Achilles Tendinopathy Treatment Plan

Rest

As you focus on recovery, try to avoid activities that aggravate your symptoms

Physical therapy

Therapy specifically directed for Achilles tendinopathy, with an emphasis on eccentric exercises (see below)

Stretching

See the attached tips on stretching exercises

Icing/Massage

Do not ice for more than 20 minutes per hour

NSAIDs

You may use a course of anti-inflammatory medications aka NSAIDs like Advil, Ibuprofen, or Motrin. You may need to take the drug for a couple of weeks before notable changes are seen.

Achilles Tendonitis Eccentric Heel Raises

Eccentric Heel Raises: (3 sets x 20 repetitions, every day)

  1. Stand barefoot with both feet on the edge of a stair, step, or box, with the heels extending over the edge (fig 1).
  2. Put your hands on a countertop, stair railing, chair, or any secure structure that will allow you to maintain balance.
  3. Using the unaffected foot, perform a single leg heel raise by pushing down on the step as if it were the gas pedal of a car. (Note: If both heels are affected, you will perform a slow heel raise using both feet to a count of 3 seconds up.)
  4. Once you are up on your toes, you will shift your weight to the affected foot. (Note: If both heels are affected, pick one foot to perform step 5 for each repetition.)
  5. Slowly lower the affected heel to the starting position to a count of 3 seconds down.
  6. Perform 12 repetitions of this exercise per set. The goal is to perform 36 repetitions total, every other day. It is recommended that you split this up by performing 3 sets of 20 repetitions, preferably spread out over the course of the day (one set each in the morning, midday, and night).
  7. If you are able to complete 20 repetitions fairly easily, you may add weight in 5-10 lb. Increments.

Stretching

Achilles Tendonitis  Stretching Fig 2

Fig 2

In one exercise (fig 2) you lean forward against a wall with one knee straight and heel on the ground. Your other knee is bent. Your heel cord and foot arch stretch as you lean. Hold for 10 seconds, relax, and straighten up. Repeat 20 times for each sore heel. It is important to keep the knee fully extended on the side being stretched.

Achilles Tendonitis Stretching Fig 3

Fig 3

In another exercise (fig 3) you lean forward onto a countertop, spreading your feet apart with one foot in front of the other. Flex your knees and squat down, keeping your heels on the ground as long as possible. Your heel cords and foot arches will stretch as the heels come up in the stretch. Hold for 10 seconds, relax, and straighten up. Repeat 20 times.

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