Best achilles tendinopathy exercises & stretches

Posted 1 Apr '22

Achilles tendinopathy is a painful condition that occurs in the Achilles tendon. The Achilles tendon joins the heel bone to your calf muscle , and it is the largest tendon in the body. It helps your foot move and lets you tip toe and propel yourself when you run, climb or walk.

Achilles tendinopathy can be caused by a single large injury, or from repeated tiny injuries that occur over time. So, while Achilles tendinopathy is a common ailment for people who play sport, it's also found in people who aren't very physically active.

Achilles tendinopathy is usually painful, and the pain is felt in the back of the leg or heel. It's common for this pain to come and go, and be the most prominent first thing in the morning, or straight after exercising. In most cases, Achilles tendinopathy will escalate over time, and the pain will be felt for longer, and more severely.

There are a number of ways that you can help Achilles tendinopathy at home, like through the use of icing, rest and gentle stretches. However, if the pain is felt in the areas of the Achilles region for ten days or more, you should contact a medical professional to have it looked at. If you already suspect you have Achilles tendinitis, you should get it looked at immediately, as the longer the condition is left, the harder it is to treat.

Sometimes, a physician may suggest localised steroid shots or orthotics to treat the ailment. Shockwave therapy, Dry needling, platelet-rich plasma (PRP) injections are all methods that are commonly used to treat Achilles tendinopathy. Shockwave therapy is highly recommended, as it is a non-invasive treatment that stimulates an immune response within the body which initiates healing to the treated area. It's done by a podiatrist or doctor who will use a handheld probe to send high and low-energy shockwaves to the site of an injury.

In very severe cases, a doctor may recommend surgery to remove damaged areas and to repair what's left of them. Even when surgery is conducted successfully, some patients may not be able to engage in high-impact sports again. This is why it's so vital to have Achilles tendinopathy diagnosed and treated quickly.

It's important to note that while the conditions of Achilles tendinopathy and Achilles tendonitis sound similar, they are actually different. Achilles tendonitis develops when Achilles tendinopathy escalates to a more serious condition. However, the symptoms and treatment of the two ailments is similar. Below we touch on exercises and stretches that are appropriate for both tendonitis and tendinopathy.

Common symptoms of Achilles tendinopathy

People with Achilles tendinopathy may experience some, or all, of the following symptoms:

• Sudden pain felt in the back of the heel or lower leg
  
• Gradual pain that's felt after exercising and gets worse over time
  
• Swelling in the back of the heel
  
• Tenderness when you touch the back of the heel
  
• A cracking noise when you move your ankle
  
• Severe pain in the heel/ankle/lower leg the day after exercising

Strengthening exercises for Achilles tendinopathy

Seated toe taps

1. Sit in a chair with both feet flat on the ground and knees shoulder-width apart.
   
2. Slowly pull your toes towards the ceiling, with your heels flat on the ground.
   
3. Lower your toes back down so that your feet are flat on the ground again.
   
4. Repeat this exercise a total of fifteen times to complete a set.
   
5. Complete a total of three sets.

Seated heel raises

1. Sit in a chair with both feet flat on the ground.
   
2. Put a weight on your knee - you can use dumbbells or something moderately heavy like a backpack or bag of rice.
   
3. Press your weight towards the balls of your feet and raise your heel off the ground.
   
4. Slowly lower your heel back to the ground until it's positioned flat again.
   
5. Repeat this action for a total of 15 times on each foot to complete a set.
   
6. Rest between sets and complete a total of three sets.
   

Single leg heel raise

1. Stand with both feet flat on the ground, and hold on to something like a chair or countertop for balance if you need it.
   
2. Pick your right foot off the ground and bend it at the knee, so that you're balancing on your left leg.
   
3. Press your weight towards the balls of your feet and raise your heel off the ground so that you're standing on your tip toes.
   
4. Slowly lower your feet back to the ground until it's positioned flat again.
   
5. Repeat this action for a total of 15 times on each foot to complete a set.
   
6. Rest between sets and complete a total of three sets.

Achilles tendinopathy stretching exercises

Standing calf stretch

1. Stand in front of a wall, so that your palms can be pressed flat against the wall, but your arms remain straight out in front of you.
   
2. Move your right leg forward, with your knee bent slightly.
   
3. Move your left leg behind you so that it's straight, and make sure your heel is pushed flat to the ground.
   
4. You should be able to feel a stretch in your calf, hold this position for 30 seconds.
   
5. Return to the starting position.
   
6. Repeat this stretch twice more.
   

Sitting egg stretch

1. Stand with your feet shoulder-width apart, your legs straight and your feet pointed slightly outwards.
   
2. Bear your weight on the balls of your feet, and lower your body until your bottom touches your heels.
   
3. Place your hands on the floor in front of you and put your elbows between your knees.
   
4. Lean forward and press your elbows outward against the knees
   
5. Slowly lower your heels until you feel a stretch.
   
6. Hold for 30 seconds and then return to your original standing position.
   
7. Repeat this stretch twice more.

Seated towel stretch

1. Sit on the floor with both of your legs out straight in front of you.
   
2. Loop a long bath towel around your right foot and hold the ends with both hands, while keeping your back straight.
   
3. Slowly pull the towel to lift your right leg up, but make sure that your leg stays straight. Keep your left leg straight on the ground.
   
4. Raise your leg until you can feel the stretch.
   
5. Hold this position for 30 seconds.
   
6. Return to the starting position.
   
7. Repeat this stretch twice more.

Aerobic Exercise for Achilles tendinopathy

Whether aerobic exercise is recommended, will depend on your specific type of Achilles tendinopathy. Some cases can be rehabilitated through Achilles tendon stretches and exercises, however, some Achilles tendon disorders will need to be rested while they recover.

You should always consult a medical professional before undertaking a new exercise program. If a medical professional does recommend aerobic exercise, they will likely suggest something that's low impact, like walking or water aerobics.

Tips to prevent Achilles tendinopathy

Increase your aerobic activity gradually

When you step up your exercises significantly, you're pushing your body and making it more prone to injury. Achilles tendonitis is much more likely to occur when it's overworked, or when a load that's too high is put on it.

For this reason, you should gradually increase exercise at a steady pace. A good rule of thumb is to increase it by 10% per week. For example, if you're running 3kms five times a week, you can increase the distance to 3.3kms for a week, before raising it another 10%. These increments will allow your body to adapt to the extended activity, and lower the risk of an Achilles tendon injury.

Build up your calf muscles

Strong calf muscles can remove the stress that's put on the Achilles tendon, which reduces the risk of injuring it. As well as reducing the risk of developing the ailment, Strengthening exercises that are aimed at your calves and lower limbs can also help rehabilitate the area. However, some cases of Achilles tendonitis should not be rehabilitated while they heel. So it's important to check with a podiatrist, physio, or doctor before undertaking any exercise.

Stretch your lower legs

Like strengthening exercises, stretches can be beneficial both to prevent Achilles tenonitis and to treat it. As a preventative measure, stretches can help to increase flexibility in this area, which can help to stop injuries from occurring. As a treatment, stretching can help provide relief by loosening the area. To target the Achilles and calf areas specifically, you can do the stretches listed above.

Choose appropriate footwear

Ill-fitting shoes or shoes with poor support can cause Achilles tendinopathy. When exercising - especially during cardio or aerobic exercise - you will likely be using your feet and this will include your Achilles tendon. So, your shoe should always fit correctly and provide adequate support to prevent injury. Well-fitting and supportive shoes can release the tension in the tendon significantly.

Rest between workouts

If you don't give your body time to heal between intense workouts, muscles are more prone to injury, and any micro-tears that may occur can worsen. This is especially true if your body isn't used to being active for extended periods of time. If you feel any soreness after exercising or playing sport, you should rest until you feel normal again.

When to see a podiatrist about Achilles tendinopathy?

If you suspect Achilles tendinopathy, you should always have it checked out by a professional as soon as possible. Podiatrists are doctors of the feet and lower limbs, so they are experts in diagnosing and treating Achilles tendinopathy.

A podiatrist will be able to undertake a physical exam to diagnose Achilles tendinopathy. If you do they can work with you to put together a treatment plan, as well as recommend stretches and exercises that can help with related Achilles tendon pain.

Book your appointment with our podiatry team online here or call us on (07) 3356 3579.