In our ongoing quest to DEprioritize stretching from your rehab & prevention routines, the achilles tendon has to also be close to the top of our list. (click the buttons if you want to read up on our earlier content about this concept)…
“But Doc, it feels good!”
“I have stiff ankles, though. Shouldn’t stretching help my range of motion?”
I get it. Stretching your calves feels great most of the time. It can even be useful in temporarily dealing with stiffness around your ankles!
But if the problem with Achilles Tendon pain was simply that your calf muscles needed to be a little longer, then we would all be fixed by now and running along without that agonizing heel stiffness & pain every morning wouldn’t we?
The Gastroc/Soleus Complex & Achilles Tendon
THE REAL PROBLEM
While there are a bunch of potential factors that can contribute to Achilles Tendon-related injury (your shoes, your running mechanics, your genetics, your mobility routine, etc), the real problem is usually that your achilles tendon lacks resiliency to the kinds and amounts of stress that you’re feeding it. Common examples of things I hear from the hundreds of Achilles Tendinopathy cases I’ve worked with are:
Your Body Needed More Time to Adapt to a Huge NEW Stimulus…
“This is my first marathon, and the race is only a month away. I’ve followed the plan but don’t understand why my heel is hurting so bad!”
You Didn’t Respect the Terrible Toos (Too Much/Too Soon/Too Long/Too Fast/Too Hard)…
“I haven’t ran much throughout the winter, and when the sun came out in the Spring I just couldn’t hold back anymore. I probably tripled my weekly running mileage over the past few weeks before my heel started hurting.”
You Didn’t Allow a SKILL to be Gradually Developed…
“I just strung together 10 double unders (jumping rope with 2 passes under each repetition) last week for the first time, and todays WOD had rounds with 100 reps in it. So I figured I’d go for it!”
The underlying problem here is a matter of tissue capacity. That is, when we feed a tendon sudden stress that it’s just not able to handle on a regular basis, we often run into problems. Our bodies crave stress to grow. But to stay away from these pesky kinds of injury, our bodies crave GRADUAL stress.
THE REAL SOLUTION
If flexibility isn’t really the problem, and tissue capacity (how much stress your tendon can handle without getting ticked off) IS the problem, then we’re left with an obvious solution:
Do the things that will increase tissue capacity…
So here are 5 of our favorite ways of building up your achilles’ so that you can get back to life as it was!
1. TIPTOE WEIGHT SHIFTS [ISOMETRIC]
I like this exercise when dealing with really angry achilles. The kind that get ticked off just from walking around, or immediately after you get out of the car.
Why? isometric exercise can do a good job of building a base level of strength, generating some healthy blood flow to the achilles tendon, and getting your calf muscle/tendon complex used to some force production. Some studies make claims that isometrics are even helpful for reducing pain, although these findings are not yet conclusive.
2. CONE TAPS [ECCENTRIC]
Cone taps are a great and relatively easy/beginner-level exercise to begin to introduce the kind of strength that we need for things like running, walking, hiking, and squatting.
Why? this “eccentric” exercise (when a muscle is lengthening/stretching and resisted at the same time) is a way to introduce some mild strength-promoting work to a healing achilles tendon. A large part of things like walking & squatting involve your foot being planted on the ground while your knee moves forward towards/over your toes in a controlled manner. These cone taps help to simulate that stress in a safe way!
3. CALF RAISE NEGATIVES [ECCENTRIC]
Shown here are two of our favorite variations. Calf raise negatives are another great way to train your calves to be long AND strong. An eccentric muscle contraction (muscle activity while the the muscle is stretching out) is another great way to build strength & resiliency in the muscles that support their tendons.
Why? More often than we realize, our muscles are contracting WHILE they’re stretching out. A prime example of this is the terminal (or “last part”) phase of the running stride. Right before your heel lifts off of the ground to swing forward for the next piece of ground to grab, your calves are working overtime in an eccentric contraction. Calf raise negatives like these variations are a great way make sure your achilles tendons are bulletproofed against this kind of stress!
4. GASTROC & SOLEUS RAISES (CONCENTRIC)
The two main supporting structures to the achilles are the gastrocnemius and soleus muscles. When an achilles tendon is no longer towards the “bees” section of the pain scale (see below, seriously—this has to be the best scale out there to describe pain), concentric exercise is a great way to build strength.
Why? While we use eccentric contractions for a lot of activities, we rely heavily on concentric activity as well for many activities such as double unders (CrossFit), running, changing direction & sprinting (soccer, football), and jumping (basketball, so many others!).
DEFICIT GASTROC RAISES, DEFICIT SOLEUS RAISES, END-RANGE CALF RAISES
5. HOPPING (PLYOMETRIC)
Credit to Mick Hughes, a Physiotherapist in Melbourne, for this one. I love the idea of having a small bit of assistance to the hopping movement. Towards the end stages of rehab & prevention, I’ve heard many people struggle to be painfree through really getting back into the higher-level dynamic movements like jumping, running, or hopping. This is a creative variation to modify the hopping movement just a bit, in order to make it more manageable for a freshly rehabbed achilles tendon.
I’d love to hear from you about your struggles AND success stories dealing with Achilles Tendon problems!
There are so many ways to work with an achilles tendon problem without medications, injections, or surgery. So please reach out to a healthcare professional like me for help if you’re struggling through this kind of an injury!
I LOVE BEING ABLE TO HELP MY ACHILLES PATIENTS GET FROM PAINFUL EVERY SINGLE MORNING WHEN THEY WAKE UP TO RUNNING AND JUMPING WITHOUT ANY PAIN!
If you’d like to learn more about working with me, please reach out and don’t let your heel pain become a longer term problem! You can even setup a free 15-minute phone consultation with me here:
TALK WITH THE DOC
