We discuss how the amount of load placed through a tendon versus the ability of the tendon to deal with this load results in either a healthy tendon or tendinitis (tendonitis). We discuss how we can manipulate this load balance through reduced activity, technique modification and strengthening the tendon. AGAIN, we reinforce that you should rarely REST YOUR TENDON!! We help you understand some of the various load that may cause tendonitis, as well as principles of rehabilitation including strengthening and stretching exercises to improve Achilles pain. We look at some exercises that not only strengthen the tendon, but also help decrease achilles load by controlling rotation through the lower limb. We discuss some progressions of exercises through the rehabilitation program.

Hey guys and girls, it’s Anthony from GrandStand Sports Clinics. Today’s topic is achilles tendonitis and the best ways that you can manage it so you can get back to doing the activity you love as soon as possible. Now for those of you who are new to this channel, we make a series of videos which explain different pathologies and look at taping techniques to make sure that you’re able to do what you love as as soon as possible. So if you like what you see, hit the like button and please consider subscribing.

Anyone who’s had achilles tendonitis can tell you just how frustrating an injury can be, particularly when it starts to interfere with your training for an event or for the season mode. What we need to understand is that achilles tendonitis is simply a disparity between the amount of load that you’re asking of the tendon and the capabilities of that tendon to withstand that load. If you’re interested more you can have a look at our previous tendon video which explains some of the different stages of tendinitis. Our aim in achilles rehabilitation is to try to reduce the disparity between the ability of their tendon to deal with load and the amount of load that we’re placing upon it. One of the simplest things we can do to try to decrease the load on a tendon is to actually give it some rest but as we spoke about in the previous video, rest isn’t the best thing for the tendon and long term if we want to make the tendon better we’re better to try and work through it we can certainly look at decreasing some of the loading factors such as decreasing the mileage increasing the recovery time between exercise bouts or having a look to make sure that our Footwear are a good match for our feet. If you’re going to continue training whilst having achilles tendonitis it’s absolutely important to know just the right volume in the load so that you’re not actually making your condition worse and this is a good time to talk to physiotherapists to really diagnose what stage of your tendon is in but also what’s the appropriate load to be putting through it. So that you’re not jeopardising your own rehabilitation long term.

A physio should be able to give you some guidance about what’s a safe load for you to continue doing how much pain is acceptable and things you can do, such as massage and stretching in order to keep the tendon as healthy as possible. Now calf stretching is a pretty simple thing to do and we don’t want to spend too much time on it. If you are interested in looking at ways to stretch your Achilles, have a look at this video which we posted not so long ago. Now long-term, the best way to deal with achilles tendinitis is to increase the strength of the achilles tendon so there’s better able to deal with the loads that you want to throw at it when you’re preparing for an event. We don’t need to get too complicated with the types of exercises we choose the strength of the tendon but we need to make sure that there’s a reason for doing the exercises and that they’re going to lead to an end or end result. One of the most common exercises you’ll start with is a hill race and that’s because there’s really good evidence that that exercise works very well in the long term for dealing with achilles tendonitis. Now the heel raise works specifically on the tensile properties of the Achilles tendon and improving your score on a hill raised is going to improve the tensile strength of your achilles tendonitis.

The other thing you need to keep in mind is as we spoke about in the previous video, tendons don’t like rotation and sometimes that’s the stress which overloads a tendon so if we’re looking at doing running specific exercises we need to try to minimise rotations for our running style. Now if it’s a good idea to get your running gait assessed to see if you are someone who drops through the knees or through the hips when you’re running because that could be increasing the rotation load on the Achilles. Regardless of that, it’s always a good idea to do some lower body strength and control exercises to make sure that we’re keeping everything in as good of alignment as possible because that’s going to again decrease the load on the Achilles. In this series of exercises that we’re just going to have a look through you’ll see that we start from very very basic movements which are slow and controlled and putting load through the Achilles an be moving the exercises to become more and more running specific but we also want to be looking at how the foot responds at impact so it’s important to have some sort of impact activity in the exercise and it can be as simple as starting with skipping and moving through to the lateral hops that we see here once we’ve developed good movement competence. In our balance exercises we can increase the demands on the system by increasing more weight or resistance through the movement or increasing the balanced component of the movement itself.

Now these exercises are just an example of some of the exercises that may be beneficial to you and again it depends a lot on your individual running mechanics and the targets you have in terms of your running goals regardless of your goals it’s a good idea that your exercise program incorporates three different components. The first one being strengthening of the tendon so that it’s better able to deal with the loads. Secondly, it’s a good idea to incorporate stretching and angle range of motion because again a more mobile ankle is going to decrease the stress on the Achilles tendon. Thirdly we should have some global movement patterns incorporated into the program to ensure that all the joints are working in a coordinated controlled and stable manner. Finally you need to understand that a good rehabilitation program for tendon is going to cause some pain, it’s okay for the tendon to be soft following the exercises. That’s a sign that they’re having the effect of your after if the exercises are increasing your pain to such a level that you’re finding it hard to back the exercises up you have to question whether you’re doing too much and again loading the tendon too much a good rule of thumb that I like to use is that after your exercises the tendon will be sawed now as long as you’re okay to repeat that exercise session in two days time then you’re probably on the right track make sure you and your physio are on the same page when it comes to how much pain you should be feeling after these exercises. Achilles tendonitis is a pain but again if you understand the principles behind it in terms of making the tendon stronger to deal with the load or decreasing the load through equipment or running modification, then it’s something which is pretty easy to get on top of. It will take time but through a sound organised and staged rehabilitation program you will make a recovery and most importantly you’ll make yourself more bulletproof to the loads that you’re going to be throwing at it.

In the future if you’ve got any more questions about your achilles tendonitis or what we’ve spoken about today, please leave a comment down below and we’ll make sure that we get back to you! Let us know how you are traveling with your rehabilitation for your achilles tendinitis. Likewise if there’s any other topics that you’d like us discuss in future videos, let us know and we’ll see what we can do for you. Hope this has been useful in understanding how to rehabilitate your achilles tendon and giving you some ideas for some exercise progressions that you might move through. Until next time we’ll see you later ~