-11 months now.
Great video with good explanations.
Hip impingement please!!🥲
Very informative as usual!
Maybe a bit too specific but, what changes with the progression if midsubstance tendinopathy is accompanied by tibialis anterior muscle pain that extends down to the front of the ankle?
SO INTERESTING DOC