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Rehabilitation
for Achilles Tendinitis
Alternative exercises
When
can I return to my sport or activity?
How
long will the effects of the injury last?
Read
more about Achilles Tendinitis
Rehabilitation
for Achilles tendinitis often includes the following:
- Reduce activity
during the acute phase.
- Ice injury multiple
times per day (place foot/ankle in bucket of ice water).
- Use 1/8" felt
pad heel lifts in both shoes until symptoms are gone.
- Perform gentle
exercises, such as hopping on toes or jump roping, to build elasticity
in the muscle and tendon. Start minimally, and only after pain is gone.
- Use anti-inflammatory
medications such as ibuprofen to reduce inflammation and speed up recovery.
The major objectives
of rehabilitation from Achilles tendinitis are to improve the elasticity
of the calf muscle and to gradually increase pain-free range of motion
at the ankle. Exercises to achieve these goals include:
- Gastrocnemius
stretch
Stand in front of a wall and flatten your palms on the wall, elbows
extended. Bend elbows and lean into the wall while keeping back and
knees straight and feet flat on the floor. Lean as far into the wall
as first significant pain allows, attempting ultimately to rest forehead
on the wall. Hold this position for 10 to 20 seconds, then extend elbows
while maintaining hand contact with the wall. Rest for five to 10 seconds.
Perform this procedure 10 times at least three times daily. While this
exercise can be modified to stretch only the injured side, doing both
sides is recommended to protect the uninvolved side from injury while
rehabilitating the injured tendon.
- Soleus stretch
Stand in front of a wall and flatten your palms on the wall, elbows
extended. Slightly flex knees but keep back straight. Feet must remain
flat on the floor or ground. Lean as far into the wall as first significant
pain permits and hold this position for 10 to 20 seconds. Extend the
elbows while maintaining hand contact with the wall. Rest for five to
10 seconds. Perform this cycle 10 times at least three times daily.
While this exercise can be modified to stretch only the injured side,
doing both sides is recommended to protect the uninvolved side from
injury while rehabilitating the injured tendon.
- Foot flexion
Sit on the floor, extending the injured-side leg and flexing the opposite
leg at the knee. Loop a towel under the instep of the injured-side foot
while holding an end of the towel in each hand. Gently draw back on
the foot with the towel until first pain intervenes. Hold this position
for 10 seconds. Relax the arms and the foot and rest for 10 seconds.
Do this routine 10 times at least three times daily. Perform the same
routine with the uninjured side to protect it from injury.
- Double leg raises
Stand erect with hands resting lightly on a chair back, table, or other
supporting structure. Slowly raise up on the toes to the point of first
pain at the injury site. Hold this position for 10 to 15 seconds, then
return to start position. Rest for five seconds. Perform this sequence
10 times at least three times daily. This exercise both rehabilitates
the injured tendon and helps protect the uninjured one.
- Single leg raises
Stand erect with one hand resting lightly on a supporting structure
placed beside you. Flex the knee farthest from the supporting structure
and raise the heel backward so that body weight is on the opposite leg.
Slowly raise up on the toes of the weight-bearing leg. In the instance
of the injured side, raise up only to the point of first pain. Hold
this position for 10 to 15 seconds, then return to start position and
rest for five seconds. Perform this cycle 10 times. Reverse the position
of the legs and do the same sequence as described for the first exercised
leg. Perform this series at least three times daily. This exercise both
rehabilitates the injured tendon and helps protect the uninjured one.
Attempt exercise 5 only after you can do exercise 4 through the full
range of motion without significant pain. When you can do exercise 5
effortlessly and without pain, add resistance by holding a one- or two-pound
weight in each hand. As strength builds, increase resistance in two-
to three-pound increments for each hand.
Alternative exercises
During the period when normal training should be avoided, alternative
exercises may be used. These activities should not require any actions
that create or intensify pain at the site of injury. They include:
When can I return
to my sport or activity?
The goal of rehabilitation is to return you to your sport or activity
as soon as is safely possible. If you return too soon you may worsen your
injury, which could lead to permanent damage. Everyone recovers from injury
at a different rate. Return to your activity is determined by how soon
your Achilles tendon area recovers, not by how many days or weeks it has
been since your injury occurred.
You may safely return
to your sport or activity when, starting from the top of the list and
progressing to the end, each of the following is true:
- You have full range
of motion in the injured leg compared to the uninjured leg.
- You have full
strength of the injured leg compared to the uninjured leg.
- You can jog straight
ahead without pain or limping.
- You can sprint
straight ahead without pain or limping.
- You can do 45-degree
cuts, first at half-speed, then at full-speed.
- You can do 20-yard
figures-of-eight, first at half-speed, then at full-speed.
- You can do 90-degree
cuts, first at half-speed, then at full-speed.
- You can do 10-yard
figures-of-eight, first at half-speed, then at full-speed.
- You can jump on
both legs without pain and you can jump on the injured leg without pain.
How long will the
effects of the injury last?
With proper rehabilitation, a first occurrence diagnosed and treated in
its early stages usually lasts two weeks. If the injury has recurred several
times, full recovery may take as long as six weeks.
Frequent episodes
of Achilles tendinitis may result in formation of calcium deposits in
the tendon. Such a complication may require surgical treatment; full recovery
under such circumstances can take months.
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