Have you ever had pain in the calf or back of the heel that won’t go away? There’s a good chance it could be Achilles tendonitis.
The Achilles tendon is the strongest and most utilized tendon in the body. Unfortunately, because of how often we use it, it also is very prone to an overuse injury.
If left untreated, an acute Achilles tendonitis can turn into a chronic Achilles tendinopathy.
Achilles tendon problems don’t have to go on forever though!
There are many ways to treat an Achilles tendon injury, such as with exercise. Let’s take a closer look at the root cause of this issue and dive into the best exercises to help treat it.
It’s helpful to know where the Achilles tendon is located.
The Achilles tendon starts at the mid-calf. It connects the two primary calf muscles in the back of the leg, gastrocnemius and soleus, to the heel bone of the foot.
Where the Achilles tendon runs is important because of its role in the leg.
Role of the Achilles Tendon
By way of the Achilles tendon, each calf muscle is able to plantarflex the ankle, or point the foot and ankle in a downward direction. This motion is necessary for many of our daily and recreational tasks, such as with walking or taking the stairs.
Because of how often we use this Achilles area, it can develop irritation and inflammation if used too much.
This is a common occurrence in sports, particularly those that require running or jumping, such as with basketball, track and field, football, soccer and baseball.
Signs of Achilles Tendonitis
- Pain and tenderness around the Achilles tendon
- Limited ankle range of motion
- Calf muscle weakness
- Pain with walking, running or jumping that is eased with rest
Your medical doctor or a specialist, such as a sports medicine physician or podiatrist, may do additional imaging or special tests to confirm your diagnosis.
Imaging may include an X-ray to confirm no bony structures are contributing to your pain. There may also be use of an MRI and ultrasound for a more in-depth assessment of the soft tissues, such as for inflammation and blood flow status.
One Achilles tendonitis test you may see used to ensure the tendon has not ruptured is the Thompson test. During this test, your calf will be squeezed.
If the foot and ankle do not plantarflex, or point down, during the squeeze, then there is a chance of an Achilles tendon rupture.
exercises for achilles tendonitis
If you’re having new Achilles tendon pain, it can be confusing to consider exercise as a way of helping to relieve this pain. Believe it or not, it’s actually okay to exercise with Achilles tendonitis.
While it’s important after the pain begins to allow time for rest, it’s just as important to re-introduce progressive exercise.
Many times, your doctor will refer you to a physical therapist to rehab the tendon and develop a home program to prevent the pain from coming back.
During physical therapy, you will be shown a variety of exercises. Gentle exercise is a great way to promote healing in the early stages of recovery, and gradually over time incorporate more vigorous exercises.
Physical therapy will involve a combination of strengthening exercises and effective stretching exercises.
Today we’ll look at the top 5 exercises to help recover from your Achilles injury.
1. Calf Stretch
Seeing as there are two primary calf muscles connected to the Achilles tendon, gastrocnemius and soleus, it makes sense for there to be an individual calf stretch for each.
These are perfect to do when your calves feel tight.
Gastrocnemius Calf Stretch:
- You may find it more comfortable to place your hands on the wall for this stretch to help with balance.
- Place the healthier leg straight forward and the affected leg straight back into a small lunge.
- Keep the front knee bent and the back knee straight as you lean forward.
- You should feel a stretch in the calf and a little bit into the Achilles tendon.
- Hold the position at least 30 seconds or up to 1 minute, then you can also repeat on the other leg.
Soleus calf stretch:
Perform this stretch exactly like the gastrocnemius calf stretch, except with a small difference.
Instead of keeping the back leg straight, have the knee slightly bent. You’ll feel more of a direct Achilles tendon stretch with this.
Hold the position at least 30 seconds or up to 1 minute, then repeat on the other leg.
2. Heel Raises
A standing heel raise is a great exercise to begin gentle strengthening of the calf muscles. Standing heel raises can be performed with both legs at the same time or a single leg at a time.
The double leg calf raise is more of a gentle exercise versus the single leg version and is recommended to begin with when you’re in the early phases of recovery. This will ensure avoiding further inflammation and irritation of the Achilles tendon.
- Place the feet shoulder width apart and stand with the legs straight.
- Lift both heels off of the floor at the same time, then slowly lower your heels down to the floor.
- Repeat 10-15 repetitions for 2-3 sets, as tolerated.
*Tip: If you have stairs and want to make this a little more challenging, stand with your feet on the edge of a stair and your heels off the stair. As you lower down, allow a heel drop slightly below the stair. This requires greater eccentric control and lower of the leg through a larger range of motion.
3. Resistance Band Calf Exercise
This is probably the most gentle exercise to strengthen the calves.
- You can either sit in a chair with one leg straight in front of you or sit on the floor with the legs extended and the knees straight.
- Wrap a resistance band (light, medium or heavy) around the ball of foot of the affected leg, while holding the other end with your hands.
- Slowly plantarflex, or point, the foot on the affected leg as far as your range of motion will allow. Return to your starting position.
- Repeat 10-15 repetitions for 2-3 sets. You can repeat on the other foot also.
4. Calf Plantar Fascia Stretch
Seeing as the plantar fascia also attaches to the heel on the bottom of the foot, it’s never a bad idea to stretch this area, as it will only help the Achilles tendon, which also attaches to the heel.
You should feel a stretch with this one along the entire bottom of the foot, into the heel and the Achilles tendon.
- Sitting in a chair, cross the affected leg over the opposite leg, like a figure 4.
- Place one or both hands on the bottom of the foot, near the base of the toes.
- Slowly flex the ankle back, while simultaneously stretching the toes back also.
- Hold this stretch for at least 30 seconds or up to 1 minute. You can repeat on the other side also.
5. Alternating Forward Lunge
A forward lunge is a little more of an advanced Achilles tendonitis exercise, but as long as it doesn’t increase your Achilles tendon pain, you can give it a shot.
During an alternating forward lunge, the front leg will push off in order to switch sides. This push-off will engage the calves, and therefore the Achilles as well.
- Begin with the feet side by side. You may want to practice this next to something sturdy, such as your countertop, in case of needing support for your balance.
- Seeing as you will be alternating legs, let’s say we start with the right leg.
- Keeping the hips forward, step forward with the right leg into a small or medium size lunge to begin with.
- Make sure the front knee is bent but does not bend forward past the toes. Keep the back leg slightly bent too.
- Once you’ve stepped forward into the lunge, push off with the front leg back to your starting position.
- Repeat with the opposite leg, while continuing to alternate sides for 10 repetitions each. Practice 1-2 sets.
Achilles Tendonitis Treatment at Home
The above exercises are examples of what you may perform while in physical therapy or as part of a home exercise program.
Is there anything else you can do to help treat Achilles tendonitis?
Treatment for Achilles tendonitis will usually involve more than just Achilles tendon stretches and strengthening exercises.
While we’ve already mentioned rest for the Achilles tendons, you may also require one or more of the following:
- Regular use of ice (no more than 20 minutes at a time maximum)
- Anti-inflammatories (this may also be prescribed by your medical doctor)
- Sometimes the use of a brace is also necessary
Be sure to allow the Achilles tendons the appropriate amount of time for proper recovery. It’s well worth the wait to get back to what you enjoy doing better and stronger than ever!
Who can I see to treat my Achilles tendonitis?
A variety of healthcare professionals are trained to properly diagnose and treat Achilles tendonitis. This may include your family medicine doctor, podiatrist, a sports medicine doctor, and physical therapist.
How often should I stretch my Achilles?
During the initial stages of recovery, you may want to try stretching at least 2x/day. It can be beneficial to even stretch more than this, if it feels helpful for your pain, such as before and after a longer standing activity, like walking.
How often should I ice my Achilles?
Ice for no more than 20 minutes at a time maximum. You can ice several times per day if necessary for pain control but try to have at least a 30-minute break between sessions.
You may find it beneficial to ice after exercising or walking for extended periods of time.