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Achilles Tendon Pain Physiotherapy

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.

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.

How do we treat Achilles tendon complaints?

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.

Achilles Tendon Exercises

1. Calf Strengthening Exercises

• Start with standing flat on both feet, slowly tip toe as high as possible. Do this as slowly as possible. 10 times is 1 set, do 3 sets daily.
• The second calf strengthening exercises, is done in sitting. Place both feet flat on ground, and slowly push off and resisting the ground. Do this as slowly as possible. 10 times is 1 set, do 3 sets daily

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:

• Raise up on the non- painful leg and drop on the painful side – we advise you take 3 seconds to lower down on the painful side.
• Repeat this for 3 x 15 reps (have a 1-minute break between sets)
• Add weight to the exercise – either hold a dumbbell in one hand or put a weight in a ruck sack

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.