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Achilles Tendon Injury RehabThe following article offers suggestions for achilles tendon injury rehab. Always consult a healthcare professional to assess your specific situation. Active Rehabilitation of an Achilles Tendon Injuryby Brad Walker The last 20% is the most crucial aspect to your complete recovery. If you've ever suffered from a sporting injury in the past, you'll know how annoying it is to think you're recovered, and then out-of-the-blue, you're injured again and back to where you started. It is one of the most frustrating and heart-breaking cycles an athlete, or anyone else for that matter, can go through. Achilles Tendon Injury: Active Rehabilitation Most people will refer to this phase of your recovery as the active rehabilitation phase, because during this phase you will be responsible for the rehabilitation process. You will be doing the exercises and activities required to speed up your full recovery. The aim of this phase of your Achilles tendon rehab will be to regain all the fitness components that were lost because of the injury. Regaining your flexibility, strength, power, muscular endurance, balance, and co-ordination will be the primary focus. Without this phase of your rehabilitation there is no hope of completely and permanently making a full recovery. The first point to make clear is how important it is to keep active. Without some form of activity the injured area will not receive the blood flow it requires for recovery. An active circulation will provide both the oxygen and nutrients needed for the injury to heal. Warning! Never, never, never do any activity that hurts your Achilles. Of course you may feel some discomfort, but never push yourself to the point where you're feeling pain. Be very careful with any activity you do. Pain is the warning sign; don't ignore it. Achilles Tendon Injury Recovery: Range Of Motion Regaining a full range of motion of your Achilles and ankle joint is the first priority in this phase of the rehabilitation process. A full range of motion is extremely important, as it lays the foundation for more intense and challenging exercises later in the active rehabilitation process. As you work through the initial stages of recovery and your Achilles tendon injury begins to heal, start to introduce some very gentle movements. First bending and straightening your ankle, then as you get more comfortable with this simple movement, start to incorporate some rotation exercises. Turn your ankle from side to side, and rotate clockwise and anti-clockwise. When you feel comfortable with these range of motion exercises and perform them relatively pain free, it's time to move onto the next phase of the active rehabilitation. Achilles Tendon Injury: Stretch and Strengthen
When attempting to increase the strength of your Achilles, be sure to approach this in a gradual, systematic way of lightly over-loading the muscles and tendons. Be careful not to over-do this type of training. Patience is always a requirement for any stretching routine. An effective and relatively safe way to start is to begin with isometric exercises. With these exercises the ankle joint itself does not move, yet force is applied to the calf muscles and contracts the Achilles. For example, imagine sitting in a chair while facing a wall and then placing the ball of your foot against the wall. In this position, you push against the wall with your foot and at the same time do not let your ankle joint move. The muscles contract but the ankle joint does not move. This is an isometric exercise. The above example strengthens the Achilles and ankle joint in all directions. Pushing your foot to the left or right against something immoveable, as well as pushing down (as above) and pulling up. It's also important at this stage to introduce some gentle stretching exercise to help further increase your range of motion and prepare your Achilles for more strenuous activity to come. While working on increasing the flexibility of your Achilles, it's also important to increase the flexibility of the muscle groups around the injured area. These include the calf muscles, and the anterior muscles of your shin. Stretching is one of the most under-used techniques for improving athletic performance, preventing sports injury, and properly rehabilitating sprain and strain injury. Don't make the mistake of thinking that something as simple as stretching won't be effective. Achilles Tendon Injury: Balance and Proprioception This phase of the rehabilitation process, often overlooked, is one of the main reasons why old injuries keep re-occurring. Once you feel some strength returning to your Achilles tendon it's time to incorporate some balancing drills and exercises. When muscles and tendons are torn, nerves sustain damage. These nerves send vital information to the brain about the specific position and location of the Achilles tendon and ankle joint in relation to the rest of your body. Without this information the muscles, tendons, and ligaments are constantly second-guessing the position of the Achilles and ankle joint. This lack of awareness about the position of the lower leg can lead to a re-occurrence of the same injury long after you thought it had completely healed. Balancing exercises are important to help re-train the damaged nerves around your lower leg and ankle joint. Start with simple balancing exercises such as walking along a straight line or balancing on a beam. Progress to one-leg exercises like balancing on one foot, and then try the same exercises with your eyes closed. When you're comfortable with the above activities, try some of the more advanced exercises like wobble or rocker boards, Swiss balls, stability cushions, and foam rollers. Achilles Tendon Injury: Plyometrics and Sports Specific Exercises This last part of the rehabilitation process will aim to return your Achilles tendon to a pre-injury state. By the end of this process your Achilles should be as strong, if not stronger, than it was before you injured it. This is the time to incorporate some dynamic or explosive exercises to really strengthen your Achilles tendon and improve your proprioception. Start by working through all the exercises you did above, but with more intensity. For example, if you were using light isometric exercises to help strengthen your Achilles and calf muscles, start to apply more force, or start to use some weighted exercises. From here, gradually incorporate some more intense exercises. Exercises that relate specifically to your chosen sport are a good place to start. Things like skill drills and training exercises are a great way to gauge your fitness level and the strength of your Achilles and lower leg. To put the finishing touches on your Achilles tendon injury recovery, I always like to do a few plyometric drills. Plyometric exercises are explosive exercises that both lengthen and contract a muscle at the same time. These are called eccentric muscle contractions and involve activities like jumping, hoping, skipping, and bounding. These activities are quite intense, so remember to always start off easy and gradually apply more and more force with each stretch. Don't get too excited and over-do-it; you've come too far to do something silly and re-injure your Achilles tendon. About the Author Brad Walker is an internationally recognized stretching and sports injury consultant with 20 years of practical experience in the health and fitness industry. Brad is a Health Science graduate of the University of New England and has postgraduate accreditations in athletics, swimming, and triathlon coaching. He has worked with elite level and world champion athletes and lectures for Sports Medicine Australia on injury prevention. Brad is also the author of The Stretching Handbook, The Anatomy of Stretching, and The Anatomy of Sports Injuries.
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