Physical Therapy For Achilles Tendonitis

How Can I Take Care Of Myself If I Have Achilles Tendinitis

Achilles tendinitis can be frustratingly slow to heal. It can take time for your symptoms to disappear completely. Follow your healthcare providers instructions, so you dont re-injure the tendon and worsen the symptoms.

If youre trying nonsurgical treatments to avoid or delay surgery, expect to wait a few months to see improvement. To keep the tendon healthy:

• Attend physical therapy.
• Avoid certain activities or sports.
• Stretch the muscle.

Restores Your Balance And Proprioception

Your physical therapist may also incorporate specific exercises to restore or improve your balance and proprioception since youve had to go through a period of immobilization

Examples of exercises that your PT may have you do to restore your balance and proprioception include the following:

• Single leg stance
• Using a BAPS board

How Is Achilles Tendinitis Treated

Your provider will first recommend nonsurgical treatment. It may take a few months for the pain to get better especially if youve already had symptoms for a few months.

Nonsurgical treatment methods include:

RICE method:

• Rest: Stop doing activities that stress your tendon. Switch to low-impact activities, such as swimming, that put less stress on the Achilles tendon.
• Ice: Put ice on your tendon for up to 20 minutes, as needed throughout the day.
• Compression: Compress, or put pressure on, the tendon using an athletic wrap or surgical tape.
• Elevation: To reduce swelling, lie down and raise your foot on pillows so its above your heart.

Protect your tendon. Avoid walking up steep inclines or overstretching the tendon, such as by standing on a ladder rung. Wear:

• Supportive shoes, heel lifts or custom orthotics. Dont walk barefoot.
• Splint at night to help the Achilles tendon stay stretched while you sleep.
• Walking boot or walking cast if the pain is severe.

Other nonsurgical treatments that can help:

• Nonsteroidal anti-inflammatory drugs such as ibuprofen. Dont take the medication for more than one month without talking to your provider.
• Exercises you can do at home, such as calf stretches.
• Physical therapy, which uses strengthening exercises, massage, stretching and running re-education to help you feel better and regain your strength.
• Shockwave therapy, which uses strong sound waves to reduce pain and promote healing.

Don’t Miss: Does My Insurance Cover Therapy Blue Cross Blue Shield

How Can A Physical Therapist Help

Physical therapy promotes recovery from Achilles tendinopathy by addressing issues such as pain or swelling of the affected area, and any lack of strength, flexibility, or body control. You and your physical therapist will work together to develop an individualized treatment program to help you achieve your specific goals in the safest and most effective way possible. Your treatment may include:

Education. Your physical therapist will work with you to identify any possible external factors causing your pain, such as faulty footwear or inappropriate movements or exercises. Your physical therapist will assess your footwear and recommend improvements, and develop a personalized exercise program to help ensure a pain-free return to your desired activities.

Pain management. Many pain-relief strategies may be implemented, such as applying ice to the area, putting the affected leg in a brace, using heel lifts, or using therapies such as iontophoresis , or therapeutic ultrasound. These strategies can reduce the need for pain medication, including opioids.

Manual therapy. Your physical therapist may apply hands-on treatments to gently move your muscles and joints in order to improve their motion and function. These techniques often address areas that are difficult to treat on your own.

Evidence Supporting How To Rehab Achilles Tendinopathy

While Achilles Tendinopathy is a straightforward diagnosis, there is no consensus on the most effective way of intervening. When we dive into the literature we find numerous interventions including stretching, neuromuscular re-education, manual therapy, patient education/activity-modification, heel lifts, night splints, orthoses, taping, low-level laser therapy, iontophoresis, dry needling, and exercise.

Out of all these, which do you think is the ONLY intervention that is backed up by strong evidence? You guessed it, exercise!

A mechanical load has been shown to decrease pain when imposed on midportion Achilles tendinopathy. Youll learn exercises that induce mechanical load later in this article. That is not to say there is no benefit with the alternative interventions when dealing with Achilles tendon pain activity modification and iontophoresis are actually supported by moderate-level evidence. Manual Therapy has also been shown to mitigate pain through pressure massage.

Courtesy of Jill Cook

Why is it that you have tried every injection, massage, taping technique, electrotherapy, and medication without any long term results? Here is a great image by Tendon Expert Jill Cook, showcasing just how important improving load capacity is when it comes to how to rehab Achilles tendinopathy. Rehab should primarily focus on the center of this chart, restoring the capacity of this tissue is achieved by loading.

Recommended Reading: Sports Physical Therapy Of Ny

Inclusion And Exclusion Criteria

The sample population included patients who were referred for conventional physical therapy treatment for insertional Achilles tendinopathy that was diagnosed by orthopaedic foot and ankle surgeons per history and physical findings. Physical findings of Achilles tendinopathy included swelling, pain at the insertion of the Achilles tendon, and startup pain . Inclusion criteria were symptoms present for at least 3 months and age of at least 18 years. Patients were excluded if they had rheumatoid arthritis, generalized polyarthritis, Reiter syndrome, bleeding disorders, severe endocrine disease, tumor, local infection, advanced peripheral vascular disease, or if they were pregnant. In addition, they were not eligible for enrollment if they had previous Achilles tendon surgery, ankle arthrodesis, hindfoot fracture, or leglength discrepancy of more than onehalf inch. If a patient had symptoms in both Achilles tendons, only the tendon that the patient considered worse at the initial visit was followed in the study.

Data Extraction And Analysis

The kappa statistic was used to calculate the inter-rater reliability of the modified PEDro scores. The magnitude of agreement was defined as per Hopkins , where 0.9 to 1.0 represented almost perfect to perfect agreement, 0.7 to 0.9 very high agreement, 0.5 to 0.7 high agreement, 0.3 to 0.5 moderate agreement, 0.1 to 0.3 small agreement, and 0.0 to 0.1 very small agreement.

Read Also: Shockwave Therapy Machine For Home Use

What Is Achilles Tendonitis

Achilles tendonitis is a common condition that occurs when the Achilles tendon becomes irritated and inflamed due to repetitive stress on the tendon or a sudden increase in the amount of or intensity of exercise that places too much stress on the Achilles tendon. Achilles tendonitis can occur within the tendon itself or at the point where the tendon attaches to the heel bone.

There are two types of Achilles tendonitis:

Achilles tendonitis results in swelling, pain, and irritation of the tendon and can limit the individuals ability to walk, jump, and run. If a sudden pop is heard in the back of the calf or heel, rupture or tearing of the Achilles tendon may have occurred, often requiring surgery and rehabilitation.

• Pain and stiffness along the Achilles tendon in the morning

• Pain along the tendon or back of the heel that worsens during activity

• Severe pain the day after exercising

• Thickening of the tendon

Check For Biases And Effects

Statistical analyses indicated no bias in the assignment of protocol by age , sex , duration of symptoms , or activity level prior to injury. Patients assigned to the experimental group had a higher mean BMI than those in the traditional protocol , but the difference was not statistically significant . Because some heavier patients had difficulty performing the eccentric strengthening exercise and others reported doing better at 6 weeks and did not return at 12 weeks, an intention to treat analysis was performed and demonstrated no effects of incomplete followthrough on outcome. An exercise diary was provided for each patient. Most participants had received other treatments prior to this study implying that the success was related to their compliance.

Also Check: Float Therapy And Wellness Spa

What Should Be Done In The Early Stages Of This Condition

In the early stages of the condition it may be wise to combine active rest with techniques that help decrease swelling. This would mean refraining from running, long distance walking, or any other higher intensity activity that may have led to this issue in the first place. The active part of this equation would include gentle strengthening and range of motion exercises for the region to help improve blood flow for healing and address some of the issues that may have contributed to the condition in the first place. It is important to elevate the leg above chest level so that gravity can assist in decreasing swelling. If desired, ice can be used in combination with these methods as well.

Heal Your Heel Pain: Physical Therapy For Achilles Tendon Pain

Do you ever experience pain in the back of your heel? Does this pain limit your ability to walk, run, and carry out daily tasks? You may be experiencing a condition called Achilles tendinopathy. Achilles tendinopathy is a common and painful condition, often endured by runners and endurance athletes, that results in functional limitations due to pain.

As part of my doctorate studies at George Fox University, I conducted research on individuals with achilles tendinopathy. As you may be experiencing, this condition makes it difficult to resume regular activity and exercise.

Read Also: Physical Therapy Jobs Charlotte Nc

Risk Factors And Common Causes Of Achilles Tendonitis

There are a number of factors that can put you at risk for Achilles tendonitis. For example, those who run or participate in high-impact sports or fitness programs are at risk for developing Achilles tendonitis since it is a condition caused by overuse. As you age, you are more at risk for this condition as well. Having flat feet can put more strain on your Achilles tendon and also put you at risk for Achilles tendonitis. Men are more likely to develop this condition than women, but it can happen to both.

There are a variety of causes for Achilles tendonitis, including factors such as the following:

• Wearing shoes that do not fit properly or that are too stiff while running or playing sports
• Tight, weak, or injured calf muscle
• Running on hard or uneven surfaces
• Sudden change in fitness routine
• Not warming up or stretching the calves before exercising
• Excessive running or physical activity
• An abnormality in the structure of the foot
• Being overweight

Physical Therapy For Achilles Tendonitis Infographic

Achilles tendonitis is an inflammation of the Achilles tendon, which is the largest, strongest tendon in the body connecting the calf muscles to the heel bone. The Achilles tendon plays a key role in jumping, walking, running, and standing on the balls of the feet. Achilles tendonitis often develops due to repetitive stress on the tendon or a sudden increase in the amount or intensity of exercise that places too much stress on the Achilles tendon. Achilles tendonitis can occur within the tendon itself or at the point where the tendon attaches to the heel bone.

Achilles tendonitis commonly affects athletes, particularly runners and those engaged in sports requiring running, jumping, and explosive movements, such as track and field, tennis, basketball, and soccer. Running can place up to 12.5 times a persons body weight on the Achilles tendon. Achilles tendonitis also affects a fifth of the population over age 50. With age, the tendon sustains long-term wear and tear and receives a reduced blood supply, which places the tendon at greater risk of injury.

Common symptoms of Achilles tendonitis include pain and stiffness along the Achilles tendon in the morning, severe pain the day after exercising, pain along the tendon or back of the heel that worsens during activity, thickening of the tendon, development of a bone spur, and swelling present continually that gets worse during the day with activity.

Recommended Reading: Mental Health Group Therapy Activities For Adults

The Alfredson Protocol Exercises

Before you do any exercises for your tendon, you’ll need to talk to your doctor or physical therapist. They can let you know if it’s safe to try them. If they say that it’s OK, here’s how to do the Alfredson protocol:

You’ll do three sets of 15 repetitions with your knees straight. Then, you can do the Alfredson protocol again with your knees slightly bent. This will work a muscle called the soleus, which connects to the gastrocnemius and makes your Achilles’ tendon. Again, perform three sets of 15 repetitions.

Physical Therapist’s Guide To Achilles Tendon Injuries

An Achilles tendon injury is one of the most common causes of pain felt behind the heel and up the back of the ankle when walking or running. While Achilles tendinopathy affects both active and inactive individuals, it is most common in active individuals 24% of athletes develop the condition. Males experience 89% of all Achilles tendon injuries, and an estimated 50% of runners will experience Achilles pain in their running careers. In all individuals, Achilles tendinopathy can result in a limited ability to walk, climb stairs, or participate in recreational activities.

Also Check: What Does Light Therapy Do

Physical Therapy For Achilles Tendonitis Information Exercises And More

You just had an amazing run.

You were able to increase your speed and pacing more than you ever have before.

Later, you begin to notice an aching sensation in the back of your ankle that wont go away.

You could be experiencing Achilles tendonitis.

In this guide, we will walk you through the cause and symptoms of Achilles tendonitis, and what kind of treatment plans are available for you.

How To Treat And Not Treat Achilles Tendinitis

If you or someone you know are experiencing any Achilles tendinitis symptoms, its time to take a step in the right direction. An evaluation with a physical therapist can help identify what is causing the pain and how to best treat it. Your dedicated therapist will guide you through carefully managed movement and positioning that will allow your tendinitis to heal thoroughly and effectively.

Contrary to popular belief, a combination of rest, ice, and pain medication wont guarantee your Achilles heals. Another popular remedy to avoid is massaging and stretching the tendonit can cause increased irritation and compression on the injured tissue. This can slow your recovery process and hinder the tendons full healing, placing you at high risk for re-injury.

Full recovery from Achilles tendinitis can take anywhere from three months to a year, depending on the injurys severity. Your PRO~PT physical therapist will develop a comprehensive rehab program to get you back to your sport without pain as quickly as possible.

Contact one of our clinics today and let your road to recovery begin.

Read Also: Continuing Education For Physical Therapy

How Long Is Physical Therapy For Achilles Tendinopathy

The length of physical therapy will depend on a lot of different factors, such as severity of the injury and the level of guidance you need to stay on track. Typically, you can expect to see a physical therapist 1-3 times a week for 6-12 weeks. This time can be significantly longer if you have sustained an achilles tendon rupture and need surgery first. The goal is to eventually discharge you with a home rehab program that you can continue on your own for sustainable results.

How Is It Diagnosed

Your physical therapist will review your medical history and complete a thorough examination of your heel, ankle, and calf. Your physical therapist will assess your foot posture, strength, flexibility, and movement. This process may include watching you stand in a relaxed stance, walk, squat, step onto a stair, or do a heel raise. The motion and strength in other parts of your leg also will be assessed.

Your physical therapist may also ask questions regarding your daily activities, exercise regimens, and footwear, to identify other contributing factors to your condition.

Imaging techniques, such as X-ray or MRI, are often not needed to diagnose Achilles tendinopathy. Although it is unlikely that your condition will ultimately require surgery, your physical therapist will consult with other medical professionals, such as an orthopedist, to determine the best plan of treatment for your specific condition if it does not respond to conservative care.

Also Check: Red Light Therapy Bed Before And After

Helps Prevent Future Injuries To Your Achilles Tendon

You may also have to perform ankle-strengthening exercises, which are beneficial for equipping your ankle and lower leg muscles to withstand greater force, thus helping you minimize your risk of sustaining future injuries to your Achilles tendon and ankle.

The following are some of the ankle-strengthening exercises your PT may have you do:

• Ankle resistance exercises
• Short arc quad sets
• Soleus presses The soleus is a broad, flat, powerful muscle located beneath the gastrocnemius that serves as an antigravity muscle and helps you maintain an upright posture.
• Straight leg raises