Extensor Tendonitis Phase 3

The aim of phase 3 is to further increase the load through the extensor tendon and begin to introduce plyometric exercises.

Treatment

Can be done daily.

Hot & cold therapy

Apply cold therapy 3 times daily and after any rehab exercises or training. This can be an ice massage where you rub a frozen plastic cup of water over the area or a cold therapy compression wrap. You can apply heat to the top of the foot before exercises or training.

Massage

If available get a deep tissue sports massage for your legs twice a week, In particular, the calf muscles and hamstrings. If not then using a foam roller is fine.

Foam roller

Use a Foam roller over your calf muscles, quadriceps (front thigh), and hamstrings.

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

Aim to do these exercises at least once a day:

Ankle mobility

The advantage of this exercise is that the damaged ligaments will not be stressed by sideways movement, the calf and shin muscles maintain strength and the pumping motion helps to decrease swelling.

Teaching point:

  • Pull the foot up as far as it will go (dorsiflexion)
  • Hold for a couple of seconds, and then point it away from you (plantar flexion) and hold again
  • The aim is to maintain joint mobility
  • 2 sets for 30 seconds

Foot stretching

Teaching point:

  • Start with your foot pointing up towards you
  • Use your hand to pull the foot away from you (toes pointing outwards)
  • Add a little pressure with your hands to give the front of the foot a stretch
  • 2 sets for 15 seconds
  • 3 to 5 times a day

Calf stretch bent & straight knee

Teaching points:

  • Hold the stretch for 2 sets of 30 seconds with your knee straight and then with your knee bent
  • Repeat this exercise 3 times throughout the day

Hamstring stretching

Teaching points:

  • Hold the stretch for 15 seconds, relax and hold again for 15 seconds
  • Perform on each leg separately

Activation

Aim to do these exercises 4 times a week.

Crab walks

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

SideStrikes

Teaching point:

  • Try and keep the leg straight
  • Knee leg goes quickly, trail leg goes slowly
  • Perform 4 sets of 4 steps on each side

Monster walks

Teaching Points:

  • Place a resistance band around your knees to increase the load on your lateral hip muscles
  • Walk forward and backwards
  • Maintain a good posture by keeping your head and chest up
  • 4 sets of 4 steps forward and backwards (each way)

Single leg bridge

Teaching point:

  • Lie on your back, knee bent, and push the hips upwards to work the gluteal muscles and hamstrings
  • Use one foot on the floor pushing up
  • Hold the position briefly and then lower
  • 3 sets of 8 reps

Note: Make sure you squeeze the gluteal muscles and aim to maintain a straight line from the shoulder on the ground to the knee at the top point of the exercise.

High knee march

This is a functional exercise that helps transition to running and more explosive exercises later on.

Teaching Points:

  • March forwards on your toes driving your knees high
  • 4 sets of 5 metres

High knee march lateral

Teaching Points:

  • Perform marching drill sideways, aiming to be on your toes with high knees
  • 4 sets of 5 metres each way

Strengthening

Progress through these exercises 3 times a week.

Single leg calf raise

Teaching point:

  • Hang off a step and keep the movement in a comfortable range
  • Start Bodyweight, and gradually add load with dumbbells
  • 3 sets for 12 reps

Bent knee calf raise

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 sets of 12 reps

Heavy leg press

This is best done with a leg press machine, but you can do a weighted box squat as a substitute.

Teaching points:

  • Add weight so it feels like 70% of your max effort.
  • Perform a slow controlled leg press (no more than 90 deg knee bend)
  • 3 seconds concentric (pushing up) and 3 seconds eccentric (lowering down)
  • So one rep should take 6 seconds
  • Aim for 6-8 repetitions only and perform this exercise 3 times per week

Squat

Teaching point:

  • Start with your feet shoulder-width apart
  • Tense your abs
  • Sit back – make sure to move your butt backwards, don’t just bend your knees
  • Keep your knees in line with your toes
  • 3 sets of 8 reps (50% effort)

Note: Look straight ahead and don’t round your back.

Plantar flexion to dorsiflexion (with kettlebell)

Teaching point:

  • Use a kettlebell over the toes, starting with the foot on a step, and lift the foot up and down with the KB
  • 3 seconds concentric/3 seconds eccentric (6 secs per rep)
  • 6-8 reps x 3 per week

Isometric hold (with kettlebell)

Teaching point:

  • Put toes through the kettlebell and hold in mid position
  • 3 sets for 20 seconds

Movement control

Aim to do these exercises 2 to 4 times a week.

Box jump to inside leg

Teaching Points:

  • Jump off a box or step with 2 feet and land on your inside leg
  • Maintain end position for a couple of seconds
  • 2 sets of 8 reps for each leg

Box jump to outside leg

Teaching Points:

  • Jump off the box from 2 feet landing on your outside leg
  • Maintain control of the landing
  • 2 sets of 8 reps of each leg

Drop jumps from small step

Teaching point:

  • Step off and land directly into a jump
  • Land and hold
  • 2 sets of 8 reps (6-8 inches)

Functional exercises

Aim to do these exercises 2 to 4 times a week.

High knee march linear

This is a functional exercise that helps transition to running and more explosive exercises later on.

Teaching Points:

  • March forwards on your toes driving your knees high
  • 2 sets of 10 metres

Single-leg stance 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 30 seconds for each leg

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

Conditioning

2 to 3 times per week

Running

Increase distance run – 5K is a guide. Also, begin to include acceleration and deceleration as well as offline running and slalom runs if appropriate to your sport.

E.g. Accelerate/Maintain/Decelerate 20/10/20 – 10/10/10

Aerobic fitness

You can begin to do normal swimming including front crawl and backstroke. Also, road cycling is fine at this stage.

Move on to phase 4

View all.

Exit criteria

Exit stage 3 when there are no pains on ADLs and no pain after running, and you are able to complete specifically the KB exercises with no pain or reaction.

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