Achilles Tendon Injuries: Self-Management and Effective Home Exercises

Achilles tendon injuries are one of the most common soft tissue injuries in athletes, but they can also affect anyone who engages in activities that involve repetitive strain on the lower legs, such as walking, running, or jumping. The Achilles tendon, which connects the calf muscles to the heel bone, is the largest and strongest tendon in the body. However, it’s also highly susceptible to overuse and strain. This article discusses the common causes of Achilles tendon injuries, the importance of self-management, and effective home exercises for recovery and prevention.

Understanding Achilles Tendon Injuries

Achilles tendon injuries typically fall into two categories:

1. Tendonitis: Inflammation of the Achilles tendon, usually due to overuse or sudden increases in activity.
2. Tendinopathy: A degenerative condition where the tendon undergoes changes, such as thickening or disorganization of the collagen fibers, often resulting from chronic wear and tear.

Symptoms of an Achilles tendon injury include pain and stiffness along the tendon, particularly in the morning or after periods of inactivity, swelling, and difficulty walking or performing certain movements, such as running or climbing stairs.

Common Causes

• Overuse or Sudden Increase in Activity: Gradually increasing the intensity of exercise is key to preventing strain. Sudden spikes in activity or intensifying training too quickly can overload the tendon.
• Poor Footwear: Shoes that lack proper arch support or cushioning may place additional stress on the tendon.
• Tight Calf Muscles: Tightness in the calves can increase tension on the Achilles tendon, making it more prone to injury.
• Inadequate Warm-Up: Skipping a proper warm-up before physical activity can leave the tendon more vulnerable to strain.
• Age: As we age, tendons lose some of their elasticity, which increases the likelihood of developing tendon-related issues.

Seek professional advice from one of the You First Physio team to correctly diagnose your injury and give appropriate treatment and advice.  Most of the treatment for achilles injuries is around load management and gradually restoring strength to the tendon.  This can be done from home with minimal equipment required.

Self-Management: Key Strategies for Healing

Effective management of an Achilles tendon injury is crucial for a speedy recovery. Here are some self-management strategies:

1. Activity Modification: While rest is important, complete inactivity can lead to further stiffness and loss of mobility. Instead of resting entirely, modify your activities to avoid putting too much strain on the tendon. Swimming or cycling, for example, are excellent low-impact alternatives to running.
2. Gradually increasing the load on the achilles: The achilles (like most tendons) responds well to progressively loading to get stronger.  The key is to find the right load to begin with (your physio can guide you on this) and then over the following weeks increase the load/force on the achilles.
3. Footwear and Orthotics: Consider using shoes that provide good arch support and cushioning. In some cases, orthotic insoles or heel lifts may be beneficial in reducing the strain on the Achilles tendon.

Effective Home Exercises for Achilles Tendon Recovery

Incorporating the right exercises into your rehabilitation plan is essential for recovery and preventing future injuries. Always consult with one of the physiotherapists before beginning any exercise program to ensure that it is appropriate for your specific injury. Here are a few exercises that are particularly beneficial:

Isometric Calf Exercises and Eccentric Single-Leg Calf Raises for Achilles Tendon Recovery

Achilles tendon injuries often require targeted exercises to promote healing and prevent further damage. Two highly effective types of exercises for managing Achilles tendon issues are isometric calf exercises and eccentric single-leg calf raises. These exercises help to strengthen the tendon, improve flexibility, and reduce pain. Below, we’ll break down both types of exercises and how to perform them correctly.

Your Physio is best placed to provide education and the correct level of exercises for you. The below are some examples of what might be used.

1. Isometric Calf Exercises

Isometric exercises are a form of exercise where the muscle generates force without changing length—basically, the muscle is working but not moving through a range of motion. These exercises are particularly beneficial for Achilles tendon injuries because they allow you to strengthen the muscle without causing excessive strain or motion.

Benefits of Isometric Calf Exercises:

• Improve tendon strength and endurance.
• Reduce pain and inflammation.
• Safe for individuals in the acute phase of injury.
• Can be done without much movement, providing rest to the injured tendon.

How to Perform Isometric Calf Exercises

2. Eccentric Single-Leg Calf Raises

Eccentric exercises, where the muscle lengthens while under tension, have proven to be one of the most effective ways to treat Achilles tendinopathy. These exercises focus on the lowering phase of a calf raise, which helps to rebuild the tendon and muscle strength while reducing the risk of reinjury.

Benefits of Eccentric Single-Leg Calf Raises:

• Improve tendon healing and strength.
• Target the calf muscles in a functional way.
• Help reduce long-term discomfort associated with Achilles tendinopathy.
• Essential for rehabilitation after Achilles injuries.

How to Perform Eccentric Single-Leg Calf Raises

Eccentric Single-Leg Calf Raise on a Step:

1. Stand with the balls of both feet on the edge of a step or raised surface. Your heels should hang off the edge.
2. Shift your body weight onto one foot, keeping the other foot off the step or lightly placed for balance.
3. Rise up onto both toes using both legs for assistance.
4. Slowly lower the body down on the affected leg, letting the heel drop below the level of the step. This should be done slowly (about 3-5 seconds) to maximize the eccentric contraction.
5. Once you’ve reached the lowest point, push yourself back up to the starting position using both feet.
6. Perform 3 sets of 10-15 repetitions per leg. Ensure the movement is controlled, especially when lowering your heel.

Progression:

• Start with both feet on the step and perform the exercise as a double-leg calf raise before progressing to a single-leg variation.
• As your strength improves, you can increase the number of repetitions or perform the exercise with additional weight (e.g., holding a dumbbell).

Conclusion

Achilles tendon injuries can be debilitating, but with proper self-management and a commitment to exercises that target strength and flexibility, recovery is achievable. Load management combined with targeted rehabilitation exercises can help reduce pain, improve function, and prevent future injuries. If you’re struggling with an Achilles tendon injury, consider speaking with a physiotherapist for a more tailored recovery plan and further advice.

Stay active, stay safe, and keep your Achilles tendon strong!