Achilles tendonitis, a condition characterized by inflammation and irritation of the Achilles tendon, can be debilitating and affect one’s ability to engage in everyday activities, especially those involving running, jumping, or other high-impact movements. However, with a well-structured exercise program, proper care, and patience, it is possible to alleviate symptoms and promote healing.
Understanding Achilles Tendonitis
Before diving into the exercises, it’s crucial to understand the condition. Achilles tendonitis can be categorized into two main types: mid-substance tendinopathy, where pain is experienced several centimeters above the heel bone, and insertional tendinopathy, where pain is felt at the heel bone itself[1][2].
Initial Steps in Management
Rest and Activity Modification
The first step in managing Achilles tendonitis is to reduce or stop activities that exacerbate the pain. Switching to low-impact activities such as biking, elliptical exercise, or swimming can help decrease stress on the Achilles tendon[2].
Ice Therapy
Applying ice to the most painful area of the Achilles tendon can help reduce swelling and alleviate pain. Ice should be applied for up to 20 minutes at a time, with breaks to avoid skin numbness[2].
Compression and Elevation
Using compression wraps or sleeves can help reduce swelling, and elevating the foot above the level of the heart can aid in reducing inflammation[4].
Stretching Exercises
Stretching is a critical component of Achilles tendonitis rehabilitation. Here are some effective stretches:
Calf-Plantar Fascia Stretch
Stand facing a wall with one leg extended behind you, keeping the knee straight and the heel on the ground. Lean forward, bending the opposite knee, until you feel a stretch in the calf and Achilles tendon. Hold for 15-30 seconds and repeat on the other side[4][5].
Floor Stretch
Sit on the floor with your legs extended. Use a towel or resistance band around the ball of one foot and gently pull it towards you, keeping your knee straight, until you feel a stretch in the back of your calf and Achilles tendon. Hold for 15-30 seconds and repeat on the other leg[4].
Stair Stretch
Stand on the edge of a step with your feet hip-width apart, using the balls of your feet to balance. Slowly lower your heels below the step, feeling a stretch in your Achilles tendons and calf muscles. Hold for 15-30 seconds and then rise back to the starting position. Repeat several times[4].
Strengthening Exercises
Strengthening the calf muscles and Achilles tendon is essential for recovery.
Isometric Holds
Raise up on both legs, shift your body weight over to the painful side, and hold for 30-45 seconds. Perform 4-5 repetitions daily. This exercise helps in initial strengthening without excessive strain[1].
Eccentric Contractions
Stand on both legs and raise your heels off the ground. Slowly lower down on the painful side. Perform 3 sets of 15 slow repetitions every other day. For insertional tendinopathy, stay on the ground during this phase to avoid exacerbating the condition[1][2].
Full Calf Raise
Once the pain has reduced, perform full calf raises on the painful side. Do 3 sets of 15 repetitions every other day. This exercise strengthens the tendon and calf muscles[1].
Bilateral and Single Leg Heel Drop
Stand at the edge of a stair or raised platform with just the front half of your foot on the stair. Lift your heels off the ground and slowly lower them to the lowest point possible. Start with bilateral heel drops and progress to single leg heel drops once the bilateral exercise is mastered[2].
Additional Therapies
Extracorporeal Shockwave Therapy (ESWT)
This therapy uses low- or high-energy shockwaves to promote healing of the damaged tendon tissue. It can be particularly effective when combined with other nonsurgical treatments like eccentric exercises[2].
Night Splinting
For severe pain, a walking boot or night splint may be recommended to give the tendon a chance to rest before initiating therapy. However, extended use of these devices should be avoided to prevent weakening of the calf muscle[2].
Tips for Expedited Recovery
Proper Rest: Avoid activities that exacerbate the pain and inflammation.
Ice Therapy: Apply ice packs to the affected area several times a day.
Nutrition and Hydration: Maintain a balanced diet and stay hydrated to support tendon healing.
Physical Therapy: Work with a physical therapist to design a personalized exercise program and receive manual therapy techniques to reduce pain and inflammation[4].
Most Important Facts About Achilles Tendonitis Exercises
Rest and Activity Modification: Reduce or stop high-impact activities to alleviate stress on the Achilles tendon[2].
Ice Therapy: Apply ice to the affected area for up to 20 minutes several times a day to reduce swelling and pain[2].
Stretching: Regularly perform calf-plantar fascia, floor, and stair stretches to improve flexibility and reduce stiffness[4][5].
Strengthening: Use isometric holds, eccentric contractions, and full calf raises to strengthen the tendon and calf muscles. Progress exercises based on symptom reduction[1][2].
Eccentric Exercises: These are crucial for strengthening the tendon while it is lengthening. Start under the supervision of a physical therapist[2].
Avoid Cortisone Injections: Cortisone injections are not recommended as they can weaken the tendon and increase the risk of rupture[2].
Consider ESWT: Extracorporeal Shockwave Therapy can be an effective adjunct to other treatments for promoting tendon healing[2].
Physical Therapy: Working with a physical therapist can significantly aid in designing a personalized rehabilitation program and enhancing the healing process[4].
By following these guidelines and incorporating the recommended exercises into your daily routine, you can effectively manage Achilles tendonitis and work towards a full recovery.
