Achilles Tendon pain is obviously best avoided if possible – for more info, see our previous blog post on Running Injury Avoidance here.
There are many benefits in seeking the diagnosis, treatment, and advice of a Physio, however, for those of you who want to have a go at alleviating symptoms of Achilles Tendinopathy yourself – read on.
The three most common areas of heel pain we’ve now looked at over our 3 part blog series:
Part 1 – Pain under the heel, where the muscles of the foot attach, found here
Part 2 – Pain at the back of the heel where the Achilles Tendon attaches, found here, and
Part 3 – The Achilles Tendon (this post)
For a brief introduction and overview of Heel pain, see our previous post on Heel Pain, found here.
Things you’ll need:
A Foam Roller – A great self massage tool that can be used for many common ailments, as well as a terrific preventative of injury. Alternative: Massage Gun.
A Step (not pictured)
An Ice Pack.
Here’s what you need to do:
To get over Achilles soreness, you’ll need to firstly back off on the load – running/walking/training, and then focus on restoring mobility, followed by flexibility, and finally strength. As the symptoms settle, you can then slowly start to up the load again towards your previous level. There’s a table outlining the rehab protocol at the bottom of this post.
Mobility:
Foam Roller
Foam Roller: Soft tissue self massage of the lower leg muscles, especially the bottom half – the Soleus muscle.
Start here for Achilles Tendon Pain. Don’t roll over the painful section of the tendon – move the roller higher up if need be.
Too easy? Put your other leg over the top to add a bit more pressure:
Then move the roller up a bit higher to target the Calf muscle:
Flexibility
Walk for 5-10 minutes prior to starting the flexibility exercises to get the best effect. If the heel pain is severe, stretching cold (without walking beforehand) can make the protective spasm worse. Mild to moderate pain? Feeling pretty good? Or in a bit of a rush – carry on below. But try to just cause a mild sensation of stretching.
Overstretching by applying too much force can increase protective spasm.
Stretch the Calf muscle, but back off a bit if you feel any pain:
This ones a bit awkward, but very important! Once again be gentle:
Strength
Before you start the strengthening process, we must first address a common technique mistake when performing a calf raise – Flaring the Ankles
Learning the art of ‘Toe Yoga’ will help direct the force through the Big Toe, without scrunching up and clawing with the other toes – another common error we see when people are doing a simple calf raise. Especially noticeable when doing a single leg calf raise.
Warm up with a set of heel raises.
The aim is to build up to 15 repetitions. But! Remember – The body needs time to adapt to a new exercise program. Start with 10 reps, or even fewer if you’re struggling, and add 1 rep per day to your workout till you get to the magical 15 mark.
Doing Heel raises off the edge of a step is the most important exercise to do when it comes to Achilles Tendon Pain.
It all comes down to strength. As strength of the Tendon goes up – Pain goes down.
Once you’ve been doing 15 reps for a week or 2, (see table below), progress to doing these last two exercises on one leg. Once again, try and start at 10 reps and build slowly to up to 15.
We really need to do these exercises with the Knee bent slightly as well:
Well done!
Now finish with the foot resting on an Ice Pack for 20 minutes.
How long will this take to get better!?!
Achilles Tendon pain (Tendinopathy) occurs because the tendon is too weak, which causes strain when placed under load. Tendon fibres breakdown, suffering a series of repetitive microscopic tears, leading to inflammation, swelling, and pain.
Tendons don’t heal with rest and time. The cure comes from increasing the muscular and tendon strength so it can handle the stress you are apply to it.
The Achilles needs an incredible amount of work to get the results you need and to prevent any recurrences.
It can take 4 – 6 weeks to build up the strength and endurance to simply be able to cope with the program below., and another 4 – 6 weeks until you become pain free.
Recovery from this, is by no means easy. It takes persistent and consistent effort on a daily basis.
Here’s a typical program for the average person, who’s being suffering from a moderate amount of pain in the Achilles Tendon for a few weeks:
| Weeks 1 – 2 | Do the following exercises: Once per day in week 1 | ||
| Twice per day by week 2 | |||
| Mobility | Foam Roller with as much pressure as tolerated | 2 mins Soleus | |
| 2 mins Calf | |||
| Toe Yoga | 10 reps | ||
| Flexibility | Stretch against a wall (1 leg at a time) | Straight Knee | 3 x 20 seconds |
| Bent Knee | 2 x 20 seconds | ||
| Strength | Heel Raises off the ground (both legs at once) | Straight knees | 10 reps (in week 1) |
| Straight knees | 15 reps (by week 2) | ||
| Heel Raises off a step (both legs at once) | Straight knees | 10 reps (in week 1) | |
| Straight knees | 15 reps (by week 2) | ||
| Ice pack | 20 minutes |
| Weeks 3 – 4 | Twice per day | ||
| Mobility | Foam Roller with as much pressure as tolerated | 2 mins Soleus | |
| 2 mins Calf | |||
| Toe Yoga | 10 reps | ||
| Flexibility | Stretch against a wall (one leg at a time) | Straight Knee | 2 x 20 seconds |
| Bent Knee | 1 x 20 seconds | ||
| Strength | Heel Raises off a step (both legs at once) | Straight knees | 15 reps |
| Bent knees | 15 reps | ||
| Heel Raises off the ground (1 leg at a time) | Straight knees | 10 reps (in week 3) | |
| 15 reps (by week 4) | |||
| Heel Raises off the ground (1 leg at a time) | Bent knees | 10 reps (in week 3) | |
| 15 reps (by week 4) | |||
| Ice pack | 20 minutes |
| Weeks 5 – 6 | Twice per day | ||
| Mobility | Foam Roller with as much pressure as tolerated | 2 mins Soleus | |
| 2 mins Calf | |||
| Toe Yoga | 10 reps | ||
| Flexibility | Stretch against a wall (one leg at a time) | Straight Knee | 1 x 20 seconds |
| Bent Knee | 1 x 20 seconds | ||
| Strength | Heel Raises off a step (both legs at once) | Straight knees | 15 reps |
| Bent knees | 15 reps | ||
| Heel Raises off a step (1 leg at a time) | Straight knees | 15 reps | |
| Bent knees | 15 reps | ||
| Ice pack | 20 minutes |
| Weeks 7 – 8 | Twice per day | ||
| Mobility | Foam Roller with as much pressure as tolerated | 2 mins Soleus | |
| 2 mins Calf | |||
| Toe Yoga (should be mastered by now – no need to do them) | 0 reps | ||
| Flexibility | Stretch against a wall (one leg at a time) | Straight Knee | 1 x 20 seconds |
| Bent Knee | 1 x 20 seconds | ||
| Strength | Heel Raises off a step (1 leg at a time) | Straight knees | 15 reps x 2 sets |
| Bent knees | 15 reps x 2 sets | ||
| Ice pack | 20 minutes |