If you're an athlete, then you know that injuries are just a part of the game. Sometimes they're unavoidable, and other times they're the result of taking risks. No matter how they happen, though, recovering from an injury can be tough. Especially when it comes to Achilles injuries— one of the most common injuries for athletes. Check out this guide on recovering from an Achilles injury, so you can get back to doing what you love as soon as possible!
Don’t let your Achilles tendon be your Achilles heel.
Achilles tendonitis is inflammation and pain as a result of overuse or overload. The most common causes include repetitive movements, such as running and jumping. When the tendon is not properly conditioned, it is susceptible to the development of this condition. Often times, flare-ups occur following sudden onset of activity or increasing activity too quickly. In addition, other causes can include poor mobility, improper footwear and new onset weight gain. The body will grow and adapt to stress over time, but it needs sufficient time to repair and recover. When the athlete continues to push through discomfort, the tendonitis turns into a tendinopathy. The tendon progresses through different phases of injury the longer it goes untreated. Keep in mind, the longer you hold off treatment, the longer the recovery process will be.
You guessed it, class is in session! Let’s review the anatomy of the lower leg to better understand this condition. The Achilles tendon is a thick, fibrous band of tissue that connects the calf muscles to the heel bone, also known as the calcaneus. The calf muscles include the gastrocnemius (larger) and soleus (smaller). Due to the significant stress the Achilles is subjected to, it is the thickest tendon in the body.
A structure called the peritendon covers the Achilles tendon and creates a smooth covering to allow near frictionless motion. Unfortunately, due to the poor blood supply to the tendon, it can be a slow healing process to return to normal. In general, Achilles tendonitis/tendinopathy occurs at either the insertion to the heel or in the mid body of the tendon, a few centimeters above the heel. It is important to differentiate between the two locations to help guide the treatment plan.
Now on to the good stuff!
You’re in pain, but want to minimize time away from training. It is time to heal, strengthen and put Achilles tendonitis in the rearview mirror. First and foremost, complete shut down from activity is not the answer. This may lead to improvement in pain, but it also weakens the tendon and makes it more susceptible to injury.
The rehab process can consist of both passive and active techniques. Passive techniques are things done to athlete, which include ice, ultrasound, dry needling, sraping techniques or acoustic wave therapy. While these treatments may reduce pain, they do not address the tendon’s tolerance to stress. More importantly, active techniques are things the athlete actively performs. In general, a good progression includes:
isometrics > heavy slow resistance training > return to explosive movements
Isometrics involve contracting muscle without change in fiber length. An example would be a heel raise, double or single leg. This should be performed in a standing position. It should be difficult to hold for 45-60 seconds x 5 reps. If single leg is too easy, please hold a weight while performing.
Next, heavy slow resistance training can be performed in both seated and standing positions to target both calf muscles. Each rep should be 3-5 seconds up and 3-5 seconds down in a controlled fashion. 15 reps is a good starting set size. Each week increase load and decrease number of repetitions over a 4-6 week period.
Finally, return to explosive movements such as jumps and running. Start SLOW and progress with caution. Begin with a few sets of quick hops and short duration running. Allow sufficient rest between rehab sessions at this phase. No more than 2-3 days per week. As long as symptoms do not return, gradually build as your body allows. Continue this progressive loading until back to desired level of activity. Below are a few tips for specific areas of tendon injury.
Insertional:
- Stretching may be beneficial in acute tendonitis, but should be avoided in tendinopathy to prevent worsening symptoms.
- Foam rolling or massage sticks are better options to improve mobility
- Heel raise can be a beneficial tool to keep foot in slight plantarflexion
- Orthotics are not generally recommended
Mid-Tendon:
- Night splints are often ineffective treatment options
- Stretching may not worsen symptoms, but no significant benefits seen
- Foam rolling or massage sticks are better options
And just like that, another topic in the books. With each article, you can take home a few points in the unfortunate situation you’re faced with one of these conditions.
The key points to remember with Achilles tendonitis include early identification of condition, pain management/elimination of cause, progressive strengthening and consistency with exercises. If caught early, tendinopathy can be avoided and less time missed from training.
We all have setbacks in training and in life. Control the things you can control and the rest will take care of itself. Positive outlook, 100% effort, optimal sleep, proper nutrition, responsible training and balance in life. When the body is in a state of healing, it may require additional protein and micronutrients.
There are no better supplements than Earth Fed Muscle to fill those gaps. Whey isolate protein and collagen after training, multivitamin and omegas on a daily basis and Forty Winks to optimize sleep. Until next time friends, better everyday!