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The Achilles tendon is a thick tendon located in the back of the leg. It connects the gastrocnemius and soleus muscles in the calf to an insertion point at the calcaneus (heel bone).
It is the strongest tendon in the body and allows people to push off while walking, running and jumping.
Achilles injuries can occur in several places, but the most common area is at the muscle-tendon junction – the area where the calf muscles join with the tendon.
Causes Of Achilles Tendinopathy
Also known as Achilles tendinitis, this is a chronic condition that causes weakness and breakdown of the tendon due to a series of small tears.
Developing Achilles Tendon pain is a common finding when our calf muscle group (gastrocnemius, soleus, achilles) is chronically shortened from heel elevation in footwear.
Achilles tendon pain can also develop from a repetitive strain or repeated stress that is too much for your calf muscles to manage.
Most often I see Achilles Tendinopathy in those who have a sudden increase of their training intensity or volume without the proper conditioning phase.
Achilles Tendon Recovery
Most cases of Achilles tendinopathy can be treated with conservative treatment. The most effective treatment of the tendon includes loading the tendon progressively.
Achilles injuries can be difficult to treat, especially without the right guidance. Many foot practitioners and physical therapists underload the tendon, which hinders recovery.
Tendons Need Progressive Loading
Tendons speak only in the language of load. Tendons need some controlled loading to begin to strengthen and remodel.
if you don’t load the tendon enough, its capacity will be diminished. Bodyweight exercises aren’t enough!
Progressive loading or progressive resistance is the method of gradually increasing the difficulty or intensity of rehab efforts over time.
The goal is to challenge the tendons and improve strength and muscle development.
The Solution
Transition To Functional Footwear:
The first step is to transition out of footwear with an elevated heel. A slow, gradual transition to zero drop footwear is ideal. This will place all the lower leg muscles back into their natural length-to-tension relationship.
Find my Approved Shoe List here with footwear options that are widest at the toe and zero drop.
2. Remove Fascial Adhesion:
With a repetitive strain, soft tissue adhesions develop, and must be removed to improve tensile strength and mobility. Use the fascial release tool on the gastrocnemius, soleus, and achilles tendon. Perform every 2 days.
3. Implement Progressive Loading:
Progressive loading is the method of gradually increasing the difficulty or intensity of rehab efforts over time.
There are 4 exercises below. Start with exercise number one and perform 2-3 set of 12-15 reps every other day. In 2 weeks, incorporate exercise number 2. In another 2 weeks, add exercise number 3 and so on.
Exercise 1. Calf Raises With A Ball Between Your Heels
Exercise 2. Calf Raises On A Slant Board
Exercise 3. Eccentric Loading Calf Raises:
Lift both heels and rise up on the balls of your feet
Lift one leg, and slowly lower your other foot and leg down
Then, alternate and lower the other foot and leg
Eccentric loading is the "lowering slowly" part and is extremely helpful to repair tendons
Exercise 4. Single Leg Calf Raises
Summary
I hope this article has answered your questions about Achilles Tendinopathy, and provided you with the tools you need to begin your rehab efforts.
Dr. Angela
The Plantar Fasciitis Doc
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