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Achilles tendon pain and injury is very common among recreational and elite sportspeople. That being said, it's not only for sportspeople - it's also common among sedentary individuals.
Our Achilles tendon is the largest tendon in the entire body (yeah!) and it attaches the calf muscle to the heel bone.
It is thought that up to 50% of runners will experience pain in their tendon at some point in their life.
As shared before, our tendons are really tough stuff, made of fibrous connective tissues that can take high repetitive forces.
If we compare running, running is generally a series of hops and with each hop, our Achilles tendon behaves like an organic spring which stores and springs the energy.
The "harder" the muscle-spring, the greater the amount of energy stored.
We always advise that you get properly assessed by an experienced sports or running physiotherapist whenever possible. All our physiotherapists have extensive knowledge and experience of treating Achilles tendon problems.
If you have answered YES to 4 or 5 of these questions it is likely you have an Achilles tendon problem.
So what we know is that injured tendons loses their capacity to withstand loads and forces.
Our roles as physiotherapist is to rehabilitate your tendon to
improve the stiffness of the tendon so it is able to withstand high
repetitive loads again, without pain.
Many physiotherapists and self-help guides on the internet often prescribe ice, calf massage, rest and stretches for the tendon - these can be useful with an acute tendon problem e.g. when you have had the pain for a few days but if it's chronic (ie been injured off-on or for a while now) it's a different ball game entirely.
If you just rest an Achilles tendon complaint this will reduce the pain in the short term but as soon as you go back to running, football or whatever the activity was that used to aggravate the pain, the tendon pain comes back almost immediately.
What happens is that the injured tendon simply does not have the capacity to take the loads and so becomes painful again fairly quickly. Complete rest can often make the problem even worse.
To improve your strength of your tendon and its ability to withstand load here are some exercises you can carry out in the gym. The key is to ensure they feel heavy and that your tendon has time to recover in between.
We advise that you carry these exercises out at least 3x per week, but ensure you have a day off in between because the day after a loading session the tendon is more vulnerable so a schedule of
would be good
We would always advise you consult a professional of you have not used these machines before or not used to going into the gym. If you don’t have access to the gym these exercises can be modified but from experience we find they are less effective.
1. Calf Strengthening Exercises
2. Leg press with equipment (no equipment, do chair squats). Start seated on a stable chair, and do a slow motion of sit > stand > sit. The slower the better. 10 times is 1 set, do 3 sets daily
3. Non-gym option
Here is an option if you do not have access to the gym. This program is called the Alfredson regime.
It was one of the first exercise programs to show positive effects on pain and function. However, it doesn’t work for everyone and is just one option. If pain allows we would advise you get onto the progression of this exercise as soon as possible.
The program was originally designed to be done twice a day but we advise you start every other day but you must ensure it feels very hard and you are reaching fatigue when you get close to the last few reps!
How to carry out this exercise:
Progression:
Progress the exercise by going up and down on the painful side.
If you experience pain with these exercises or a worsening of your
symptoms then we would advise you stop the exercises and get assessed and treated by
one of our physiotherapists.
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At the first session, our specialist physiotherapists will carry out a thorough assessment, helping them to select the most appropriate treatment to help you recover as well as provide treatment in the same session.
Follow up sessions are inline to provide expert treatment for your pain as well as prescribing specific exercises to reduce your risk of re-injury and giving you a long term solution.
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