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Achilles Tendonitis

Have you experienced any of the below symptoms ?
If so why not talk to a member of the Maryborough Team, and we can devise a rehabilitation programme for you.

The Achilles tendon, which pulls up the back of the heel, is the largest tendon in the body and can withstand forces of 1,000 pounds or more. It also is the most frequently ruptured It connects the large calf muscles (Gastrocnemius and Soleus) to the heel bone (calcaneus) and provides the power in the push off phase of the gait cycle (walking and running).tendon.



Signs and symptoms of tendonitis include:
Achilles tendonitis can be either acute, meaning occurring over a period of a few days, following an increase in training, or chronic which occurs over a longer period of time.

Acute achilles tendon injury:
• Gradual onset of achilles pain at the back of the ankle, just above the heel   bone.
• This develops over a period of days.
• Achilles pain at the onset of exercise which fades as the exercise progresses.
• Pain eases with rest.
• Tenderness on palpation.

Chronic achilles tendonitis:
• Gradual onset of achilles pain over a period of weeks, or even months.
• Pain with all exercise, which is constant throughout.
• Pain in the tendon when walking especially up hill or up stairs.
• Pain and stiffness in the Achilles tendon especially in the morning or after rest.
• There may be nodules or lumps in the achilles tendon, particularly 2-4cm above the heel.
• Tenderness on palpation.
• Swelling or thickening over the Achilles tendon.
• There may be redness over the skin.
• You can sometimes feel a creaking when you press your fingers into the tendon and move the ankle.

• Achilles Tendonitis or achilles tendinosis is a common cause of achilles pain at the back of the ankle.
• Mild pain after exercise or running that gradually worsens
• A noticeable sense of sluggishness in your leg
• Episodes of diffuse or localized pain, sometimes severe, along the tendon          during or a few hours after running
• Morning tenderness about an inch and a half above the point where the Achilles tendon is attached to the heel bone
• Stiffness that generally diminishes as the tendon warms up with use
• Some swelling
Tendonitis often will develop when you suddenly increase your level of activity without adequate training or conditioning.

Conservative treatment can include resting and taking anti-inflammatory medications, using heel pads or shoe inserts designed to relieve stress on the tendon and exercises to strengthen the weak muscle group.



Healing of the achilles tendon is often slow, due to its poor blood supply.

What can the athlete do to treat Achilles pain?
• Rest and apply cold therapy.
• Wear a heel pad to raise the heel and take some of the strain off the achilles tendon. This should only be a temporary measure while the achilles tendon is healing.
• Make sure you have the right running shoes for your foot type and the sport.
• See a sports injury professional who can advise on treatment and rehabilitation.
Strengthening Exercises for Achilles Tendonitis

Resistance Band Plantarflexion
• This is a gentle exercise to start with. Hold a loop of resistance band and use it to apply resistance as you point the foot away.
• Start with just 2 sets of 10 once a day and build up to 3 sets of 20.
• If it does not hurt the next day then increase the load.
• You may find with this one you can increase the resistance quite quickly.
Seated Calf Raise
• Again this is a gentle exercise but this one will strengthen the Soleus muscles.
• Sit on a chair and raise up onto you toes.
• Start with 2 sets of 10 twice a day and increase a little every two or three days when you are sure there has been no adverse reaction (pain).
Calf Raise- Both Legs
• Stand on the edge of a step and lower the heels down slowly, both at the same time.
• Place the emphasis on the downward phase.
• Reverse the movement and rise up onto your tip toes.
• You can adjust the pressure on the injured leg by taking most of your weight on the good leg.
• Repeat this exercise as many times as is comfortable.
• Do not over-do it, especially in the early stages. It is better to do too little rather than risk causing inflammation to the tendon.
• Repeat 10-15 reps of the exercise daily to start with. Progress to doing two and then three sets at a time.
• Apply cold therapy to the achilles tendon after exercise.
Eccentric Heel Drop
• Stand on a step with the heels off the back.
• Start on the tip toes of the injured leg only.
• Lower the heel down below the level of the step. Ensure this is done slowly and under complete control.
• Once at the bottom, put the other foot on the step and use both legs to push back up.
• Start with a low number of reps (e.g. 5-10) as this is a very hard exercise. Gradually increase the numbers performed.
Achilles Tendonitis Stretching Exercises
Stretching is an important part of the treatment and rehabilitation of achilles tendinitis. Below we outline some simple stretching exercises.
Gastrocnemius Muscle Stretch
• Once comfortable to do so, this stretch should be used at least 3 times a day.
• Stand in a wide stance position with the leg to be stretched at the back.
• Keep the back heel firmly on the ground as you lean forwards and push against the wall in front.
• Hold for 15-20 seconds and repeat three times. Gradually hold the stretch for longer (up to 45 seconds).
Soleus Muscle Stretch
In addition to the above stretch this one will stretch the Soleus muscle lower down in the back of the leg.
• The same principles apply but it is important to bend the stretching leg at the knee.
• This takes the Gastrocnemius muscle (which attaches above the knee) out of the stretch.
• Again, hold for 15-20 seconds and repeat 3 times. Do this at least 3 times a day.
Stretching on a Step
• This stretch can be performed to further the stretch on the calf muscles and achilles.
• Stand on a step with the toes on the step and the heels off the back.
• Carefully lower the heels down below the level of the step until you feel a stretch - make sure you have something to hold on to! 
• Hold for 15-20 seconds.
• This should be performed with the knee straight and then repeated with the knee bent to make sure you are stretching both muscles.
• You should feel a gentle stretch. Be careful not to over-do this one.
Perform carefully on one leg if you need even more of a stretch

Soleus Muscle Stretch
In addition to the above stretch this one will stretch the Soleus muscle lower down in the back of the leg.
• The same principles apply but it is important to bend the stretching leg at the knee.
• This takes the Gastrocnemius muscle (which attaches above the knee) out of the stretch.
• Again, hold for 15-20 seconds and repeat 3 times. Do this at least 3 times a day.
Stretching on a Step
• This stretch can be performed to further the stretch on the calf muscles and achilles.
• Stand on a step with the toes on the step and the heels off the back.
• Carefully lower the heels down below the level of the step until you feel a stretch - make sure you have something to hold on to! 
• Hold for 15-20 seconds.
• This should be performed with the knee straight and then repeated with the knee bent to make sure you are stretching both muscles.
• You should feel a gentle stretch. Be careful not to over-do this one.
Perform carefully on one leg if you need even more of a stretch
Soleus Muscle Stretch
In addition to the above stretch this one will stretch the Soleus muscle lower down in the back of the leg.
• The same principles apply but it is important to bend the stretching leg at the knee.
• This takes the Gastrocnemius muscle (which attaches above the knee) out of the stretch.
• Again, hold for 15-20 seconds and repeat 3 times. Do this at least 3 times a day.
Stretching on a Step
• This stretch can be performed to further the stretch on the calf muscles and achilles.
• Stand on a step with the toes on the step and the heels off the back.
• Carefully lower the heels down below the level of the step until you feel a stretch - make sure you have something to hold on to! 
• Hold for 15-20 seconds.
• This should be performed with the knee straight and then repeated with the knee bent to make sure you are stretching both muscles.
• You should feel a gentle stretch. Be careful not to over-do this one.
Perform carefully on one leg if you need even more of a stretch

Soleus Muscle Stretch
In addition to the above stretch this one will stretch the Soleus muscle lower down in the back of the leg.
• The same principles apply but it is important to bend the stretching leg at the knee.
• This takes the Gastrocnemius muscle (which attaches above the knee) out of the stretch.
• Again, hold for 15-20 seconds and repeat 3 times. Do this at least 3 times a day.
Stretching on a Step
• This stretch can be performed to further the stretch on the calf muscles and achilles.
• Stand on a step with the toes on the step and the heels off the back.
• Carefully lower the heels down below the level of the step until you feel a stretch - make sure you have something to hold on to! 
• Hold for 15-20 seconds.
• This should be performed with the knee straight and then repeated with the knee bent to make sure you are stretching both muscles.
• You should feel a gentle stretch. Be careful not to over-do this one.
Perform carefully on one leg if you need even more of a stretch

If you have this injury and need help with strengthening this tendon, please speak to a member of the Maryborough Club Team. We can take you through each of the stretches above and the strengthening exercises.

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   Maryborough Hotel and Spa, Maryborough Hill, Douglas, Cork, Ireland.
                  GPS Latitude - N 51 52.375 Longitude - W 8 25.082
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