Achilles Tendonitis Phase 2

The aim of phase 2 is to gradually increase the load through your calf.

As you improve you should increase the speed of the downward phase.

Session is:

Warm-up
Stretching
Isotonic quad loading (3 sets of 8-10 reps so mild discomfort is felt on the last set
Ice

Treatment

To be done daily.

Rest

Avoid all jumping and plyometric exercises. If you have rested for two weeks in phase 1 then move to relative rest as pain allows.

You can start running depending on the level of your pain.

For example:

If your pain is 7/10 or greater during, after, or the next day, avoid running for a minimum of 2 weeks.
If your pain is 3/10 or less, you may wish to increase the load on exercises.
If your pain/discomfort level is 3 to 5 the day after exercises then this is fine.

Cold & Compression

Apply a cold compression wrap or ice.

Apply cold for no more than 15 minutes as the injured tissues are very close to the skin and do not need longer.

Ice should be wrapped in a wet tea towel to avoid ice burns, or better still use a commercially available cold therapy compression wrap.

Apply 3 times a day, or every 2 hours for 10 minutes.

Bracing/Taping

Wear an Achilles tendon strap if comfortable. This works by applying pressure over the tendon.

Foam roller

All foam rolling exercises are 3 sets for 20 seconds each.

1) Calf

This exercise massages the calf muscles at the back of the lower leg.

The leg is rolled over the roller along the full length of the muscles from the ankle to just below the knee and back again.

More pressure is applied from the ankle upwards following the direction of blood flow in the muscles.

2) Quadriceps

This exercise performs a myofascial release and stretches on the quadriceps muscles at the front of the thigh.

The roller is applied along as full a length of the muscle as possible with more emphasis or weight from the knee upwards, following the direction of blood flow along the muscles.

3) Hamstring

This foam roller exercise massages and applies myofascial release to the hamstring muscles.

Pressure is applied from just above the knee upwards following the direction of blood flow.

Mobility & stretching

These exercises should be done daily if pain-free.

Quad stretching

Teaching points:

Keep your knees together and gently pull your leg up
You should feel a stretch at the front of the leg which should not be painful
Hold onto something for balance if you need to or try holding your ear with the opposite arm
Hold the stretch for 30 seconds and repeat 3 times with a short break in between
Aim to do this exercise 1-2 times per day

Note: This should be comfortable, don’t force the stretch!

Calf stretch (bent & straight knee)

Teaching points:

Hold the stretch for 30 seconds with your knee straight and then with your knee bent
2 sets
Repeat this exercise 1 to 2 times a day

Calf stretch (bent & straight knee)

Teaching points:

Hold the stretch for 30 seconds with your knee straight and then with your knee bent
2 sets
Repeat this exercise 1 to 2 times a day

Hamstring stretch

Teaching point:

This is a convenient stretch if the ground is cold or wet.

Stand on one leg with the other resting on a bench or similar
Tilt the hips forward to increase the stretch
Ease into the stretch and hold, as comfortable – don’t force the stretch!
Perform 3 sets of 30-second holds, gently easing into the stretch
Repeat 1-2 times a day

Activation

These should be done 3 to 4 times a week.

Crab walks with band (pain free)

Teaching point:

Place a resistance band around your knees and walk sideways
This gets the hip muscles firing and fatiguing under bodyweight load
Make sure they are done pain-free on the knee
Perform 4 sets of 4 steps on each side with a short rest in between

Note: If it is painful then try not bending your knee so much, or wait a few days – You may need to go back to phase 1.

Single leg balance

The single-leg balance is a simple ankle proprioception exercise, although various progressions can be added to make it more difficult. It improves balance and proprioception.

Teaching point:

The athlete begins by standing on the injured leg only for 30 seconds
Once this is accomplished the athlete closes their eyes to increase the difficulty
So the next step is to balance on an unstable surface such as a trampette, wobble board, or half foam roller/mat
One set of 30 seconds

Double leg bridge with band

This works the gluteal muscles in particular, as well as bringing your core into play.

Teaching point:

Place a band around your knees to increase the tension on the outside hip muscles as you perform the exercise
This exercise can be done on the floor, or with feet raised
3 sets of 12 reps, with a short rest between sets

Strengthening

Progress through these 3 to 5 times a week as appropriate.

Single Leg Calf raise (Straight leg)

Teaching point:

Hang off a step and keep the movement in a comfortable range
Start Bodyweight, and gradually add load with dumbbells
3 to 4 sets
Aim for 6 to 15 reps

Single leg calf raise (bent knee)

Teaching point:

Use both legs bent at the knee
Stand on a step with the heels off the back of the step making sure you have something to hold onto for balance
Lower the heels just below the step then raise up onto tiptoes
3 to 4 sets of 6 to 15 repetitions

Split squats

Teaching point:

With your arms folded start in a split leg position and lower your hips, until the back knee is just above the floor
Stand back up and return to the starting position
3 sets of 10 reps

Double leg heel raise

You can do this exercise leaning against a wall to increase the range of motion if comfortable.

Teaching point:

Keep your feet together and knees straight
Lift up on your toes as high as you can
Lower your heels down and repeat
3 sets of 8 reps

Movement control

These exercises should be done 2 to 4 times a week.

Forward T

Teaching Points:

Stand on one leg with your knee slightly bent
Lean forwards, open up your arms pulling the non-supporting leg backwards to make the shape of a ‘T’
Maintain balance for 4 or 5 seconds and repeat
3 sets

Single leg toe taps

Teaching point:

Stand on a matt, begin by raising your right foot and tapping it forward, to the side, behind you, and to the opposite side
Then, return your right foot to the matt and repeat with the left side
3 sets of 6 reps on each side

Note: your working leg is the one on the mat.