I got achilles tendinitis from walking in the wrong shoes for too long during a trip. The pain was sometimes excruciating and just never eased up. It was always worse in the mornings. I thought being more sedentary would help but it almost made it worse. Then I stumbled upon this video from Reddit. I started seeing improvement in just 1 week of doing the exercises twice daily. I didn't even have to progress onto the weighted backpack variation. Highly recommend this protocol!! It was a lifesaver and now I'm back to running 100% pain free.
Pretty sure that's how I got mine but I thought I was crazy thinking shoes were to blame. Always wore sneakers but then bought a couple pairs of Jordan 1s low & would wear em now & then but when I'd walk longer than an hour I'd get pain. I put it off doing anything for years because I'd only have issues once a fortnight but I started working out every day so I tried this, massaging etc. I'm going to stick with this but go heavier weight lower reps.
Well presented and explained. I've suffered with a right achilles issue for years after a partial tear. I've used this protocol with success before. I've now got an issue with my left achilles and wanted to refresh my understanding of the loading protocol. Many thanks
Thank you for this nice instuctional video. It surely resurrected my running career after achilles heel pain on both legs. I started seeing improvement within a week and now slowly back to running. I cannot thank you enough..Best Wishes
@@SK-jy9pw Doing really well ..... Started slowly ...... After 3 weeks rehab as per protocol my pain had decreased by 50%.... Mobility increased by about the same ... I was in an immense amount of pain before I started ..... This approach really works ! My advice ... don’t overdo it @ the start .... take it slowly .... Another three weeks or so and I reckon that will able to start taking 1 - 2 kilometre walk - I haven’t been able to walk more than 50 yards or so for 3 months!) ☘️ Really great programme ...
@@SK-jy9pw Hi there ... Well I’m no expert in tendon rehabilitation however, I’m a RN with 30+ years experience so I have a pretty good understanding of exactly whats happening in the tendon .... I get this mid point tendonitis every couple of years .... From experience I’ve found that the secret to recovery is completing the recommended exercises daily or twice daily exactly as demonstrated ..... If you tight for time ... do less but still do “something” each day un.... just hang in there ... “gradually” increase the load and the number of repetitions .... it helps to keep a note of your daily routine ... Good luck with your rehab’ stick at it .. you’ll get there ..... I’ve also found that placing a small piece of foam under the insole of my my shoe (just under the heel ( 10-15mm) helps reduce the load on the tendon .... check out ‘Warwick Enterprises Adjust a Lift Heel Lift “ .... Take Care .... ☘️
@@user-ki4xw2rb8q Still making slow progress ... I’m so much better than when I started on the programme - I’m seldom in pain now however I haven’t been overloading the tendon as I can feel that it’s still quite tight ... but I’m 66 now so I realise that it’s a matter of taking it slow and steady ... I’m making steady progress but not quite “there” yet
Surgery should never be the go-to option for chronic musculotendinous issues. And yet, that is what people are told to do first when they go to their physicians. It’s very disappointing that in this day and age, bodywork and strengthening are still not included in treatment plans. It’s actually embarrassing for the physicians for being so behind the latest body technologies.
Yes, because they're told that surgery followed by a long rehab program can actually cure the problem, while treatments don't actually cure issues (only alleviate symptoms) and require continous treatments making it more expensive on the long run.
@@wastelander1015 That's only one scenario and "cure" can be subjective. I don't claim that surgery is not necessary ever. I'm saying other non-invasive options should be explored before going for surgery.
@@danielletanner9076 you listen to a doctor who will redirect you to a surgeon if the injury is serious enough that requires surgery. That's usually how it works. Unless you prefer neverending fisiotherapy that will not solve the problem...
good to note studies have also shown this protocol to be effective at remodelling the plantar flexor muscle-tendon units to achieve greater long term PF ROM
A lecturer at uni told us a horrible Achilles surgery story last week. Lady had a minor tear mid-tendon so they decided to do a debridement. Pt still had pn + loss of function so same surgeon decided to do ANOTHER debridement. A few months down the track a different surgeon decided it’d be best to remove the Achilles altogether and pull through another tendon (can’t remember which one - EHL maybe?). Poor lady had been on crutches for 2 years when she hobbled into my lecturers clinic.
Very good information and loading protocols. Thank you!... I wish the protocols were also instructed out loud instead of the music. Also, being picky, what would be the ideal body alignment and leg muscle engagement (for example, feet parallel with knees apart, med glutes engaged, straight back, shoulders back, head up, etc). Good thing is that what I see in the video looks easy enough to do at home.
I have achillis tendinopathy but I also have a pes planus. My fysio told me not to do the alfredson protocol beceause I would only work in the wrong, weakened foot position. He advised me to do excercises for my intrisic foot muscles so my foot position is normal in terminal stance, pre-swing and thereby relieves the pressure on my achillis eventually. What is your advise on this?
I have constant calf pain, ive had total.knee replacement surgery on both knees ive been told by my doctor i have tendonopothy can i do the exercises on the video
I have been utilizing this protocol with success, but have developed medial heel pain felt when reaching down to my foot in standing. Any thoughts on this? (Def not PF pain)
this method is done by an Australian physiotherapist called Ebonie Rio. the method based on strength training and corticospinal control by balancing excitatory and inhibitory messages through auditory and visual external stimuli (using a metronome) it is used for the purpose of decreasing pain and avoiding recurrence of tendonopathy
I suspect resting it as much as possible until the flare ups and pain are reduced. Even if it means crutches or a wheel chair for a week or more. At some point you gotta start loading the tendon with these exercises to strengthen them. Hopefully by now you've contacted a professional and got started. Hope you are doing okay
Regarding insertional tendonitis - is there a clear time of when you know it is time to gradually begin dropping the heels into dorsiflexion? I've been careful to avoid any weight bearing in that position for a couple weeks now and can confirm the flare ups stopped. If I stretch my calves or go into dorsiflexion previously it does slightly aggravate the heel. I am trying to learn when its okay to start working up to a heel drop from a step versus staying on the floor.
We don’t show the full 15 repetitions. We explain what the content of the protocol is. Also we mention the details of the protocol after showing how the exercises are done If you want to dive deeper you can always refer to the article that’s linked in the video description
Thanks for your great videos, very beneficial. Is there any additional value for stretches in case of insertional Achilles tendinopathy? If yes, how frequent would you recommend it ?
@@jiygo I would think unless there's shortening of the calf and Achilles then No, no need for added stretching. In fact following the eccentric program through the full dorsiflexion ROM should give enough "stretching", along with the added strengthening and resilience to (re-)injury.
Physiotutors Anyway, I thank you. You did a great things. I’ve already translated the text by myself. But I think you agree that with video translation would be better. 👍👏
Would you mind adding the translation? There is a link in the description that explains how to do it It would help the community from those countries a lot
There is less stress on the insertion, as said in the video right before the exercises. Insertional AT needs a lower load than Mid-portion AT in rehabilitation.
There's some interesting research by Dr Keith Baar on tendons. Basically he suggests intake of Gelatin or Collagen + Vit C 30-60mins prior to exercises. Same as the Alfredson protocol it is done twice a day however with isometrics and not eccentrics. He explains isometrics (total 5-8 mins) are better as it gives more creep. This is what I will be trying next.
Barefeet is a good option. Just not a good choice when the exercise is done on weight plates like in the video. Of course one should take into account systemic factors that can impair recovery.
When the heel drops under toes level calf muscle gets overstretched and the achilles inflamates. Best recovery exercise is calf muscle raises/without the eccentric fall/ .
The problem is rather compression in case of insertional achilles tendinopathy, in midportion AChilles tendionpathy it's not an issue. For the first group, you might want to do calf raises on the floor and work more into dorsiflexion later on
Well this look tedious, boring and long. However if want this posterior tibial tendinitis to subside it looks like this exercise routine every single day for the next 12 weeks is my best shot.
I got achilles tendinitis from walking in the wrong shoes for too long during a trip. The pain was sometimes excruciating and just never eased up. It was always worse in the mornings. I thought being more sedentary would help but it almost made it worse. Then I stumbled upon this video from Reddit. I started seeing improvement in just 1 week of doing the exercises twice daily. I didn't even have to progress onto the weighted backpack variation. Highly recommend this protocol!! It was a lifesaver and now I'm back to running 100% pain free.
Pretty sure that's how I got mine but I thought I was crazy thinking shoes were to blame. Always wore sneakers but then bought a couple pairs of Jordan 1s low & would wear em now & then but when I'd walk longer than an hour I'd get pain. I put it off doing anything for years because I'd only have issues once a fortnight but I started working out every day so I tried this, massaging etc. I'm going to stick with this but go heavier weight lower reps.
Well presented and explained. I've suffered with a right achilles issue for years after a partial tear. I've used this protocol with success before. I've now got an issue with my left achilles and wanted to refresh my understanding of the loading protocol.
Many thanks
Ğ und
Thank you for this nice instuctional video. It surely resurrected my running career after achilles heel pain on both legs. I started seeing improvement within a week and now slowly back to running. I cannot thank you enough..Best Wishes
was it surgical one?
How long did it take until you could run again?
Thank you. My pt appt is a month out & as a trainer I know these exercises but it’s nice to get some feedback that I’m doing it right
good to hear! If you want to get remote help we recommend our partners at yourphysio.online
Mid Point Tendonitis x 2 months - Excellent explanations / advice .... Will start tomorrow 14/10/2020 ... and update post with progress 👍
@@SK-jy9pw Doing really well ..... Started slowly ...... After 3 weeks rehab as per protocol my pain had decreased by 50%.... Mobility increased by about the same ... I was in an immense amount of pain before I started ..... This approach really works ! My advice ... don’t overdo it @ the start .... take it slowly .... Another three weeks or so and I reckon that will able to start taking 1 - 2 kilometre walk - I haven’t been able to walk more than 50 yards or so for 3 months!) ☘️ Really great programme ...
@@SK-jy9pw Hi there ... Well I’m no expert in tendon rehabilitation however, I’m a RN with 30+ years experience so I have a pretty good understanding of exactly whats happening in the tendon .... I get this mid point tendonitis every couple of years .... From experience I’ve found that the secret to recovery is completing the recommended exercises daily or twice daily exactly as demonstrated ..... If you tight for time ... do less but still do “something” each day un.... just hang in there ... “gradually” increase the load and the number of repetitions .... it helps to keep a note of your daily routine ... Good luck with your rehab’ stick at it .. you’ll get there ..... I’ve also found that placing a small piece of foam under the insole of my my shoe (just under the heel ( 10-15mm) helps reduce the load on the tendon .... check out ‘Warwick Enterprises Adjust a Lift Heel Lift “ .... Take Care .... ☘️
@@SK-jy9pw You’re welcome ... I hope that your problem resolves quickly .... ☘️
How is your progress?
@@user-ki4xw2rb8q Still making slow progress ... I’m so much better than when I started on the programme - I’m seldom in pain now however I haven’t been overloading the tendon as I can feel that it’s still quite tight ... but I’m 66 now so I realise that it’s a matter of taking it slow and steady ... I’m making steady progress but not quite “there” yet
Excellent advice: I will give the Alfredson Protocol a go.
Alfredson afterthought. I looked at the story behind his protocol. Does anyone know if Alfredson had a tear/rupture or just a painful damaged tendon?
Surgery should never be the go-to option for chronic musculotendinous issues. And yet, that is what people are told to do first when they go to their physicians. It’s very disappointing that in this day and age, bodywork and strengthening are still not included in treatment plans. It’s actually embarrassing for the physicians for being so behind the latest body technologies.
Yes, because they're told that surgery followed by a long rehab program can actually cure the problem, while treatments don't actually cure issues (only alleviate symptoms) and require continous treatments making it more expensive on the long run.
@@wastelander1015 That's only one scenario and "cure" can be subjective. I don't claim that surgery is not necessary ever. I'm saying other non-invasive options should be explored before going for surgery.
Wastelander 101 glad I didn’t listen to the surgeon.
@@danielletanner9076 you listen to a doctor who will redirect you to a surgeon if the injury is serious enough that requires surgery. That's usually how it works. Unless you prefer neverending fisiotherapy that will not solve the problem...
No physician I know does that.
good to note studies have also shown this protocol to be effective at remodelling the plantar flexor muscle-tendon units to achieve greater long term PF ROM
A lecturer at uni told us a horrible Achilles surgery story last week.
Lady had a minor tear mid-tendon so they decided to do a debridement.
Pt still had pn + loss of function so same surgeon decided to do ANOTHER debridement.
A few months down the track a different surgeon decided it’d be best to remove the Achilles altogether and pull through another tendon (can’t remember which one - EHL maybe?).
Poor lady had been on crutches for 2 years when she hobbled into my lecturers clinic.
Jeeeez
Thank you! Short and complete.
Thank you for this video. I will check back and let you know how I am doing in a few weeks.
So basically for intertional Achilles tendonitis: No dorsiflexion! Instead do eccentrics on flat surface with bend knee.
Very good information and loading protocols. Thank you!... I wish the protocols were also instructed out loud instead of the music. Also, being picky, what would be the ideal body alignment and leg muscle engagement (for example, feet parallel with knees apart, med glutes engaged, straight back, shoulders back, head up, etc). Good thing is that what I see in the video looks easy enough to do at home.
That the beginning should I be doing and other exercises
Thanks for those great exercises and knowledge-sharing ! :-)
I have achillis tendinopathy but I also have a pes planus. My fysio told me not to do the alfredson protocol beceause I would only work in the wrong, weakened foot position. He advised me to do excercises for my intrisic foot muscles so my foot position is normal in terminal stance, pre-swing and thereby relieves the pressure on my achillis eventually. What is your advise on this?
That track is lit AF, i'll snap my achilles by extreme dancing
Thanks for the content!
Thanks for leaving a comment 🙏🏼
Do you recommend Shockwave inconjunction with this protocol?
I have constant calf pain, ive had total.knee replacement surgery on both knees ive been told by my doctor i have tendonopothy can i do the exercises on the video
Can these exercises be done for POSTERIOR TIBIALIS TENDINOPATHY?
Can you help me for my rhomboid tendinopathy
Very good. Thank you.
Great info cheers
I have been utilizing this protocol with success, but have developed medial heel pain felt when reaching down to my foot in standing. Any thoughts on this? (Def not PF pain)
Very helpful! Thanks
Could you do us a video on the use of TNT neuroplastic training method for patellar tendinopathy , please
Never heard of it
this method is done by an Australian physiotherapist called Ebonie Rio. the method based on strength training and corticospinal control by balancing excitatory and inhibitory messages through auditory and visual external stimuli (using a metronome) it is used for the purpose of decreasing pain and avoiding recurrence of tendonopathy
I have the insertional type in both feet, induced by use of fluoroquinolones antibiotics several years ago. Are these exercises still recommended?
Fluoroquinolones can indeed be very bad for tendon health. The exercises are still recommended though.
@@Physiotutors Thank you!
hi, thank you for this video. i don't speak very much english. is it 2 per day an 3x15 rep of each excercices ? thanks you
From what I gather, yes. 3x15 = 45 reps. Twice per day = 90 reps total per day.
Thanks for this it’s very helpful. Do you have any stretches that you recommend? Do you need to finish the program before going back to running?
For any personal health or rehab questions we recommend to consult with our partners at yourphysio.online for a remote physiotherapy consultation.
I’m overweight and have pain both places. Any hope? Already lost 13kg by walking and eating right, but now walking with severe limp.
I have it in both places too, the heel insertion being in the morning.
Gonna publish a lot of videos on Achilles rehab soon
Waiting for your videos and have begun with the excersices today
Thank you for the instructions. Hope I benifit from them
Why don't you keep you knee fully extended during the eccentric phase ? Isn't it better to have the maximum length for the muscle ?
Knees bent is to increase soleus activation, which is delivers about 3 times as much force as the gastrocs
what if both legs have achilles tendinopathy? How should I get to the top of the exercise?
I suspect resting it as much as possible until the flare ups and pain are reduced. Even if it means crutches or a wheel chair for a week or more. At some point you gotta start loading the tendon with these exercises to strengthen them. Hopefully by now you've contacted a professional and got started. Hope you are doing okay
In the gym on a specialized machine it works even better
Regarding insertional tendonitis - is there a clear time of when you know it is time to gradually begin dropping the heels into dorsiflexion? I've been careful to avoid any weight bearing in that position for a couple weeks now and can confirm the flare ups stopped. If I stretch my calves or go into dorsiflexion previously it does slightly aggravate the heel. I am trying to learn when its okay to start working up to a heel drop from a step versus staying on the floor.
How it was? Have the same issue
@@gamer_1250ptylkDid you find a way?
@@gamer_1250ptylkDid you find a way?
Wel counting should have been added for easy understanding of rep..
We don’t show the full 15 repetitions. We explain what the content of the protocol is. Also we mention the details of the protocol after showing how the exercises are done
If you want to dive deeper you can always refer to the article that’s linked in the video description
Thanks for your great videos, very beneficial.
Is there any additional value for stretches in case of insertional Achilles tendinopathy?
If yes, how frequent would you recommend it ?
Nope
@@Physiotutors What about stretches for mid-portion AT?
@@jiygo I would think unless there's shortening of the calf and Achilles then No, no need for added stretching. In fact following the eccentric program through the full dorsiflexion ROM should give enough "stretching", along with the added strengthening and resilience to (re-)injury.
1:42
Great job. Thank you. But do you have this video translation in Russian or in Turkish? Thanks in advance.
We don't speak any of those languages so we have to rely on our community to translate them
Physiotutors Anyway, I thank you. You did a great things. I’ve already translated the text by myself. But I think you agree that with video translation would be better. 👍👏
Would you mind adding the translation? There is a link in the description that explains how to do it
It would help the community from those countries a lot
Physiotutors My translation is in Azerbaijani, and I translated only the exercises. If it somehow helps to somebody I’d be happy.
But if you don’t mind I also can translate these exercises in Russian also and add it here
What about someone Who is post surgery, same applies?
No
We have three videos on Achilles’ tendon rupture rehab
Why do you do the exercise on the floor for insertional AT? Thanks!
There is less stress on the insertion, as said in the video right before the exercises. Insertional AT needs a lower load than Mid-portion AT in rehabilitation.
There's some interesting research by Dr Keith Baar on tendons. Basically he suggests intake of Gelatin or Collagen + Vit C 30-60mins prior to exercises. Same as the Alfredson protocol it is done twice a day however with isometrics and not eccentrics. He explains isometrics (total 5-8 mins) are better as it gives more creep. This is what I will be trying next.
Should I do the uninjured side too so I'm keeping some symmetry in my leg muscles?
You don't do this for muscle gain. You do it to heal the tendon. This is not nearly enough for your muscles.
@@iwantlee9510 what about strengthening your tendon to prevent injury
1. Change shoes 🙃
2. Check cholesterol treatments and disorders...
Thx 4 this video
Barefeet is a good option. Just not a good choice when the exercise is done on weight plates like in the video.
Of course one should take into account systemic factors that can impair recovery.
Cholesterol?
Should I touch the wall when I do this exercise?
You can touch the wall for balance of course
When the heel drops under toes level calf muscle gets overstretched and the achilles inflamates. Best recovery exercise is calf muscle raises/without the eccentric fall/ .
The problem is rather compression in case of insertional achilles tendinopathy, in midportion AChilles tendionpathy it's not an issue. For the first group, you might want to do calf raises on the floor and work more into dorsiflexion later on
I am finding it quite painful .should I continue doing it through the pain ?
Pain should be acceptable. If it's too much then 2 legged is an option and start on a flat floor in case of insertional tendinopathy
Well this look tedious, boring and long. However if want this posterior tibial tendinitis to subside it looks like this exercise routine every single day for the next 12 weeks is my best shot.
Have a look at our other videos for Achilles tendinopathy. Not necessary to only train eccentrically and with such a high volume
How about extensor digitorum longus
tendinosis rehab. I'm seeking for that
video I've always seen an Achilles
tendinosis rehab
Change your zombie music, so ppl can take u more seriously. Thanks.