The best exercise for Achilles tendinosis?

Well, l I’ve got a question mark there in the title of this subject for three good reasons. The first is that the research and reports about this are not conclusive – how often is health related research cast-iron??  The second is that no one exercise is good for all sufferers of tendon related issues.  What works for one person, will be ineffective for someone else!  And the third is that your Achilles pain may not actually be from the tendon itself.  Other structures near the heel could be to blame, so you need a correct diagnosis to begin with.

Having said that, if you’ve had a nagging Achilles tendon problem for weeks (and probably months), which is worse when running or jumping, there’s a good chance you’ve got Achilles tendinosis.  Chances are that you’ve already seen someone about it if it’s that bad, in which case you might already know what’s to come…  

 

What is tendinosis?

Basically, a condition in which the fibres of the tendon become rather disorganized and less able to cope with the huge forces through it when your calf muscles are being used.  So further aggravation of the tendon is more likely, and for reasons that are still not quite understood, the repair process seems to get disrupted so that it takes forever to come right in some people.

An Achilles problem can start with a specific event or trauma, or gradually through very repetitive actions, often involving strong calf muscle contraction and high loads like jumping or running.  This can gradually and cumulatively inflict micro-trauma which most of the time would almost go unnoticed as it may only create minor soreness.  But over the long term the regular trauma accumulates and outstrips the recovery rate of the soft tissue, until one day you become aware of a pain for no obvious reason.

The single exercise that seems to be recommended – and which worked for me – is eccentric heel drops.  ‘Eccentric’ is just another let’s-make-it-hard-to-remember name for a strengthening exercise during which the muscle being used is actually lengthened! So an example would be looking down at your dinner compared to looking at the ceiling.  Looking up involves your neck extensor muscles contracting and shortening, which is why the neck will get shortened on that side.  This is called a concentric contraction.

But the eccentric contraction is during looking down.  This uses the same muscles, but this time working to stop your head falling down into your spaghetti!  Only the back of the neck and the same muscles will be getting longer.  

 

The exercise… So, find some steps and stand with just the front of your feet on the step towards the edge so that both heels are well off the edge.

  • Using both feet, (or even better, using any banisters and your arm strength), raise yourself onto your toes.
  • Now lift the foot on the good side slightly off the step.  All your weight is now on the side of the problem.  Hold it there for a count of three, then slowly lower your heel down all the way as far as it will comfortably go over the edge.
  • Aim for 10 repetitions, but stop when you feel your calf or tendon beginning to play up or tighten.  Increase the number at your own rate. You shouldn’t push it to the point that you created a lot of soreness.
  • If it’s really irritable and weak, try doing what I did.  Because my tendon felt particularly irritable I started using both feet as I was worried that putting all my weight just on one side would be too much.  Then I progressed to a single foot exercise after it felt stronger.  I also extended the count from 3 to longer as it would allow.
  • If you’ve got any, you can use banisters and your arms to get to the start position.

Just to finish off, I would suggest stretching the calf after wards.  You can find plenty on the web, but here’s an easy one. Sit on a cushion with your behind right up against a wall, with feet on the floor and knees bent.  Then on the affected side, Move the foot on the affected side so it’s pointing up towards you, and begin sliding that heel along the floor.  As the knee  get closer to the floor, you’ll feel a tightness in the calf.  Hold it at the point of mild tightness for a few seconds, bend your knee again, and repeat the process until you feel you’ve gained some stretch.

Posted in Adults