Help your screaming Achilles tendons

Achilles problems are the bane of many runners' lives.

Pain in the Achilles can be due to a strain, a tear, or chronic Achilles tendonitis, and likely culprits are a form/gait/muscle imbalance coupled with unhelpful running shoe designs, and/or a change in type or intensity of training. I know my Achilles tendons sometimes scream at me if I start speed work too soon; for other runners it's hill work that will set them off.

Over the years I've tried the whole menu of cures that I guess most of us go through: inserts and orthotics of various descriptions, taping, icing, massage, deep-tissue work, warm embrocation, cold embrocation, ultrasound, laser, stretching, not stretching, different stretching etc etc.

Finally I found something that worked to rehab 'em and, what's even better, prevent Achilles problems happening in the future. It involves a progressive series of resistance training exercises -- but resistance with a difference.

The difference is that you add the weight/resistance on the eccentric contraction, not, as normal, on the concentric. OK, it's easier to explain if you try it.

If you stand up in bare feet, then stand on tiptoe, then your gastrocnemius (calf) muscles are working concentrically -- they are shortening to push you into the air. At this point your Achilles tendons are "unloaded". A classic remedial stretch for the calf muscles is to stand on a step, raise on tiptoe, then allow the heels to drop below the step, so you end up stretching the gastrocs and loading and putting a stretch on the Achilles as well.

The new-style exercise to deal with Achilles tendon inflammation is to do that exercise, but do it on one leg at a time and take the weight off as you go on tiptoe, and (eventually) add weight as you slowly lower the heel below the level of the step.

A Carelton University Sports Medicine Clinic webpage explains this "eccentric calf-muscle training" clearly with pictures. It also gives a progressive training regime. There's another good article here.

In my experience total rest is not the way to go with this injury and, again in my experience, it should be significantly better in a week unless you have done some real damage (like a severe tear).

I did these exercises following deep tissue massage treatment (which also targets the scar tissue) and it works well.