Achilles Tendinopathy: A Rehabilitation Manual
Introduction
Achilles tendinopathy is a common overuse injury affecting the Achilles tendon, the large tendon connecting the calf
muscles to the heel bone. This condition is characterized by pain, swelling, and impaired function of the tendon, making
it difficult to walk, run, or participate in other activities. This manual provides a comprehensive guide to managing
Achilles tendinopathy through rehabilitation exercises and handling techniques aimed at promoting recovery and
preventing future injuries.
Understanding Achilles Tendinopathy
Achilles tendinopathy results from repetitive stress to the tendon, leading to micro-tears, inflammation, and degenerative
changes. Factors contributing to its development include overuse, improper footwear, inadequate warm-up, and
biomechanical abnormalities.
Symptoms
Pain along the Achilles tendon, especially during or after activity
Stiffness in the tendon, particularly in the morning
Swelling or thickening of the tendon
Decreased strength and range of motion in the affected leg
Phase 1: Pain Management and Initial Healing
Goal: Reduce pain and inflammation.
Rest: Avoid activities that exacerbate pain, especially running and jumping.
Ice Therapy: Apply ice to the Achilles tendon for 15-20 minutes, several times a day, to reduce inflammation.
Elevation: Keep the affected leg elevated above heart level to decrease swelling.
Non-steroidal Anti-inflammatory Drugs (NSAIDs): Consider over-the-counter pain relievers to reduce pain and
inflammation, consulting a healthcare professional for guidance.
Exercises:
Isometric Calf Exercises: Stand with the ball of your affected foot on a step, heel hanging off. Slowly lower the heel
below the step level and hold for 45 seconds. Repeat 3-5 times, twice daily.
Phase 2: Strengthening and Flexibility
Goal: Restore tendon strength and elasticity.
Calf Muscle Stretch: Stand facing a wall with one foot in front of the other. Lean forward, keeping the back heel on the
ground, until a stretch is felt in the Achilles tendon. Hold for 30 seconds, repeat 3 times, twice daily.
Eccentric Heel Drops: Stand on a step with the balls of both feet on the edge, heels hanging off. Push up with both feet
into a calf raise, shift your weight to the affected leg, and slowly lower your heel below the step level. Perform 3 sets of
15 repetitions, twice daily.
Phase 3: Functional Exercises
Goal: Return to normal activities and sports.
Single-Leg Balance: Stand on the affected leg, maintaining balance for 30 seconds. Increase difficulty by closing eyes or
standing on an unstable surface. Repeat 3 times.
Jumping Exercises: Start with low-intensity hopscotch or skipping and gradually increase intensity as tolerated.
Agility Drills: Include light jogging, zig-zag running, and shuttle runs, focusing on proper form and gradual progression.
Additional Recommendations
Footwear: Wear shoes with proper support and cushioning to reduce stress on the Achilles tendon.
Warm-Up Properly: Engage in a dynamic warm-up routine before activities to prepare the tendon for exercise.
Gradual Increase in Activity: Follow a slow and steady approach to increase training intensity and volume, avoiding
sudden changes.
Consult a Professional: Seek advice from a physiotherapist or sports medicine specialist for personalized guidance and
to address any underlying biomechanical issues.
Conclusion
Rehabilitation from Achilles tendinopathy requires patience and adherence to a structured program. By following this
manual's guidelines for pain management, strengthening, flexibility, and functional exercises, individuals can
successfully recover and return to their activities. Remember, prevention is key to avoiding recurrence, so continue
practicing good habits even after recovery.