Exercises for Achilles Tendon Pain
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- Опубликовано: 9 июл 2024
- The Achilles tendon is the largest tendon of the body for a good reason, it takes much of the load when we are running, jumping, or even walking! This tendon connects the calf muscles to the heel assisting with force transmission and acts like a spring when you push your foot off the floor. Achilles Tendinopathy is when the Achilles tendon is irritated or painful. The majority of individuals that suffer from Achilles Tendinopathy are active individuals, from the weekend warrior to the high-level athlete. Achilles Tendinopathy seems to be as high as 7-30% in runners, 2.1-5.1% in soccer players, and 12.5% in rock climbers. This video will show you an evidence-based approach to how to rehab achilles tendinopathy.
While Achilles Tendinopathy is a straight forward diagnosis, there is no consensus on the most effective way of intervening. When we dive into the literature we find numerous interventions including stretching, neuromuscular re-education, manual therapy, patient education/activity-modification, heel lifts, night splints, orthoses, taping, low-level laser therapy, iontophoresis, dry needling, and exercise. Out of all these, which do you think is the ONLY intervention that is back up by strong evidence? You guessed it, exercises! A mechanical load has shown to decrease pain when imposed on midportion Achilles tendinopathy. That is not to say there is no benefit with the alternative interventions when dealing with Achilles tendon pain; activity modification and iontophoresis are actually back up by moderate level evidence. Manual Therapy has also been demonstrated to mitigate pain through pressure massage.
Here are the 4 phases broken down in this video:
Phase 1: Isometrics
-Supine Calf Isometric With Band
-Knee Bent Single Leg Heel Raise Hold
-Single Leg Heel Raise Hold
Phase 2: Eccentrics
-Single Leg Eccentric Heel Raise
Phase 3: Isotonics
-Heel Raise On Incline
Phase 4: Plyometrics
-Double Leg Pogo’s
-Single Leg Pogo’s
Learn more about the Achilles Tendon with this article: theprehabguys.com/rehab-achil...
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Excellent, thanks Docs, just at the right time for me as coming off some achilles discomfort over the last week or so
yes, let us know how this goes for you!
Thanks
Wè we a
How much time do you spend in each phase and what cues do you use to determine when you’re ready to move on to the next phase? Also if it hurts to just walk, how do you get by day to day and then still do these exercises? Luckily I work in sales but walking to customers and traveling on planes and buses is not the best situation for my left foot mid Achilles pain. Ugh!! Plus standing all day at trade shows is brutal. Any suggestions?
You guys are better than the PTs I’ve seen, thank you!
Dah thanks for the love, be sure to subscribe! We love dropping this education a few times a month!
Wow, this is an amazing video for the Achilles heel pain. Dr. Arash is "the Achilles heel King", many thanks for your very well-explained video. I will use your super tips to recover my heel pain. I am glad to have found this and one of the best on this topic. I will definitely check out your other contributions on RUclips. Many thanks.
Hey Michael, so happy to hear you loved the video! Subscribe to our channel to take control of your health, new content coming out weekly!
Thanks bro. I watched your video and tried to move my foot mimicking the exercises. In just minutes, I feel so much better already.
Amazing! Be sure to subscribe, good content dropping weekly!
Thanks for the video
Our pleasure!
Thanks guys. This was really helpful info with well demonstrated rehab exercises. Cheers, Rob ( insertional Achilles tendonitis sufferer)
R u ok now without pain????
I've been doing the ankle and foot program and my calves and achilles are definitely feeling it - I might introduce the first one to help my Achille! Thanks!
R u completely Ok now????
nice video
I'm having this issue for the last couple week, also now I feel pain on my heel.
Will try this routine
Great video and appreciate you pointing out the distinction between midpoint and insertional tendonitis
Love it! Thanks for commenting! Be sure to subscribe, more great content dropping weekly!
Excellent informative video Docs! Do you recommend stretching after doing the phase 1 exercises on a given day?
Sir, I have been suffering from back heel pain for the last 6yrs and going through a lot of problems.Thank you for the video.I have subscribed and liked your video.Thank you for the video.👍💓
Definitely check this out as well! theprehabguys.com/foot-ankle-prehab-program/
R u ok now without pain????
Good job much love from Kenya.
Thank you so much! We appreciate all the support
Thank you Doc. I will try all these. I think i have insertional. I was stupid to play tennis with pain, learned my lesson. Hopefully i recover quickly.
Hey there! Definitely give these exercise a try and let us know what you think! If things don't seem to clear up, we have a program to tackle the issue once and for all!theprehabguys.com/program-achilles-prehab/
Thank you so verymuch.. I found all the solutions for all my pblm here.. I was feeling verymuch awkward to talk about all my problems with doctor.. Because im facing many problems.. I really dont
know how to thank you guys ❤
R u ok now without pain????
There was very little information or exercise instruction for the insertional injury. It would be good to see this
I didn’t realize I had to do isometrics for both the soleus and gastroc. But once I tried the isometric straight leg hold my Achilles felt like it was at 90% strength straight from the get-go. Thx.
You're very welcome!
Wow this is a great video and has really lifted my spirits while I'm injured. Can I ask, how often should these exercises be done? Every day?
Phil, thank you for the kind works and for sharing! Yes they can be performed everyday if tolerated! If symptoms increase, try allowing 24-48 hours in between exercises. Depends on the severity of your symptoms so listen to your body and do what feels best!
Hey Dr. Arash, I'm from Iran, thanks for the video, (Dastet dard nakone)
My ankle makes popping cracking sound while doing plyometric pogo, do you have any advice?
Where can I buy the platform that you used for the eccentric heels drops?
Thank you sooo much for this video! I am suffering from Achilles tendon for a long time and i started my rehabilitation today 🙃
Keep us updated on how things are going! Happy healing!
how you getting on with it
Hii i am getting better with the exercises and i started back sprinting! Thank you very much
Nice sir
Thanks!
Pls make some videos on shoulder injuries, explain n how it's fix..
yes! we have this!
Great video and in fact best demo. How long do you stay in each phase? What are the indicators for progression.
We've gotcha covered with all those questions with our Achilles Rehab program which you can find in the app if interested! bit.ly/tryprehabYT
Hi guys, excellent video thanks! I am currently resting after a diagnosis of mild achilles tendonitis (overuse from running) via ultrasound. I have mild pain when walking but nothing major. If i follow the 3 phase rehab in the video, what sort of timescale would you recommend for progressing through the phases and what sort of frequency per week would you recommend doing the exercises in each phase? Thanks a lot!
Hi Alex!!! We would recommend checking out our achilles program on the website. It is detailed with exercises, frequency, reps, and education videos to fully guide you throughout the rehab process!
Wow. The isometric exercises really do provide immediate relief! Can these be used during the warm-up phase before a sport?
Absolutely!
Thanks for these....But I don't see the difference between the eccentrics and the isotonics...they look so similar to me
I do the isometric where you go up on 2 then hold with 1 for 45 secs 5 times. In the morning and night and In the middle of the day I do eccentric heel drops. But not full range as it’s insertional. I’m not sure if this is enough. My pain isn’t really bad so I’m not sure if I can move on to the pylometric etc
My pain is mostly triggered by pressure on my achilles from wearing shoes or when my foot is in plantar flexion. Could these exercises still apply?
Going to try this approach and stick to it for a month. Really excited to have an approach to rid this pain.
I'm on day 2, and I think a good byproduct of the isometric stage is mind-muscle connection. Definitely feeling the burn!
Thanks for sharing this great content
Best of luck with the rehab process, Jared! Let us know how things go for you!
@@ThePrehabGuys definitely will do. Thanks for sharing great content
Lots of love from India
Thanks!
How long is typically good for each phase? 2 weeks per phase?
Brilliant video and progressions. I’m stuck at the double leg plyo at the moment, single leg plyos are causing pain.
Any suggestions to bridge this gap? Back to stage 3 for another couple of days?
Thanks.
Be patient with it! Making that jump from double to single can take time and it's always important to listen to your body but also stay consistent, trying a supported single leg plyo with your uninvolved foot resting on something or upper extremity support can be a good start!
Thankyou for such helpful video! Would it be possible to do a workout for fixing flat feet?
We have a great video coming out about arch strengthening exercises TODAY! Be sure to subscribe if you haven't already!
Hello, how many set and reps per day for pogo?
Please do a video just about extensor tendonitis in the foot.
will do!
Interested too
Hi guys, great video! For insertional tendonitis, would you recommend any stretching exercises? Thanks!
Hey Peter! Thanks for reaching out! We actually have a program designed to address just that! Check it out!
theprehabguys.com/program-achilles-prehab/
R u ok now without pain????
What city is this at?
Excellent detail thank you! Q: I find the one leg heel raise too much (painful) can I start with two feet and later down the line try with one? I have Achilles tendinopathy (fairly recent) which has set in (swollen lump on heel also). We're in a big lockdown and not being able to walk outside more than five mins due to this new problem is pretty frustrating. Thank you again - Fiona
Hi Fiona! Thank you for watching, and that is a great place to start!!!
R u ok now without pain????
What if my Achilles tendon cramps when i try doing strength exercises
How do you know when you are ready to transition from one phase to the next?
That is why having a PT is crucial for these injuries. However, I try to work into Isotonics ASAP. However make sure GREAT strength is achieved (this is relative depending on the goal of the individual) prior to performing jumping movements.
You are right about everything but you should have stressed the precautions needed for insertional. If i did what you said to do with my insertional id be screwed.
R u ok now without pain????
hi doctor
are you iranian?
A lot of pain doin single leg heel raise, should keep trying?? And, when move from isometric to eccentric? Thank you and congrats for the video!
yes thanks for the support!
R u ok now without pain????
If one feels achilles pain when walking and even more so with high velocity movement but feels NO pain doing isometrics and eccentrics. Should they move on to isotonics?
That would be a good time to progress!
Do you think Shockwave therapy is a must for Tendinopathy? I really feel it's yet another Orthopedic scam but my Dr is saying it's the only option I have. Really interested to hear your thoughts.
There is some evidence to suggest use of Shockwave. Best evidence is definitely Loading this tissue!
@@ThePrehabGuys thanks for the reply and the great content. Still weighing it up...400 euros for some potential orthopaedic quackery doesn't sit well with me
If you can tolerate the Pogo exercise, can you skip the others and go straight to the last exercise featured in the video?
You could depending on if the other exercises are tolerable or not! If any of them feel difficult, start there and progress based off of your tolerance!
If I can't stand on the foot or specifically walk on it without significant pain, should I start with the exercises at that point or wait till I can stand on it without pain?
Great question! There are a lot of exercises that can be done in sitting and typically you should be cautious about performing exercises that are giving you significant pain. Look into this for me! theprehabguys.com/program-achilles-prehab/
Maybe a video on LBP or sciatica
we have many on low back pain, have some stuff coming up soon for you though! We have a back program here as well if interested! theprehabguys.com/program-low-back-prehab/
Having issues, pain in the Achilles near to the heel. Achilles is thicker than the other. Pain when walking, swelling and slight bruising after walking. Pain, brushing and swelling goes down after rest. Would be interesting to know your thoughts
Here are 2 resources for you, one is a blog article we wrote on achilles tendon pain, and the other is a program we have designed for the achilles!
theprehabguys.com/rehab-achilles-tendinopathy/
theprehabguys.com/program-achilles-prehab/
R u ok now without pain????
What if u can’t do the calf raise? On the foot where the pain is so bad I can’t do the calf raise.
I would do the isometric he shows around 1:30. For a dynamic movement, you can sit in the exact same position as 1:30, then point your toes back towards you, then point your toes away from you. All while pulling on a band or belt or towel for resistance. This allows you to adjust the resistance as needed until you can build up to calf raise with 2 feet.
Another alternative is seated calf raise. Just sit on a chair, put a few books on your knees/thighs. Start with your feet flat on the ground, and then push your toes into the ground so your heel comes off.
R u ok now without pain???? 😊
What about having a bone spur on the heel due to insertional achilles tendinopathy?
for insertional treatment looks similar aside from going into dorsiflexion. Basically you avoid end range ankle motion to avoid compression of the tendon
R u ok now without pain????
Can you do a video on peroneal tendonitis? Please!!
Just did an instagram post on it! Be sure to follow us there if you haven't already!
Thank you. I'll have to look it up. :)
I suffer from achillies heel tendonitis mostly from doing skipping double unders my single skips are fine but I always injure my right achillies I want to try some of these will it help with this tendonitis?
Sorry to hear about that achilles discomfort! These will definitely help and so will this! theprehabguys.com/program-achilles-prehab/
R u ok now without pain????
Do you guys have any vids for treating fluoroquinolone induced tendinopathy, specifically in the achilles?
Hello! We do not at the moment, but we do have more information here on achilles rehab!!
theprehabguys.com/rehab-achilles-tendinopathy/
Ηι Matt .i also have taken fluoroquinolone for a long period of time..a urologist told me that these pills did the damage to my tendons 100%. i stopped taken them about 5 years ago..i develop tentinopathy in both hands and achilles,your question made me wonder if there is a differnce in the rehabilitation programe if you develop tentinitis from medicaion or if you got it from overuse ..could it be that tendinopathy from medication is more diffucult to manage ?? i really wish anyone would have an answer to that cause i struggle with tendon problems ever since i started taken these damn pills almost 9 years ago..any kind of exercise just make the pain worse for me,,nothing ever made it better..i gave up playing guitar cause i cant play more than 20 minutes.i wish the guys who made that video have an answer to this...
@@evantkokios6792 Yes, there is definitely a different mechanism for the tendinitis from fluoroquinolones, it's actually mitochondrial damage at the cellular level, its not technically inflammation. I don't know the exact medical terms, but I'm sure you've googled and learned about how these antibiotics interrupt the collagen matrix in our body(collagen is the large makeup of our tendons, and why people have suffered aortic aneurysms from fluoroquinolones, bc our blood vessels are made up of connective tissue and collagen too). Regular physical therapy may not work because loading damaged tendons that wont heal anyways at a cellular level, you will keep re-injuring yourself. Google "fluoroquinolones and tendinopathy: a guide for athletes" and you can learn more from that research paper. I think the only solution is stem cell injections and PRP. Some people heal from their reaction, others never do. Also look at floxiehope website.
@@Matt-fq6ly I was afraid that it might need a different approach to treat tentinopathy that is caused from medication but i wasn t so sure,,i havent gone to a doctor or a physiotherapist in years because they never really helped me with anything. I am considering the prp injections for a long time but i m afraid of the outcome..some people say it helps a lot, some say not so much.i have asked some doctors in the past about these injections and they do suggest them very strongly nowadays! thanks a lot for all the information i wish you all the best!
رجلي لتوت صالي سنه الي حدلان ما طبت
Should you do these exercises everyday?
are the workouts more effective with or without shoes on?
Generally without if you can! With still is effective. Here is more information!
theprehabguys.com/rehab-achilles-tendinopathy/
Can I use these exercises, if I have insertional tendinopathy with ossification?
Give them a try and as long as they feel comfortable they would be great for you!
R u ok now without pain????
I'm confused. My therapist let's me do an exercise on a stair step, lowering the heel under stair step leven after rising the heel. There is a strech.
My doctor says no streching. An answer would be highly appreciated.
Christine
Hi Christine, this may be really late and I hope your achilles is feeling better. I am not an expert, but as a runner that has had achilles issues here’s what I have been told. The stretches and exercises depend on where the achilles pain is located. If it is insertional (i.e. where the achilles inserts into the back of the heel of the foot), then stretching it is apparently a “no, no”. You should focus on eccentric calf exercises (lowering slow) without going into a stretch initially - that is, stop at the floor and as you get stronger do it from a stair and go a bit past into slight stretch. Eventually you will go to full stretch.
For non-insertional achilles issues (ie higher up from the heel pain) the stretching is apparently the way to go. The strength exercises for this are now both eccentric and concentric and with a certain amount of stretch and with increasing loads as you can handle them.
In all cases, you should only work to discomfort but NO PAIN. As the tendon gets stronger start to push it more (one leg, longer stretch, add a bit of weight….).
Hope that helps and your healing has gone well.
Happy trails!
@@paleolithic6671 Thanks so much for your detailed answer. It 's a guideline for me because the pain has come back recently.
@@paleolithic6671 This was even helpful for me - I made the big no-no of stretching the other day and ran 4 miles... which was extra bad. Grateful to know now for moving forward with my ankle rehab.
@@Christine-bw9ff Sorry to hear that and I hope the recovery is speedy - I completely understand how frustrating it can be! All the best Christine and hope it gets better soon. Keep us posted!
@@jonblackwell9520 Thanks for taking the time to reply Jon - really thoughtful of you. I hope your ankle and achilles feel better soon. I am also doing some balance exercises to ensure that my ankle gets stronger along with my achilles (hoping to have the achilles do less work going forward if my ankle stabilizes!). All the best Jon and wishing you a speedy recovery! Cheers!!!
How many reputations should be done and for how much duration?
Here is an article that gives more of a breakdown related to your question.
theprehabguys.com/rehab-achilles-tendinopathy/
What are the reps or times for each exercise?
Here is more information for you!!
theprehabguys.com/rehab-achilles-tendinopathy/
Hey dr my doctor told me that i should wear a heal lift for 4 months what should i do ?
theprehabguys.com/program-achilles-prehab/ check this program out for me!
Would you recommend doing all phases simultaneously or just sticking to one of the phases at a time?
typically a slow progression phase by phase
Arash jan man ghesmate balaei moch Pam yezare be samte dakhel dard mikone mother footbal herfei, hame Dr hae iran pamo didan ama migan chizish nist ama aziat mikone , agar midoni komakam kon lotfan ya age daftari dari mozahemet shim . Best wishes ur Iranian countryman , wait for your answer for my tissue ❤🙏
I don't see any difference between the isometric and isotonic holds.
Isometric involves not moving through a range of motion with resistance, isotonic means you are moving through a range of motion with resistance! Great question!
@@ThePrehabGuys I understand what each term means. It's just that I didn't see any difference in your demonstrations for isometric and for isotonic exercises. Identical movements for both---strange!
Had achilles pain for 19 months. Tried everything. Physio. Stretches. Changed shoes. 4 x rounds of shockwave therapy. Massage. Yoga. Literally nothing works.
I'm sorry to hear that - achilles pain can be so nagging at times! Hoping it's feeling better now!
So basically calf excersises is all there is to do
Yes, heavy loaded calf exercises. This is only way to strengthen the tendon.
What brand of slant board is used in the video?
It's an adjustable wooden slant board but there are lots of great options!
I like it till the last one. I ain't jumping. I am a distance runner, Olympic lifter. I don't jump. I don't like it sketches me out. Jumping is nothing but risk on my mind.
Jumping can certainly be intimidating for many! Dependent on your sport and history with jumping, but it's a good way to build of tendon load capacity as we progress with our exercises!
Tim Tebow’s lost twin
LOL
I dont think this guy is a doctor
Repent and turn to God
You mean the one and almighty god, Allah?