Achilles Tendon

Tendonitis, treatment, what do to if you tear it

Any tendon issue is going to arise from misuse or overuse. Regardless of which, you may want to reassess your training. We’ll just get right into the solutions instead of worrying about how you got here.

What Are The Best Ways To Treat Achilles Tendonitis?

To treat Achille’s tendonitis, you should focus on exercises that isolate the Achilles tendon. A tendon is isolated the same way its connected muscle is. The way to treat Achille’s tendonitis is to load the tendon (source); isometrically and isotonically as well as increase blood flow via scraping. The treatments are as follows:

1. Heavy isometrics

2. Weighted calf raises

3. Scraping (Graston, IASTM)

Heavy Isometrics

• Achille’s tendons love isometrics

• Isometrics allow the tendon to be overloaded in a safe position

• 3 sets of 30 seconds

• 2x a day, separated by at least 6 hours

• This should be difficult, 8/10

• Should also be heavy

Calf Stretch

This is NOT a static stretch. This is going to be moving the muscle through as much pain free ROM as there is.

• Perform this single leg

• Lower the heel off the step until you feel pain

• Hold this position for 1 second

• Release and go back to start position

• Perform this again and find that painful range again

• As you perform more and more reps, that painful sticking point will get higher and higher and full ROM is established

• Perform 50 reps per session, twice a day

• Repeat for as long as needed to restore full ROM

Loaded Calf Raises

Do not progress to this phase until you have full ROM. Strengthening a muscle in a limited motion will result in causing more dysfunction and increasing injury risk. Below are three options pending what equipment you have access to.

• Complete 3 sets of 12 reps

• Increase reps before weight

• Progress from 12-15-20 reps, add weight when 20 is achievable and then restart back at 12 reps

• Calf raises can be loaded with anything

• If you don’t have weights, hold literally anything with weight

Scraping

The Achille’s tendon has poor blood flow. Scraping will improve blood flow as well as encourage proper collagen alignment

Scrape for 3-5 minutes per day. Perform this 3x a week

Treating Achille’s tendonitis is a simple, not necessarily easy task. Load the tendon as much as tolerable and improve circulation to the area.

The issue should resolve in a few days/weeks. Remember, you did not develop this condition overnight so the fix will follow a similar timeline.

Achilles’ Rupture

How To Determine If There Is An Achilles Rupture

You don’t ever want to deal with this. Just ask our resident Tiger. Bengal popped his over a decade ago being a CrossFit hero. No, he didn’t walk it off as calmly as Kobe did

1. MRI will confirm the tendon is torn and where (source)

2. The Thompson test. This test is almost as reliable as an MRI and can be done by anyone without needing to see a doctor. In the presence of a positive Thompson test, an MRI is done as a confirmation as opposed to a diagnostic

If this test is negative, you did not tear your Achilles.

How Is The Achilles Torn?

An Achilles rupture occurs when the tissue is loaded well beyond its capacity when in a lengthened position. An Achilles tendon tear is often reported as a feeling of being kicked in the back of the leg or hearing a sound like a gun going off.

This is most common during a forceful jump, a sudden pivot or sudden acceleration. An Achilles tear is most common in men over the age of 30, particularly weekend warriors.

The Achilles tendon has an avascular (low blood supply) zone in the middle 2-3 inches. Most tears occur here. This is also the spot that most tendonitis issues pop up in

Now What?

If you tore your Achilles, you most likely need surgery. There is some more nuance to this now than there used to be however.

If you are an active athlete, especially high level, you will need surgery. However, in a non-athletic population, there is growing evidence that a non operative route can be successful.

You get tossed in a boot, the tear eventually scars down entirely and you can continue to go about your day to day life.

Dealing with Achille’s issues? Reach out to us to get you back on track