How To Rehab Insertional Achilles Tendonitis - Achilles Tendon Pain
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- Опубликовано: 24 июл 2024
- Have you been experiencing pain in your Achilles tendon area?
Have you been icing, stretching, and doing the internet's, "Top five exercises to heal your Achilles tendinitis?".
Well, folks, we should chat a little bit.
Not all injuries are the same. They are all a bit different in their own way. When it comes to Achilles tendon pain, there is something we need to take into account.
Is the pain in the upper region of the tendon, or the lower region of the tendon near the heel bone?
The answer to this question will drive your Achilles tendon pain rehabilitation program.
There are two types of Achilles tendon injuries: mid-portion and insertional. Mid-portion Achilles pain is as it sounds; the pain sits right in the middle portion of the tendon. Insertional Achilles pain occurs where the tendon meets the heel bone.
The rehabilitation program for these two injuries differs. That is why your typical "five exercises" you find on the internet may not be your fix. Today, I am going to focus on the latter and discuss Insertional Achilles Tendon Pain.
Pain in the lower portion of the tendon does not like the same things mid-portion tendon pain does! That is why your eccentric calf raise & heel drop protocol may not be working for you. What's important for insertional Achilles tendon pain is to avoid tensile and compressive loads! This means avoiding excessive stretching and things such as heel drops.
So, what should you be doing to help your insertional Achilles tendon pain? Here are five things that may help!
1. Single Leg Heel Raises: Place one leg up on a step or object while your other leg remains on the ground. Perform a single leg calf raise and perform 10 repetitions x 30 second holds.
2. Bridge on Toes: Lie on your back with your knees bent. Keeping your toes in contact with the ground, raise your heels and buttocks off of the ground. Perform 2 rounds of 10 reps x 10 s holds.
3. Seated Weighted Heel Raise: While sitting in a chair, place a weight on the top of the knee of the affected leg. Perform a calf raise and hold x 5-6 seconds. Perform 2 sets x 10 reps.
4. Creep Walk: While standing, perform a slight hip hinge (hips back, neutral spine) and slightly bend your knees. Raise your heels slightly off of the ground( like there is a ketchup packet underneath) and walk around for 3 rounds x 30 seconds with weights in both hands.
5. Shoulder Extension with Calf Raise: This exercise requires the use of a resistance band. While standing, holding on to a band with both hands, pull your arms straight backward and raise up on your toes for 2 sets of 10 x 10 second holds.
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Great exercises! well done
I went to three different foot doctors that did no tests, just said "Achilles tendonitis, stretch it" and I kept saying the pain was coming from lower than what they were describing. Years I've had this pain and stretching made it worse. It wasn't until I found out that insertional Achilles tendonitis better matched what I was feeling and I discovered these exercises, that I started to feel some relief.
I was doing the complete opposite of what I needed because of lazy doctors that couldn't be bothered to listen. One of them spent less than a minute with me and didn't even look at it before saying, "stretch and put Voltaren on it."
Oh boy, so sorry to hear that, but glad you are past it
Ya this deserves a like. There are so many other achilles medical conditions out there but I think this is exactly what I have an insertional achilles tendonitis. I thought I had plain old achilles tendonitis, then a bone spur, then bursitis, then the Hagrid deformity thing and the exercises for those injuries have been probably slowing down my recovery. This is the most confusing injury I ever had and the freaking longest one too. I've had it for a year now...
Did It get better. If yes how?
@@thermoplastischesaethylend1046 ya it’s better. But not 100% yet. There still feels like there’s a knot in my heel.
@@Artkidtek How do you manage walking. Im always scared to train because even all the walking previous that day hurt my achilles and then Idk If I should still trajn it
Mine originally first happened from pushing an overloaded double buggy for hours every day. Now it is a reacuring injury. Thanks for this help.
Great video - just what I needed. Heels are feeling exponentially better with those exercises. Many thanks
I'm a tennis player and a fitness coach. Insertional achilles tendonitis pain started 3-weeks ago, left and right heels. I'm going to give your exercises a try for a few weeks. Thanks.
Amazing. So good.
thank you so much. now i understand why going downhills is much of a relief to my Achilles
Very interesting thankyou
Very helpful!! My pain won't go away. Running injury. I've been struggling with this for 6 weeks! These exercises make so much sense!!
Thanks for watching
Thanks for instructional exercises, I suspect I've insertional Achilles tendonitis , will give it a try, hopefully it will work.
R u ok now????
Or still suffering???
Please reply
Ill give it a try, I have this soccer injury since 2018, I tried almost everything 2 different doctors many therapy sessions , tapes, nothing worked. the pain is on on left side of the back of my foot. at least with those exercises I didn't feel pain so I guess I'm on the right track. thank you for sharing your knowledge.
I've been struggling to rehab this condition for about 9 months now with only very incremental improvement and a visible swelling around my heel. Stretching has always been a big part of my program but since learning that the compression caused by this is counter to recovery and dropping them, things have finally started to improve. I've still a way to go but I can feel things are different now and I'm on the right track. Finally. Hoping to get back to running soon!
thank you doctor for this amazing video, I have been suffering from this problem since the last week in my right foot because of lots running as a beginner, I find it very difficult to walk and painful too, I will try these exercises and I will be in touch.
first day: all the exercises made me feel better except the walking exercise made me feel pain idk why.
How are you doing now? I'm asking coz I have the same experience as you, the creep walk is difficult and painful
I am totally fine, thanks. I just stopped running and playing legs in the gym and even I did not do the exercises mentioned in the video, and keep in mind not to stretch your calves because it worsens the problem.
I hope you recover quickly. @@marygracemargate3857
In tradition medicine archilles tendon probems are a result of burn out. Burnout affects the lower back and abdomen area which then affects the archilles. Check if you have been over doing things, are drained to the bone, exhausted and tired. Focus on healing that as well as your archillles directly
So excited to try this route. Been struggling with this pain for 2-1/2 years, several podiatrists/physical therapists and even surgery. How often should I perform these exercises? Thanks for sharing your expertise with the world.
Oh thank you 😊 I've been dealing with this for over a yr know and looks like I've been doing all the wrong excersisce. Getting ready to have surgery for it. I may out it off until I try these.
Thanks for the exercises! I really hope they'll help me fight with this nasty problem.
Of course! Thanks for watching
R u ok now??
Just wanted to thank you Dr.Ash, I finally got a diagnosis of this and the doctors office was recommending the calf stretches like for plantar fasciitis. I’ve been in pain for 7 months. I literally started doing these exercises and felt better in one day. I’m walking like it wasn’t even there. Thank you!!
Thank you.
Did you do those heel drops stretches for those 7 months before you saw this video?
@@troyturnbull420 yes, I had no idea it was the wrong rabbitt hole, lol
@@teresaleab9884 How inflamed did your heel get?
@@troyturnbull420 pretty bad, felt helpless especially when trying to stay active :/
I have both! Started as insertional then spread upwards
awesome
Good video, very appreciated! I have had this awful injury for a long time… therapists always advice heel drops off a step. Will follow your exercises daily now. How long should I do it for? I’m 29 and live in Sweden. Cheers!
Same age i have recently had this problem, do you work while having this pain?
Dr. Ash, i was recently diagnosed with this and it was recommended to do heel lift/raises on the edge of a step for 60 - 100X PER day. I am going to try your recommendations. How many times per day should I be doing these and all of them, or just choose certain ones and stick with that for awhile? And, TY for doing this video, great help.
Thank you for the recommendations. I've been struggling through this injury for about 5-6 months now. My previous approach was stretching, combined with strengthening only to realize insertional tendonitis requires a different focus. I'm fearful by avoiding stretching my calf I may do additional damage post run. Should I avoid calf stretching altogether or are there some calf stretches that are okay for insertional Achilles tendonitis? thanks!
Life Saver for Runner
Thanks for the video! I'm wondering what stretches, if any, I should be doing along with this program.
Thanks for watching, we can’t give individual advice here, your best bet is to find a local PT and get some advice
do you recommend doing all of those exercises in a workout? Seems like a lot, as if it might stress that insertional area with all that repetition. Thanks so much, btw, for this video! It seems maybe only ten percent or less of youtube achilles videos address the two separate types of pain. And your video describes far more exercise remedies than any others that do.
We can give specific advice here, how many you need is very individual
I don't have pain on the tendon but some numbness and tingling. Then pain near the insertion and kind of an overall plantar fasciitis thing where it's worst when I first step out of bed. It's made worse by hiking. It's been like 10 months.
Thanks so much for those exercises and tips!
With what frequency do you recommend doing those? Every day, maybe every other day? For how long (I know this is a variable and very dependend on recovery)?
Thanks for watching, yeah a lot of that is very dependent on your situation and hard to say here
I've had insertional Achilles tendinitis/tendinopathy for over 2 months now. I can't wear shoes with backs on them because it hurts so much on the back of my heel!
I am a little over 8 months post achilles rupture (non-op) injury and I started feeling the insertional achilles pain only in the last couple of weeks. Maybe it's because I have been walking mainly in sandals in the last few weeks, or maybe it's because I signed up to the gym about a month ago and started more seriously working on my calf strength, or maybe it's just random. But the pain is most severe in the mornings, or after being inactive for some time (even after just 30 mins of sitting). Once I get moving, after about a couple of mins, it gets warmed up and the pain becomes much more tolerable and kind of recedes into the background.
I still have a considerably sized bump on my achilles, which my doc says is mostly a scar tissue. And I still don't have anywhere near full strength back in my injured calf. Do these exercises apply to someone like me, who is technically still recovering from an achilles rupture injury?
Thanks!
I have a question. I have been going through pain for the last 1 year but it only appears when I walk on go for a run. I do not feel any pain when I play basketball or other sports. But whenever I walk a bit I feel so much pain. What should I do?
37 year old male and I have been suffering with what I believe is insertional achilles tendonitis for 1 year. Nothing seems to be working and 2 MRI’s have shown no issue. I also have low dorsiflexion in the same foot. Shall I avoid improving dorsiflexing from the floor (e.g. squat positions) as I’m wondering if this could have something to do with my issue? Really struggling to walk longer then 5 minutes and would welcome any advise please.
Is Bone spur formation to the back of the heel bone insertional tendinitis?? if so then there is hope doing these exercises without surgery?
is there any limit in calf stretches for insertional tendonitis? like calf board is okay to use?
I have Haglunds Deformity and Retrocalcaneal Heel spur. Hope to have my surgery soon.
Did you have surgery? If so, how was it and how is recovery?
I was prescribed eccentric calf raises for achilles tendonitis, but nobody ever discussed the different types (and I believe it to be insertional). After years of doing the same eccentric calf raises, I still have the issue more around the insertion point and possibly starting to cause spurs. I have also tried CALFPRO for stretching, which seems to make things worse (also leading me to believe that insertional exercises described here could help). My question is: Should I suspend the eccentric calf raises altogether during this experiment? And is a device like CALFPRO for stretching also going to cause more issues with insertional achilles tendonitis?
What do you suggest for micro tears? My official MRI showed: Diffuse hypertrophic achilles tendinosis with 2 x 0.4 x 0.6 cm combined interstitial/partial thickness tear at the medial aspect of the watershed zone. I'm walking ok but too much pressure on the foot causes sharp shooting pains at the lower achilles. I also have low grade distal post tibial tendinosis. And Midfoot arthrosis. I blame much of this in a hip replacement (2 years ago) and a knee replacement (3 monthes ago) that caused my walking gait to be off. Uneven surfaces are hard on me. Need to get back to spring/summer activities. Yard work, golf, etc. Thoughts?
You definitely had a good MRI technician. I went through the process of getting an MRI and they had nothing conclusive to tell me. They said it probably was a small partial tear, but then the orthopedic doctor said it was old age and I am not old yet…..we have horrible health care here. Every time I try to do the sitting calf raises and ankle rolls, which are very very low-key, the tendon just gets stiff and I can’t walk hardly. I am between a rock and a hard place. And I am so damn tired of it. Nothing that works for everyone else works for me. I’d probably be better off doing none of the exercises and just keep moving around.
When can I start the exercises? I have swollen heel for 4 days and it’s going down now. Should I wait for it’s no longer swollen before doing the exercises? Thank in advance!
I work on dirt eqpt . But recently more so. I climb up into machine through loose dirt
Can I begin these exercises just as I’m coming off a steroid burst for a flare? Off the steroid yesterday, beginning Naproxen today.
How many times a week should i do these exercises?
Started doing "creep walks" before I even saw this video. I didn't even realize this is what they were called. I just started walking on my balls of my feet because it relieved the tension and some pain. It's good to know that it's an actual exercise.
I packed and moved last August, seriously upping my activity though I do workout regularly, and shortly after I moved in, I stepped from hard flooring onto carpet and felt a horrible tearing pain in the back of my heel. Over a couple months it healed and I felt back to normal for over 3 months, back to normal workouts, then once again stepped from hard flooring to carpet and had another 10/10 tearing pain that was so severe in the back of my heel. This time was even worse. I'm now at week 5 using heel lifts and doing toe raises but still limping, very slow progress. My PA doesn't think I need imaging, but I can't help wondering if I seriously damaged something. I would be thankful to hear your thoughts
you definitely need to go and get a scan my friend.
Hey ma'am really helpful video, can you tell me how much time would it take it to heal completely
That’s very hard to say it will be different for everyone
Any advice for mid portion achilles?
Hi great stuff. Should I see a physical therapist or podiatrist? I have pain here. Not sure if it’s bursitis. Gout?
Find a solid local physical therapist
Does the Achillles tendon hill itself ,I had some x -rays done and the diagnostic was that there was a clean rapture of 5 cm ,and every time I walk there is a sound of tack -tack ,will it hill itself through exercise or will I need to operate
I think I have insertional Achilles tendinitis and multiple channels have recommended the intervals with heel raises and it only makes it hurt worse. I wonder why?
Hi I have been suffering from insertional achiilies tendonitis from 3 months now, can I do these exercises, will it relieve pain? And also how about the cold and hot compresses when should they be applied? Pls reply I really was looking for such videos
R U OK NOW?????
any improvement
How many times per day for these exercises?
When i do tip toe it hurts. Should i continue the exercise?
Is there a difference between achilles tendonosis and tendinitis? I was told that I have tendonosis and that I shouldn't run anymore period 😢
doing the exercises hurts my achilles tendonitis, should I rest it before doing this?
what about squats and lunges?
WHY ARE YOU YELLING? Lol, I do appreciate the video. Good exercises.
@4:32 … two rounds of 10 second hold?? Do you mean 2 rounds of5 reps of 10 seconds holds? Asking for clarification 🙏
@Ashley Witson, PT, DPT The description says yet something different. It says: "2 sets x 10 reps x 5-6 seconds". Could you please clarify which one is accurate?
I injured my insertiona achilles due to ramping up my training to much, wearing wrong cleats (played football), AND I wasn't doing any type of warming up or recovery exercises before and after workouts, practices, and playing games. I was stupid
Although it's been 6 months since then, I can walk without pain, however after running or jumping for long periods it hurts afterwards and I can't do anything for 2 to 3 days. I need to get back to running regularly.
My case is exactly word-by-word same as yours? If you have found a solution then please reply.
@@pranayp2239 have you found anything that helps?
@@pippilulu1 Nope ;-(...Avoid walking as much as possible.. This works however this is not viable thing.
I have the same story,
Does anyone found any solution?
0:06 Um that's not insertional achilles tendonitis, that's mid-portion achilles tendonitis. Or am I misunderstanding?
I think this is what I have. The tendon doesn't hurt, but it hurts right at the heel. Every morning it's really sore and I've tried stretching and icing it for over a year now and it's still bad everyday v
Don't stretch!!
@Dima Singh Rana Manhas no stretching without warmup will not cause insertional Achilles tendinitis. Achilles tendinitis is and overload issue and strangely enough the way to fix it is to load the hell out out the tendon with the exercises so that the tendon can handle the load you place upon it during the activity that you do
Please tell me how anyone is supposed to do these without ripping out their entire Achilles? This just makes me so angry because I can’t even do a sitting calf raise without my tendon getting totally stiff. And I just keep having stabbing heel pains at the insertion point. Especially after I’ve put my legs on a vibrating roller because I don’t have someone to push into the upper calf muscles to get at the trigger points, which are the origin of this injury. You haven’t mentioned anything about that.
How long should I be doing these exercises and what's next?
Thanks for watching! We can’t give medical advice here but you should get in to see a PT in your area
Good video thanks. BUT no stretching?
That's right - no stretching. Stretching compresses the tendon on the heel bone and irritates it. This is where I went wrong for months. As soon as I stopped the stretches and only did exercises like these which also don't cause that compression, things started to improve.
How often should this be done? Daily? 4 times a week?
Every day, twice per day, at least 5 days per week I think.
How often should these exercises be repeated? Research shows it could take at least 12 weeks to fix, is that also the outcome with your clients?
12 weeks would be a fast rehab. Some people have had this on and off for a decade or more.
R u ok now???
@@Priyan0000 yes. Mine took around 10 months to fix. I had both insertional tendonitis and also bursitis. Solution was plenty of rest and wearing shoes with a high heel to toe.
1.With bursitis first aim is to kill inflammation completely so plenty of rest, ice and anti inflammatories. I also used chondrotin cream.
2. Before starting any exercises start with gentle calf stretching. This is crucial before starting to run or even strengthen.
3. Then gradually start to increase strength and see how it feels. Sometimes you need to back off. Important to also keep flexible calves as tight calves might make this re-occur. When strengthening i l took a collagen (15g) supplement 30/45 mins before exercise. Look up research by Dr Keith Baar.
Good luck
With regards to exercise frequency I wouldn’t do these daily. With tendons it’s important to wait 24 hours to see how they respond. Nevertheless gradual is key, be patient as setbacks will delay this. I would do exercises EOD (so 3 times/week).
@@dominicborg5638 Now you fully healed?????
Are compression socks bad for it?
nope
Thank you for this, but it seems like you’re only addressing athletes. How about a 61-year-old woman who is mostly sedentary? I was minding my own business and this soreness just developed a few weeks ago without a specific injury. I’ll do your exercises happily but would love to know more about prognosis and timeline.
Sorry to hear about your situation, we can’t offer individual advice on here, and especially without seeing you it would be hard. Our advice would be to find a good local PT familiar with tendonopathy
You have to do the exercises through pain?
Any suggestions?
Would tendonitis show up on mri??
it can yes
Any good shoes can you recommend for insertional achilies
Something with a heel over an inch. Maybe 2 inches and don't walk around barefoot.
You need something much more low-key for people that need to start at the bottom. If I did any of these, I wouldn’t be able to walk at all.
why is she yelling at me?
yet another self proclaimed youtube doctor.
Can't get rid of it 😭
Hope your pain goes away soon. God bless!!
@@ok_nextpls7513 thanks so so much
Same. Nearly 2 years now
CREEP WALK!
How the hell is someone supposed to do this exercise if they have no strength to do it? My entire Achilles would rip out if I tried to do this.
Stop yelling please
Can you provide your opinion for cold vs hot water therapy.?