Start eccentric calf strengthening, Achilles injury?

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jco131's picture

jco131

Question:

Start eccentric calf strengthening, Achilles injury?

Hi All

I am battling with Achilles tendonitis - have been to see a podiatrist and have got some orthotics. Have been doing RICE treatment as well as warming up properly and stretching. I have cut back on my exercise and am now down to one basketball session and two weight-training sessions per week. The Achilles is still sore for a day after each basketball practice but I am reluctant to stop going to practice altogether (it being a team sport and all!).

My question is ..is it okay to start doing eccentric calf strengthening even though the injury does not seem to be 100% better? An article on this site http://www.sportsinjurybulletin.com/archive/achilles-tendinosis.html suggests doing this strength training twice a day, 7 days a week for 12 weeks.

Patrick13's picture

Patrick13

Hey

Peak Performance published a book about achilles- tendinites:

http://www.pponline.co.uk/books/achilles-tendinitis.html

Hope this helps,

Regards,

Pat

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AlexWolf's picture

AlexWolf

To get a positive response from achilles tendon training, you will need to have a high dosage of conditioning as stated above. Traditional 3 x week is not enough to get a the response you are looking for.

Tendons will need to be loaded sub maximally to get a conditioning response. The conditioning will assist in the tendon recover.

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jco131's picture

jco131

Thanks Alex and Pat - I have not actually started doing any conditioning of my calf muscles yet (the podiatrist and a friend who is a physio told me it is not advisable to do strengthening while the tendon is still sore – they suspect it was caused by overuse but I am not so sure. I am beginning to wonder if I will ever get to start doing the conditioning since it is always sore..). The weight training I am currently doing does not include any calf conditioning...

So, in your opinion I should start intensive daily eccentric calf strength training as soon as possible, and it will assist in the recovery of the tendons?

Also, excuse my ignorance but what does it mean to be loaded "sub maximally"?
Thanks
Joanne

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physioroute's picture

physioroute

Eccentric training of teninopathies has recently been researched intensly recently, and from the point of view of achillies tendinosis (no such thing as a tendinitis)it has been proven to be the best first line of defence to reduce the acute and even chronic irritation.
Happily as you have got a tendinosis you are at a much lesser risk of rupturing - see light at the end of a tunnel!!
sub maximal eccentric basically means - a load that works the muscle into a stretch but not full load - any clearer?? the exercise consists of standing on a step lower down over the edge with the heel of your BAD leg, stretching the tendon BUT raise up on your good leg. Take no oad through the tendon on shortening. reps of 10 as often as you can literally 5-10 times a day. DO NOT OVERLOAD OR DO IT QUICKLY. hope that helps

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jco131's picture

jco131

Hi physioroute
Thanks this does help but I still feel a bit ignorant here. I have done a bit of research on the tendinosis/ tendinitis thing and agree that I probably have tendinosis but I still have lots of questions.

1. On the stengthening.I am keen to get started but how do I do the exercise if I have the problem in BOTH tendons?

2. Do I have to stop playing basketball altogether until the problem is sorted – according to my reading it could take months – I have only recently started playing again after a very long break – I am only going to one session a week and am really taking it easy – warming up, stretching, not sprinting, taking lots of breaks etc but I AM in pain the day after the practice..(The problem did not originally start with basketball but with running – I am not doing any running or walking any more)

3. Is there an option of these polidocanol injections I have read about?

Thanks in advance.

Joanne

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physioroute's picture

physioroute

To answer you
1) as it's both you can still do the exercise by standing on the step, placing the "good" foot on the step and then the other one hanging off the edge, so that the "good" leg is bent at the knee. Then lower down your bad heel and bend your "good" knee. By just straightening your bent "Good" knee you wont put extra pressure on the tendon. Then repeat on the other.
2)As for training I would consider giving yourself a short "break" of a week to a fortnight - I know thats not ideal but by working the achillies within a controlled enviroment and "resting" it the rest of the time you should be able after that to greadually return to the training. I would consider swimming as an alternative for those 2 weeks.
3)As for the injections personally I would advise that as a last ditch attempt - you have to have a bloomin good orthopaedic doctor to do that, and really I would not class you as chronic or debilitating enough to risk it, be positive it's a short lived annoyance if treated with respect if you go at things "Gung - ho" you can make it worse.
let me know how you go

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sldc's picture

sldc

Your achilles tendonitis, is probably due to the fact that you started playing basketball again, in other words all the extra jumping loading the calf muscles which is putting extra strain through the tendon.(I've played basketball for a number of years)
I would not recommend you do too much strengthening till the pain settles,so stick with the RICE.
I would also recommend you have get some soft tissue treatment on any tight lower leg muscles and no direct treatment of the achilles tendon as this can sometimes make things worse. Without full examination its difficult to comment on what is the underlying cause but more than likely due to tightness of the surrounding muscles.
Good luck on your road to recovery.

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Heila's picture

Heila

I also suffer from Achilles Tendinites. My physiotherapist has advised to sleep in a 'splint', to keep the ankle in 90 degrees flexion. She says this helps for the tendon not to bo back to the shortened stage. What is your opinion in this regard?
I will also like some info with regards as how to prevent this injury. I'm a long distance runner, and tend to get this injury now 2x a year. Sometimes in the left leg and sometimes in the right. How should I train to prevent this. I don't really want to give up running.

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