👉 A set of hand weights will enable you to gradually increase the difficulty of your Achilles rehab exercises: geni.us/BUZ3ZKB If you buy anything via this link, we may get a small commission at no extra cost to you.
Such a helpful video! I had three physio sessions with a highly recommend physio in my area, and all they did was rub deep heat on my foot for 15mins each time 🤦♀️ I’ve learned so much more from your videos than from any practitioner I’ve actually paid good money to get help from. Thank you!
This is by far the best and most nuanced guide I have stumbled across. My Achilles rehab is now on track again. The goal is to once again conquer the Ironman distance. Not this year and probably not even next year but 2026 🙂
I suffer from pains on the back of my heel in some 'random' morning or after some sleeps. It hurts when walking and especially when standing with heel lifted. It takes one or several says to disappear itself. Stranglely I notice that most of the time it heals or at least feels much better after I play table tennis. When searching for explanations on the internet, I came across your videos and now everything makes sense! I am just now following the very first few exercises here and the pain has significantly reduced. Thank you!
Extremely informative this is EXACTLY what my physio is doing with me. I am coming up for a year in rehab and just starting to slowly build up the running miles. The biggest thing I have noticed is Achilles tendonitis rehab takes time, patients and persistence!
Your videos are exceptional! I'm so happy I came across these. I had flat foot reconstruction surgery a few years ago which included an Achilles lengthening. My right foot feels great but my left Achilles has been sore ever since 17 months after my surgery. I recently found out I have mild tendenosis. I'm going to talk to my podiatrist this week to understand what needs to happen moving forward, I'm just concerned about living with pain permanently. Unfortunately there isnt as much information on TH-cam about tendonosis as there is about tendonitis. Im going to use your tips and hopefully my Achilles will make a turn around.
The terms tendonosis, tendonitis and tendinopathy all refer to the same thing - it really is just a matter of scientists not agreeing about the finer details about the amount of inflammation involved - we discussed the different terms in detail in this article: www.treatmyachilles.com/post/what-s-the-difference-between-achilles-tendonitis-tendinosis-tendinopathy-and-tendinitis
This is really helpful. I have suffered with multiple Achilles tendonitis over the last couple of years when I started running. I only did calf raises but when I stopped doing it, I was back with the pain...Now I want to sign up for a more structured rehab and need guidance like this. I am ready to give 6 months to this and control my addiction to run long distances as this rehab should help me to be a better runner in the long run
Hi Sujoy, If you need help with this, you are welcome to book a video consultation with one of our physiotherapists, who can do an assessment of your injury and provide you with a personalised rehab plan. More info: www.treatmyachilles.com/
Absolutely incredible explanation, Maryke. Thank you so much for all this incredible and sound advice. I feel like you've answered so many questions of mine in such a clear and methodical way. There is hope after all!
This information has been so very helpful. I just spent a month in a soft cast do to my severe tendonitis. I am 50 years old and I am a dance instructor. I did well without the boot for a week and ended up having to do a lot of walking and set myself back. I'm very scared that I'm never going to be without pain and will always be walking weird, not being able to go back to dancing. Going to watch the menopause video next!
Hello Tina I am telling you in all sincerity to completely cure your problem you need shockwave therapy it works 100% everytime everything else is fluf I feel when it comes to this problem 3 sessions once weekly from a physio that has the machine , google shockwave therapy and achilles tendonitis good luck
I hope you are better now? I love dancing, I'm 51 and a doctor mindlessly prescribed Levofloxacin which caused me tendonitis. It's one month ago and I'm still working through it (had before all this paid for a walking holiday so was worried how that will work) but ! I'm hopeful 🙏
An excellent and informative video, as suffering from both Achilles and plantar facia pain I have come to realise how weak my calves and ankles/feet are, even though I do a lot of cycling it just doesn't load them the same. So recently when I started do lots more walking / jogging these issues flared up as without doubt I didn't have the capacity within them to take these extra new loads. So now 5 steps backwards and following the advice laid out here to strengthen those calves and tendons and have the patience and commitment that is outlined to see this through, no quick fix here especially as I am a 68 year old male and the body just doesn't heal / recover like it used to.
So many videos on this subject! Barely any go into depth on what to do. This video is awesome!! Covers all the 'in depth' information that is needed. Best video out there!! I wish you were located here in Arizona then I would come to do therapy there! Thank you Maryke!! Skal!
Thank you. Very useful. I’m recuperating from Achilles tendinitis. Glad I found these tools this tine around. When physical therapy isn’t available at the moment, this guidance and support is appreciated.
This video is what my doctor should have ordered! After not being helped very much by a variety of doctors in my HMO, I stumbled across your video. You gave me hope and a way forward toward returning to my gentle hiking activities. Yosemite, here I come in a few months! 🏞 Thanks so much for the super excellent video!
Hello, back in February of this year, I got my first ever achilles tendonitis injury on my right foot (90% positive it's mid portion). I was in that limbo of taking 2-3 days off, trying to run again, and then pain would come back. Eventually, I took 6 weeks off after this, where I also learned the importance of eccentric heel drops. After 12 weeks, I finally began running again, but it was a slow return to running. I will say, I never incorporated weights SPECIFICALLY into my ECCENTRIC HEEL DROPS, but I kept up with my other lifts as normal. Now in November, just 4 weeks out from a marathon, I got injured again. I pretty much stopped all eccentric heel drops 5 weeks before this, since I was feeling good and felt that I didn't need to do any more heel drops, but I kept up with my core sessions (x4 weekly) and strength training (x2 weekly), where during my strength training sessions, I would do weighted calf raises off the ground (two 25 lb dumbbells). Did I get injured again because I stopped doing all of these heel drops? Should I have kept up with it 2-3 times a week at the very least, or is it because I never incorporated weights specifically for eccentrics into my first rehab program? Any insight you have would be greatly appreciated.
Hi there, We cannot provide individual treatment advice without doing an in-depth assessment of your injury and your personal circumstances, as the advice might not be appropriate for you. You're welcome to book a video consultation with one of our physios if you would like an assessment and a personalised treatment plan: www.treatmyachilles.com/
Two Main questions I have. I am 100% confident that I have tendinopathy in my left heel. We just got back from a two week vacation on Hawaiian Beaches and did a ton of sand walking as well as many many miles of walking on sandals everyday. Combine that with coming home to a vigourous couple of hours of pickle ball last night, and this morning almost could not get down the stairs with it being highly irritated and very tender to touch the attachment point of my heel. My question is at what point should I start doing heel and calf raises to rehab at? And my second question is is the fact that I have tendinopathy increase the likelihood of a possible tear or rupture of my Achilles ? I have watched well over an hour of your videos, and they are absolutely outstanding, as all these other commenters have expressed. Thank you so very much for having this outstanding information online for us to assess our issues.
Tendinopathy goes through stages - it sounds like you're in the reactive phase which (if you've never had tendon pain there before) means that your tendon is acutely irritated. If you allow it to properly settle down, it will usually recover relatively quickly and you have no real risk of rupture. However, if you continue to irritate it and it starts dragging on for several months, then it enters a disrepair and eventually degeneration phase where the tendon starts to lose strength - then you have an increased risk of rupture. In your case, you don't yet need rehab exercises - you need to let it rest first and then start with super gentle moves. If you want help with getting back to your normal activities, this is something that our team of physios can assess and help you with via video call. You can read more about how the online consultations work here: www.treatmyachilles.com/treatment-packages
Tore my right Achilles while playing basketball back in 1994...long recovery and okay, but now in 2024 my LEFT Achilles has begun to ache. I use gentle tape on it and it doesn't hurt much;I use Tiger Balm also and antibiotic ointment along with ice once a day. Has hurt less, but what long-term solution is there since I am much older now (but still in good shape via cycling)? have appointment with a foot/ankle Dr in s few weeks...am +65 years old. Good video! Major props.
Maryka, this video is very helpful and well done, as all of your videos are! You and your team are outstanding in your knowledge and approach to Achilles tendonopathy. I have been working with Kevin for the last couple months, he is wonderful and he has me well on the road to recovery. Thanks to you, Kevin, and your organization for all you do to help.
Really like all the information on your video. My MRI impression is thickening of the mid Achilles tendon compatible with tendinnosis. Would these exercises work for me? And would like to go back to low impact easy flowing movement. Thank you.
I discuss all the types of exercises that one can do in this video, so I can't tell which ones can work for you because it will depend on how sensitive your tendon is, how strong it is and how it reacts to specific movements.
THANK YOU SOO VERY MUCH FOR THIS VIDEO AND THANK GOD FOR YOU PEOPLE HELPING ME WITH GIVING ME PEACE OF MIND I GOT HURT WITH MY ACHILLES TENDONITIS FROM A VERY CLOSE VAIN EXPLODED I HAD TO STOP THE BLOOD FROM SHOOTING OUT ACROSS THE ROOM 😢 OR BLEEDING TO DEATH I PINCH MY TENDONITIS AND DID NOT HAVE SURGERY YET A DOCTOR SAID JUST CUT THE STRANDS OFF AND YOU WILL HAVE A LIMP BUT I KNEW THAT WAS NOT THE ANSWER I WANTED SO IM BEEN NURCEING MY SELF BACK WITH THE HELP OF MY WIFE SO FAR SO GOOD BUT THE PAIN IS UNBELIEVABLE
Don't know - it depends on your Achilles's stage of recovery and tolerance to load and what type of exercises you are doing or what the goal of the session is.
Great information, but nobody talks about the role of the calf muscle in potentially causing Achilles tendonitis. I had levoquin antibiiotic two years ago and started having Achilles pain a little more than a year ago. But during the whole time I was dealing with tight calf muscles that I couldnt seem to restore to a normal state of relaxation. Could the levoquin cause the tight calves, which then causes the Achilles problems? As an engineer, it seems to me that the only thing that can act on the Achilles is the calf muscle. Therefore, why is there not more attention to the muscle and how to restore regular elasticity?
This has actually been investigated and tight calf muscles is not something that has been found to contribute to this condition - it is more that they are a symptom warning that something else is going on and the calf and Achilles are not in good condition. However, research studies report on large cohorts and it is not to say that your case is different - it might well be that the levoquin caused a change in your muscle tissue because it seems to affect all tissues.
I have insertional achilles tendinitis for many years. Thank you for this complete guide, my question is : Some times I have pain in the tendinit region and in its vicinity, but some times it burns, only tendinit, a very small reginon for several minutes. Do these two indicates the same thing ? The pain comes the next day after an intense exercie and stands a long time. The burning seems to be random and not stands very long time, I put ice on it. If the tendinit point burns the next day of an exercise, should I reduce the intensity of the exercise as in the case of pain ?
The rule with rehab and exercise is usually that it is OK to do as long as: 1. It only causes a slight discomfort while doing it, AND 2. It does not cause an increase in your pain and swelling that lasts for more than 24 hours So if your tendon pain is still increased above normal 24 hours after the session then perhaps you need to make it a bit easier. The other thing to keep in mind is that when you've had pain for more than 3 months, the body starts getting good at creating pain for no reason - it becomes oversensitive. So the random burning that only lasts for a few minutes likely falls into that category of pain that doesn't really mean anything but is just being caused because the system is oversensitive. How you react to it sounds fine.
The thickness is caused by the change in the structure of the tendon - the evidence for whether you can turn the structural change around is contradictory with some studies showing you may be able to and others showing not really. As for how to turn it around - the treatments that can affect healing include relative rest, strength training, perhaps PRP (although evidence still not very strong), and all of this applied over a long enough period - several months rather than weeks. You can find a summary of the treatments supported by research here: th-cam.com/video/H1nfgU1amvg/w-d-xo.html and a discussion about how the tendon is affected structurally here under the symptoms chapter: th-cam.com/video/cNOxd3w37K0/w-d-xo.html
Thank you so much for sharing this information . I REALLY want to do these rehab movements but it 'feels' so counterproductive to train something that seems injured. So say there are some tendon micro tears causing pain, the concern is it will get worse. Am I the only one that thinks like this?
There isn't any microtears when you have tendonitis - that's nonsense people tell you on the internet - I've made a video where I explain this: th-cam.com/video/wbA1BtvBUmA/w-d-xo.html But if you're still worried about this, perhaps consulting one of our team can help - our team of physios can assess you and provide a rehab plan via video call. You can read more about how the online consultations work here: www.treatmyachilles.com
That will depend on your tendon's tolerance and what activities you want to get back to and what type of rehab plan you are following. It is usually best to start with no weight and then slowly build it up. If you're a runner we usually build it up to at least 20% of your bodyweight e.g. 12kg in your case but it depends - if we've found that a more high load plan is better then you may be working at a 8 rep max (so a weight that fatigues your within 8 reps), but building to that over 12 weeks and starting only with 15 rep max during initial weeks - it really just depends on how your tendon is responding to different approaches.
Hi Marika, wow what informative information you’ve provided ! So I have “Insertional Calcification tendinosis of the Achilles tendon. The Proximal Achilles tendon demonstrates loss of tendon fibres striation suggestive of degeneration or partial tear. Mild distension of the retrocalcaneal Bursa, measuring 2 x 4 mm. Does this info suggest miner or serious injury……. Playing paddle ball 🙈many Thanks
It means that it likely: 1. Doesn't like being stretched and will feel worse if you walk around in flat shoes or barefoot 2. You may be at increased risk of tearing it further if you play sports that involve quick movements like paddle ball because it may not be strong enough to handle it. So, make sure you strengthen it properly before going back to paddle ball.
Good review. I had the bad luck in having a hematoma along with calcific tendonitis (not sure if there was a connection, or how!), but definitely lost some strength in my right calf. We are conservatively treating the hematoma with compression, and I am seeing a PT next week, but have been doing the eccentric heel raises... Have you ever seen these two things happen simultaneously?
Hematomas can cause calcifications in muscles but I am not sure about tendons - it's not something that I've come across but I think it is just more rare to get a hematoma in a tendon. We generally knock or hit our muscles.
Thank you for your reply- the hematoma is in the medial head of the gastrocnemius, but it happened as I was dealing with the tendonosis, I wonder if I overdid my rehab for the tendon issue and caused the hematoma. Makes the rehab a little more tricky!
Hi there, Here are two videos of ours that may answer your questions: Compression socks: th-cam.com/video/CJm5wynYdS0/w-d-xo.html Blood flow: th-cam.com/video/lh0IBZmq7kk/w-d-xo.html Hope it helps!
Great video! Question: you mention 12-24 weeks to even a year. I’ve dealt with insertional tendonitis before that was manageable during American football season by heel wedges, warming up, and ibuprofen., plus rehabbing during the season. Rest after was necessary but I never had to stop all running for 12-24 weeks to heal. Is this healthy or was I putting myself in high danger of a rupture? I’m now getting the same pain from recreational basketball. Have taken two weeks off with rehab and hoping to reintroduce with wedges, cushier shoes, continued strength training, and less total playing. Give it a go or stay shut down for 12+ weeks no matter what? I do not want to lose all my sport specific conditioning and skills.
It sounds like you managed your insertional tendinopathy very well. It is absolutely fine to keep as active as possible as long as your symptoms are improving over time and you don't find the sport you do is aggravating it further. The rule with rehab and exercise is usually that it is OK to do as long as: 1. It only causes a slight discomfort while doing it, AND 2. It does not cause an increase in your pain and swelling that lasts for more than 24 hours It is only when you continue to aggravate it to a level that it hurts more for several days and just push through pain while training etc. that you end up increasing risk of tearing.
@@TreatMyAchilles thank you so much! What I find is more than a little but not a lot of pain when I play, but by 24 hours it is back to just discomfort. So I think I need to take some time off but probably can ease back in as you say. Thank you again!
Yes, very useful video, thanks for it. But also i have a question. I have problem with that parts only while i stand for a long time in my work, on the other hand i can easly walk 15k or more steps and dont feel any pain. So on which part of exercise i must focus on? Thanks
I would look first at what shoes you wear for work and if you can change them to be more like your shoes that you can walk in. Placing heel lifts in may help th-cam.com/video/crzrN0KseWg/w-d-xo.html
It is, but you need to avoid the positions that stretch or work the tendon - Ali has just made a video about how to adapt yoga poses that will be released early in March and the same concepts apply to Pilates as well.
Hi Maryke, amazing helpful video, best among what I search 😊👍 Can I ask, how long should I wait for my tendons to recover from exercises if my tendon pain stated after using 3 pills of ciprofloxacine?
It really depends on how your body reacts so go on what you observe but often in case of Cipro it is best to only train x2 a week with x2 days between sessions. However, it the exercises are still low load, then x3 a week with at least 1 full recovery day can sometimes be OK.
Thank you! I'm a runner and I want to have some aerobic trainings while recovering. Is it safe to add cycling (easy intensity)? Can I do it after/before the strength session or it should be a separate day?
It really depends on how sensitive your tendon is - most people with mid-portion Achilles tendonitis are OK with cycling but some cases of inserional tendonitis can get more painful through it. So best is to test a gentle session and see. If it is an easy session and you don't feel that it works your calves much, then you can do it on the same day as your exercises. Although, I would recommend that when you do it the first time, do it on its own, otherwise you wont know if it is the cycling or the exercises that irritate your tendon if it increases pain.
Thanks for all the informations, I've watch most of your videos. I've been struggling with Achilles tendon pain and soreness for 3 months now. As of now, I'm able to do single leg raise with 20% extra body weight, 45 sec jump rope x3 with 2 mins rest and 8 by 3 squat jump at 60-80% effort in a single session fine, and I feel 'relatively' pain free after 24 hrs. I did try getting back to playing basketball at 70% effort while playing 1/3 - 2/3 of my original duration(20- 50 mins actual playing time). I feel a little sore after 24 hours, but my Achilles feels a lot better 48 hrs after my basketball session. Two questions: Am I at risk of rupturing my tendon going back too soon with my routine? I have heard you say pain is a bad assessment on the condition. How do I know how damage is my Achilles is or what stage of the healing process I am at?
It actually sounds as if you're pitching everything at a very good level: 1. Your Achilles is strong if that is the rehab you have built up to = rupture risk is super low, especially since you are sensible with easing into basketball 2. The way your pain is reacting, it is showing us that your pain system is still getting sensitized for 24 hours but that you're actually doing it good because you then feel better. So pain is getting triggered but it is not causing injury. Bear in mind that I don't know you and your situation fully and my advice may thus not be correct, but I think if you continue at the same level for a couple of weeks and not increase training intensity or frequency too quickly (allow it to settle into it) then you will make a good recovery from here. Try to picture the training load in your rehab session vs. how much your body has to do in your training session - the jump is quite large = why the body will take a bit of time to adapt to it even at 70%. If you ever did want more tailored advice for your situation, you are welcome to consult one of the team via video call - you can read more about it here: www.treatmyachilles.com/
Hey I love your videos! I'm a marathon runner and usually run 70km per week, have been for months now. I had a normal run week, did a park run sprint and then was on a long road trip sitting in a car for up to 9hrs. The next day I had excruciating pain in my left Achilles. The pain has improved and to be honest I haven't stopped running as it feels good when I run. I do have a 'rubbing' sensation when I do calf raises and the tendon feels very hard. Have you had patients with this sensation before?
Yes, those are all signs of Achilles tendinopathy or tendonitis. It is typical for the tendon during the early stages to feel better with exercise but then often more uncomfortable later - I've discussed it in more detail in this video: th-cam.com/video/cNOxd3w37K0/w-d-xo.html
So a question I have is you talk about high load exercises vs. low load exercises (high volume but low weight), do you do a mixture of both? Would you have somebody do a high load (low volume high weight) session twice a week but also do low load daily?
Yes, for some patients we do that because it makes them feel more comfortable. But not everyone tolerates that protocol - some people do better just doing the high load twice a week and then doing other activities like walking or swimming or cycling on other days
About doing the load exercises should we do it in the end of the day and then go to bed to rest , because doing it... let's say, in the morning and then go to work and walk etc can aggravate? And then in the next day if we feel pain we can't really say if it was the load exercise itself or if I just walked to much
If you feel pain the next day it means that the total load (exercises + walking) was too much the previous day. It does not matter what time of day you do the exercises because the load is added together. So you have to reduce either your walking or the exercises or both a little until you find the correct balance.
Hi Marika...how often do you recommend icing the tendon? Upon rising, after walking, or just throughout the day? I have been putting my foot I to the cold swimming pool . But because of inflammation I never use heat. Is that ok? Thanks so much...
Icing is actually not something we recommend to do routinely. I find that using gentle movements work better first thing in the morning to get the tendon going and then during the day using the right shoes and load management. If a patient do have to ice for pain management, it is usually only twice a day but there is no best time - it depends on when then feel they need it. I've discussed ice and heat in this video: th-cam.com/video/WXRbl7XZG50/w-d-xo.html
I have had pain for a decade, and it has slowly increased. I am a waiter 5 days a week, so reduced load really isnt an option. I started cycling, and that seems to be helping, but I gotta do much more with the calf raises. Its definitely insertional tendonitis too.
Thanks for sharing. Here's our article with some tips for people whose job makes it difficult for them to reduce the load on their tendon. www.treatmyachilles.com/post/achilles-tendonitis-rehab-what-if-you-can-t-rest-your-tendon
Hello, thank you for this informative video! I've had insertional Achilles tendonitis for just under 2 weeks now. My range of motion and dorsiflexion is terrible at this stage, so much so that I can't attempt these stretches, even isometric, without severe pain. I cannot even keep my feet parallel and pain free without my affected foot having its heel completely raised off the ground. What would you recommend I do to get to a place where I can do these stretches without any pain? For now I'm using the RICE method, taking NSAIDs, and using crutches to not put any extra load on the tendon when I attempt to walk, but otherwise feel like a sitting duck. Any advice is appreciated, thank you!
Cases like yours usually does best with a individualized approach to rehab where the exercises are adapted to what suits you. It also sounds as if you can benefit from wearing shoes that have a raised heel + heel lift inserts - Alison discusses them here: th-cam.com/video/crzrN0KseWg/w-d-xo.html If you wanted help with figuring out your rehab and getting back to your normal activities, this is something that our team of physios can help you with via video call. You can read more about how the online consultations work here: www.treatmyachilles.com/
I am doing 50 kg (110 lbs) 1 leg bench press. I am not sure if it's too much to start with. the pain level the next day stays the same (sore to touch). insertional achilles tendonitis - self diagnose
The rule for rehab and any activity when recovering from this injury is usually that it is OK to do as long as: 1. It doesn't cause a significant increase in your symptoms during or in the 24 hours after the workout or activity 2. And any increased pain or discomfort should settle within about 24 hours
"At low rates of loading, tendons are more viscous or ductile and, consequently, can absorb more energy compared to high loading rates. At high rates of loading, tendons become more brittle and absorb less energy, but they are more effective at transferring loads.Therefore, tendon load can be increased in 2 ways when prescribing exercise: by the external load or by the speed of movement" How do I make sure I'm not starting with way too much of a weight for it to be built viscous ductile?
Sever Achilles insertional tendonitis can be recovered totally? If I do the physiotherapy shown in the video, approximately how many days it will take to recover? after recovery can I start running?
It's not possible to know what is right for your case without assessing you. The exercises has to be tailored to your specific case and severity - otherwise they can make your pain worse. If you wanted tailored rehab advice and help with getting back to your normal activities, this is something that our team of physios can help you with via video call. You can read more about how the online consultations work here: www.treatmyachilles.com
Hi. Do you think it is too risky to shadow box on my toes during the recovery period after Achilles tendonitis? It has been 2 months and I have no pain unless I climb stairs at a fast pace.
I understand the rehab part, but what about normal walking around causing pain and being stiff throughout the day while at work and at home? Unfortunately I can’t rest as much as I would like.
Not sure if you will see my other comment, so also leaving it here: It can really help to change to a shoe with a small heel on it or place heel lifting inserts into your shoes to take the strain off your Achilles while you walk. This video explains about it: th-cam.com/video/crzrN0KseWg/w-d-xo.html Maybe you can also benefit from this video where I summarize the best treatment options: th-cam.com/video/H1nfgU1amvg/w-d-xo.html If you wanted help figuring it out, this is something that our team of physios can help you with via video call. You can read more about how the online consultations work here: www.treatmyachilles.com/
Hormonal yes - Menopause causes issues: th-cam.com/video/nhsErPtAVz0/w-d-xo.html I also recently found an article that showed that testosterone replacement therapy may increase risk of tendon injuries but I've not had time to review it properly.
Hi, i had broken my fibula 10weeks ago..now it's already healed and the doctor told me that i can begin with walking.. my ankle is stif and i try all your exercise and my ankle is getting a little looser. My question is. Is it normal that my ankle is still swollen. Thank you for your videos.
Yes, ankles can swell for several months after a fracture - these exercises are for Achilles tendonitis so they may not actually be enough or correct ones for your fractures ankle. I would suggest you get a correct rehab plan from a physio.
I have started doing rehab exercises and my tendon feels stronger. However the more calf raises and isometric exercises I do the more then left Achilles tendon (the injured one) feels how I would describe as stiff, rigid and fluidy (there’s a weird sensation which feels like a build up of fluid) There’s no pain other than mild discomfort. Should I keep doing exercises or stop until tendon is no longer thicker and stiffer than the other? Thanks
It is difficult to advise without actually assessing you but here are 2 thoughts that spring to mind: 1. No, you should not wait for the tendon to be the same as the other before doing exercise because it is the exercises that will get it to be the same 2. However, to be helpful the exercises should be pitched at the right level for your tendon and it sounds as if yours may be a bit too much (either how often you do them, or how many, or with how much weight) so I do think you likely need to adjust your rehab programme to be less intense or perhaps follow a different patter. So I would suggest that you book a review with your physio to have it assessed and adjusted. Creating plans are not an exact science and they have to be adjusted according to how the tendon reacts. If you wanted more specific rehab advice and help with getting back to your normal activities, this is something that our team of physios can help you with via video call. You can read more about how the online consultations work here: www.treatmyachilles.com/
Thank you for great videos. I thought I had typical symptoms of achilles tendonitis (from sudden increase of running). During last run slight pain in achilles tendon. Next day I can felt quite bug pain even when walking (in mid-portion area - in the middle to the inner part of tendon). But tendon is not painful on pressing and it is OK in the morning and it is getting worse with more load during the day. It is very painfull during heel rises. Could it be something else than achilles tendonitis?
@@TreatMyAchilles Thank you for response :-) So for those who might be interested. Ultrasound scan showed small achilles tendonitis. So if it's caught early, it can probably show these symptoms. Recommendation from doctor is rest and 8x ultra sound treatment. I will apply relative rest and slowly start with proggresive loading with excercises from your videos.
@@TreatMyAchilles That is an excellent vlog on the basics of retrocalcaneal bursa. So there is really no exercises to help it along, but I understand. What are your thought about PRP injections for the bursa? Seems like it would be much safer than cortisone.
As far as I know PRP is used for regenerating things that don't want to heal (kickstarts healing process) but with bursitis it is usually chronic inflammation that is the problem so I am not sure it will be of much use. However, I am not an expert on PRP so best to ask this question to a doctor who is.
This video contains lots of different exercises and some of them will be safe and others not. It is usually safe to start calf raises while your Achilles is still swollen but they have to be at the correct level for your current strength which can only be established through getting you do movement tests and also listening to how your tendon reacts to normal daily tasks. So it is always best to have your exercises prescribed by a physio or similar who has assessed you. If you wanted more specific rehab advice and help with getting back to your normal activities, this is something that our team of physios can help you with via video call. You can read more about how the online consultations work here: www.treatmyachilles.com/
I've had Achilles Tendonopathy for about 16 months. I've progressed definately (considering walking even 50M seems like HELL at first). I stopped doing Alfredson's Protocol and am doing one leg heel raise/drop (with 12.5kg of weight, am able to tolerate it with a pain level of 2 out of 10). However, when I tried to go up to 15kg of weight it got me a flare up so I rested for about a week and it seemed fine again. Than I tried slowly to work it up to 15kg again but the flare up comes back again. Should I just stop attempting to go to 15kg of weight? (I'm about 75kg male). I can currently also do one legged hopping on injured leg for 20 reps with just a niggle. I want to able to safely return to running but I felt like it would be neccesary to be able to do heel raise/drop with 25% of my weight added before doing so. Also does colder climate make the pain feel worse? I feel like I get more flare up in winter than in warmer seasons.
There are plenty of different ways to get back to running and the 20% target doesn't work for everyone. It sounds like you already have a pretty strong Achilles but that it gets sensitive when you load it heavy. 1. It may be that yours does better from this point by simply easing slowly back into sport 2. or it may be that you need to simply spend a lot more time working on using 12.5kg 3. or that you should perhaps start with a lot fewer reps when going to 15kg. 4. Or another option is to switch to doing more plyometric exercises instead. 5. It may also be that you are simply trying too hard with the exercises and forcing it too low over the step etc. hence annoying it. Hope those options give you some ideas to try. If you want more specific rehab advice and help with getting back to your normal activities, this is something that our team of physios can assess and help you with via video call. You can read more about how the online consultations work here: www.treatmyachilles.com/treatment-packages
To give you an example - my colleague Steph also found the high load stuff just made hers worse - here's how she managed the final part of getting back to running www.treatmyachilles.com/post/i-treated-hundreds-of-patients-for-a-painful-achilles-and-then-it-happened-to-me
For Achilles the pain has to be on the Achilles tendon - it can also refer into the soleus but if the tendon is not painful when pressed or squeezed it is likely not going to be the Achilles. Remember to compare it to the other leg because squeezing the tendon is usually a bit tender - so check how it feels compared to the uninjured side. But the only way to know for sure is to have a scan - ultrasound is usually good
One thing I haven't seen touched on: are squats and deadlifts dangerous to the tendon? I'd like to keep strength training while I've cut running to stay somewhat in shape, but I don't want to risk setting myself back. My guess is that squats could potentially irritate my insertional tendonitis, since the knees go out over the toes at bottom. Deadlifts I'm not sure about.
My Achilles tendon is really sore after doing 6 mile walks. I’ve started strengthening exercises but they are really sore, is this normal? I’m not sure if I’m doing the right thing or not. I’m still waiting for a physio appointment….I am in the UK so getting a physio appointment will be months away. Thanks…I walk a lot and I don’t know what to do to get this better.
Sounds like you're likely overdoing your strength exercises - if they are not pitched at the correct level, they aren't useful. They should not cause pain while doing them. This video may have more appropriate advice: th-cam.com/video/2str9FtRTKc/w-d-xo.html If you want more specific rehab advice and help with getting back to your normal activities, this is something that our team of physios can help you with via video call. You can read more about how the online consultations work here: www.treatmyachilles.com
That's why, when we set targets for our patients' rehab exercises we use % of bodyweight. So we will for instance get them to strengthen until they can do their exercises with a weight that is equal to 10% of their bodyweight (that would be 6kg for a person who weighs 60kg and 10kg for a person who weighs 100kg) but their targets are also influenced by the type of sport they want to get back to.
I wake up with no pain in my achillis, then when i walk a little I feel some burning. Then when I sit I feel like it settles down. Is this a good time to start strength training on it ?
I think you first need to get it properly diagnosed because what you are describing does not sound like typical Achilles tendonitis/tendinopathy symptoms. It sounds more like a nerve that is irritated.
How is your achilles? Was it nerve? I think that I have the same problem. Tendon is OK in the morning, pain while walking, which settles down. But my injury occured at the end of run (mild pain, which was worse the day after)
Great video and channel! I'll make my story brief: I'm 37, I am a tennis player and I've been dealing with my left achilles for 2 years now. I've been doing physiotherapy, heel raising exercises and I got it to a point where I can play again an average of 10hrs a week without any pain. My problem though, is that the affected area is still pretty sensitive at touch and I'm scared to get it worse again, do you have any suggestions? I've been using a massage gun in the last month as well but it doesn't help too much. Thanks for your time!
In my experience that extra sensitivity when you touch it remains for long after it has healed - it is not related to the injury but actually just a hangover from it - if you can play tennis for 10 hours your Achilles is strong and there is truly no reason to worry about it. I often have to tell patients to stop poking their tendons because it just makes you anxious and the more anxious your become the longer it will stay sensitive for - it's related to this video about how pain is created: th-cam.com/video/FAKBWWYUfqU/w-d-xo.html
Thanks very much for this valuable information! Quick question, will the lump/nodule on my achillies which is painful when pressed ever dissapear with rehab or is it permanent? Thanks
I am 14 years old. and I injured my achilles tendon playing soccer. I haven't played football for 5 months. I used to go to physical therapy and the pain decreased. now I'm just resting my achilles tendon. I still feel pain in my achilles tendon, but it doesn't hurt too much. when will I return to football and will I be allowed to play football?
Hi Jole, Unfortunately it is not possible to tell when someone can return to playing their sport without having done an in-depth assessment of their injury and surrounding circumstances.
That likely means that you are trying calf raises that are too hard or in a too aggravating position for it. Test what it does if you do only 3x8 of double heel raises in shoes (with heels on them like trainer). If that causes pain reduce it for next test. If it is OK either stick to that for another session or start to slowly increase it. You have to start really easy to find the lower baseline of what it wants to do.
👉 A set of hand weights will enable you to gradually increase the difficulty of your Achilles rehab exercises: geni.us/BUZ3ZKB
If you buy anything via this link, we may get a small commission at no extra cost to you.
I heard my Achilles with cycling I have rested for 3 weeks was at the physio 2 times I ride today but still the pain is there in the Achilles
Such a helpful video! I had three physio sessions with a highly recommend physio in my area, and all they did was rub deep heat on my foot for 15mins each time 🤦♀️ I’ve learned so much more from your videos than from any practitioner I’ve actually paid good money to get help from. Thank you!
Glad it was helpful!
Your level of description is awesome; it gives me the understanding to enable me to make adjustments to your recommendations based on my own body.
This is by far the best and most nuanced guide I have stumbled across. My Achilles rehab is now on track again. The goal is to once again conquer the Ironman distance. Not this year and probably not even next year but 2026 🙂
Thanks for watching, and good luck with your recovery!
you did the best video about this!
I suffer from pains on the back of my heel in some 'random' morning or after some sleeps. It hurts when walking and especially when standing with heel lifted. It takes one or several says to disappear itself. Stranglely I notice that most of the time it heals or at least feels much better after I play table tennis. When searching for explanations on the internet, I came across your videos and now everything makes sense! I am just now following the very first few exercises here and the pain has significantly reduced. Thank you!
You're welcome, and good luck with your recovery!
Extremely informative this is EXACTLY what my physio is doing with me. I am coming up for a year in rehab and just starting to slowly build up the running miles. The biggest thing I have noticed is Achilles tendonitis rehab takes time, patients and persistence!
Your videos are exceptional! I'm so happy I came across these. I had flat foot reconstruction surgery a few years ago which included an Achilles lengthening. My right foot feels great but my left Achilles has been sore ever since 17 months after my surgery. I recently found out I have mild tendenosis. I'm going to talk to my podiatrist this week to understand what needs to happen moving forward, I'm just concerned about living with pain permanently. Unfortunately there isnt as much information on TH-cam about tendonosis as there is about tendonitis. Im going to use your tips and hopefully my Achilles will make a turn around.
The terms tendonosis, tendonitis and tendinopathy all refer to the same thing - it really is just a matter of scientists not agreeing about the finer details about the amount of inflammation involved - we discussed the different terms in detail in this article: www.treatmyachilles.com/post/what-s-the-difference-between-achilles-tendonitis-tendinosis-tendinopathy-and-tendinitis
This is really helpful. I have suffered with multiple Achilles tendonitis over the last couple of years when I started running. I only did calf raises but when I stopped doing it, I was back with the pain...Now I want to sign up for a more structured rehab and need guidance like this. I am ready to give 6 months to this and control my addiction to run long distances as this rehab should help me to be a better runner in the long run
Hi Sujoy,
If you need help with this, you are welcome to book a video consultation with one of our physiotherapists, who can do an assessment of your injury and provide you with a personalised rehab plan. More info: www.treatmyachilles.com/
Absolutely incredible explanation, Maryke. Thank you so much for all this incredible and sound advice. I feel like you've answered so many questions of mine in such a clear and methodical way. There is hope after all!
Glad it was helpful!
This information has been so very helpful. I just spent a month in a soft cast do to my severe tendonitis. I am 50 years old and I am a dance instructor. I did well without the boot for a week and ended up having to do a lot of walking and set myself back. I'm very scared that I'm never going to be without pain and will always be walking weird, not being able to go back to dancing.
Going to watch the menopause video next!
Hello Tina I am telling you in all sincerity to completely cure your problem you need shockwave therapy it works 100% everytime everything else is fluf I feel when it comes to this problem 3 sessions once weekly from a physio that has the machine , google shockwave therapy and achilles tendonitis good luck
I hope you are better now? I love dancing, I'm 51 and a doctor mindlessly prescribed Levofloxacin which caused me tendonitis. It's one month ago and I'm still working through it (had before all this paid for a walking holiday so was worried how that will work) but ! I'm hopeful 🙏
An excellent and informative video, as suffering from both Achilles and plantar facia pain I have come to realise how weak my calves and ankles/feet are, even though I do a lot of cycling it just doesn't load them the same. So recently when I started do lots more walking / jogging these issues flared up as without doubt I didn't have the capacity within them to take these extra new loads. So now 5 steps backwards and following the advice laid out here to strengthen those calves and tendons and have the patience and commitment that is outlined to see this through, no quick fix here especially as I am a 68 year old male and the body just doesn't heal / recover like it used to.
Thanks for sharing, and good luck with your recovery!
This woman is amazingly gifted at explaining things! Extremely helpful. Many thanks!
Glad it was helpful!
So many videos on this subject! Barely any go into depth on what to do. This video is awesome!! Covers all the 'in depth' information that is needed. Best video out there!! I wish you were located here in Arizona then I would come to do therapy there! Thank you Maryke!! Skal!
You're welcome!
This is an unbelievable video, as are the others of yours I’ve just watched. Thank you so much!
You're welcome!
This is the real deal. Thorough, practical, and accurate. Thanks Maryke, Kevin and TMY
You're very welcome!
You were big help in my Achilles tx. I agree with everything you say.
Thank you. Very useful. I’m recuperating from Achilles tendinitis. Glad I found these tools this tine around. When physical therapy isn’t available at the moment, this guidance and support is appreciated.
This video is what my doctor should have ordered! After not being helped very much by a variety of doctors in my HMO, I stumbled across your video. You gave me hope and a way forward toward returning to my gentle hiking activities. Yosemite, here I come in a few months! 🏞 Thanks so much for the super excellent video!
Glad it was helpful!
Thanks!
Thank you so much for your support.
Hello, back in February of this year, I got my first ever achilles tendonitis injury on my right foot (90% positive it's mid portion). I was in that limbo of taking 2-3 days off, trying to run again, and then pain would come back. Eventually, I took 6 weeks off after this, where I also learned the importance of eccentric heel drops. After 12 weeks, I finally began running again, but it was a slow return to running. I will say, I never incorporated weights SPECIFICALLY into my ECCENTRIC HEEL DROPS, but I kept up with my other lifts as normal.
Now in November, just 4 weeks out from a marathon, I got injured again. I pretty much stopped all eccentric heel drops 5 weeks before this, since I was feeling good and felt that I didn't need to do any more heel drops, but I kept up with my core sessions (x4 weekly) and strength training (x2 weekly), where during my strength training sessions, I would do weighted calf raises off the ground (two 25 lb dumbbells). Did I get injured again because I stopped doing all of these heel drops? Should I have kept up with it 2-3 times a week at the very least, or is it because I never incorporated weights specifically for eccentrics into my first rehab program? Any insight you have would be greatly appreciated.
Hi there,
We cannot provide individual treatment advice without doing an in-depth assessment of your injury and your personal circumstances, as the advice might not be appropriate for you. You're welcome to book a video consultation with one of our physios if you would like an assessment and a personalised treatment plan: www.treatmyachilles.com/
Thank you so much for your great video. You break everything down and explain it so well. I'll use these to help my current injury.
You're welcome, and good luck with your recovery!
Wow, just what I was looking for. Thankyou 🙌 and such a well put together and paced video 👏👏
So glad!
Thank you so much, this has been incredibly informative and helpful
Glad it was helpful!
Two Main questions I have. I am 100% confident that I have tendinopathy in my left heel. We just got back from a two week vacation on Hawaiian Beaches and did a ton of sand walking as well as many many miles of walking on sandals everyday. Combine that with coming home to a vigourous couple of hours of pickle ball last night, and this morning almost could not get down the stairs with it being highly irritated and very tender to touch the attachment point of my heel. My question is at what point should I start doing heel and calf raises to rehab at? And my second question is is the fact that I have tendinopathy increase the likelihood of a possible tear or rupture of my Achilles ? I have watched well over an hour of your videos, and they are absolutely outstanding, as all these other commenters have expressed. Thank you so very much for having this outstanding information online for us to assess our issues.
Tendinopathy goes through stages - it sounds like you're in the reactive phase which (if you've never had tendon pain there before) means that your tendon is acutely irritated. If you allow it to properly settle down, it will usually recover relatively quickly and you have no real risk of rupture. However, if you continue to irritate it and it starts dragging on for several months, then it enters a disrepair and eventually degeneration phase where the tendon starts to lose strength - then you have an increased risk of rupture.
In your case, you don't yet need rehab exercises - you need to let it rest first and then start with super gentle moves.
If you want help with getting back to your normal activities, this is something that our team of physios can assess and help you with via video call. You can read more about how the online consultations work here: www.treatmyachilles.com/treatment-packages
Excellent video.
Thanks for the visit
Please tell me about insertional Achilles tendon pain exercises
She did
th-cam.com/video/mWUzsQILzWA/w-d-xo.html
Maryke, this was such a HELPFUL video. Thank you so much for your very clear explanations.
Glad it was helpful!
Thank you for a great video!
You're welcome!
Tore my right Achilles while playing basketball back in 1994...long recovery and okay, but now in 2024 my LEFT Achilles has begun to ache. I use gentle tape on it and it doesn't hurt much;I use Tiger Balm also and antibiotic ointment along with ice once a day. Has hurt less, but what long-term solution is there since I am much older now (but still in good shape via cycling)? have appointment with a foot/ankle Dr in s few weeks...am +65 years old. Good video! Major props.
very nice explained !!!
Thanks!
Maryka, this video is very helpful and well done, as all of your videos are! You and your team are outstanding in your knowledge and approach to Achilles tendonopathy. I have been working with Kevin for the last couple months, he is wonderful and he has me well on the road to recovery. Thanks to you, Kevin, and your organization for all you do to help.
Thank you! x
Such amazing information. This is a life saver! Thank you!
So glad!
Excellent video, full of very useful information,clear explanation and links. Thank you Maryke!
You are welcome!
Brilliant!!!!
Thank you very impressed!
Excellent advice
Glad you think so!
Excellent video! Really informative. Thank you.
Very welcome!
Really like all the information on your video. My MRI impression is thickening of the mid Achilles tendon compatible with tendinnosis. Would these exercises work for me? And would like to go back to low impact easy flowing movement. Thank you.
I discuss all the types of exercises that one can do in this video, so I can't tell which ones can work for you because it will depend on how sensitive your tendon is, how strong it is and how it reacts to specific movements.
clear information, very useful!
Glad to hear that!
THANK YOU SOO VERY MUCH FOR THIS VIDEO AND THANK GOD FOR YOU PEOPLE HELPING ME WITH GIVING ME PEACE OF MIND I GOT HURT WITH MY ACHILLES TENDONITIS FROM A VERY CLOSE VAIN EXPLODED I HAD TO STOP THE BLOOD FROM SHOOTING OUT ACROSS THE ROOM 😢 OR BLEEDING TO DEATH I PINCH MY TENDONITIS AND DID NOT HAVE SURGERY YET A DOCTOR SAID JUST CUT THE STRANDS OFF AND YOU WILL HAVE A LIMP BUT I KNEW THAT WAS NOT THE ANSWER I WANTED SO IM BEEN NURCEING MY SELF BACK WITH THE HELP OF MY WIFE SO FAR SO GOOD BUT THE PAIN IS UNBELIEVABLE
Thank u soooo much Maryke for this informative and detailed session to cure the achilles tendonitis. How many sets should i be doing it durung a day?
Don't know - it depends on your Achilles's stage of recovery and tolerance to load and what type of exercises you are doing or what the goal of the session is.
Very thorough video thanks
Very welcome
Great information, but nobody talks about the role of the calf muscle in potentially causing Achilles tendonitis. I had levoquin antibiiotic two years ago and started having Achilles pain a little more than a year ago. But during the whole time I was dealing with tight calf muscles that I couldnt seem to restore to a normal state of relaxation. Could the levoquin cause the tight calves, which then causes the Achilles problems? As an engineer, it seems to me that the only thing that can act on the Achilles is the calf muscle. Therefore, why is there not more attention to the muscle and how to restore regular elasticity?
This has actually been investigated and tight calf muscles is not something that has been found to contribute to this condition - it is more that they are a symptom warning that something else is going on and the calf and Achilles are not in good condition. However, research studies report on large cohorts and it is not to say that your case is different - it might well be that the levoquin caused a change in your muscle tissue because it seems to affect all tissues.
Thanks for your help!@@TreatMyAchilles
I have insertional achilles tendinitis for many years.
Thank you for this complete guide, my question is :
Some times I have pain in the tendinit region and in its vicinity, but some times it burns, only tendinit, a very small reginon for several minutes.
Do these two indicates the same thing ?
The pain comes the next day after an intense exercie and stands a long time.
The burning seems to be random and not stands very long time, I put ice on it.
If the tendinit point burns the next day of an exercise, should I reduce the intensity of the exercise as in the case of pain ?
The rule with rehab and exercise is usually that it is OK to do as long as:
1. It only causes a slight discomfort while doing it, AND
2. It does not cause an increase in your pain and swelling that lasts for more than 24 hours
So if your tendon pain is still increased above normal 24 hours after the session then perhaps you need to make it a bit easier.
The other thing to keep in mind is that when you've had pain for more than 3 months, the body starts getting good at creating pain for no reason - it becomes oversensitive. So the random burning that only lasts for a few minutes likely falls into that category of pain that doesn't really mean anything but is just being caused because the system is oversensitive. How you react to it sounds fine.
Great video, thanks! Do you have any recommendations that are scientifically based for how to reduce the thickness of a tendon that has tendinitis?
The thickness is caused by the change in the structure of the tendon - the evidence for whether you can turn the structural change around is contradictory with some studies showing you may be able to and others showing not really. As for how to turn it around - the treatments that can affect healing include relative rest, strength training, perhaps PRP (although evidence still not very strong), and all of this applied over a long enough period - several months rather than weeks. You can find a summary of the treatments supported by research here: th-cam.com/video/H1nfgU1amvg/w-d-xo.html and a discussion about how the tendon is affected structurally here under the symptoms chapter: th-cam.com/video/cNOxd3w37K0/w-d-xo.html
@@TreatMyAchilles Very helpful. Thank you!
@@TreatMyAchilles Thank you! If the thickening remains, is there evidence that this impacts athletic performance adversely?
Thank you so much for sharing this information . I REALLY want to do these rehab movements but it 'feels' so counterproductive to train something that seems injured. So say there are some tendon micro tears causing pain, the concern is it will get worse. Am I the only one that thinks like this?
There isn't any microtears when you have tendonitis - that's nonsense people tell you on the internet - I've made a video where I explain this: th-cam.com/video/wbA1BtvBUmA/w-d-xo.html
But if you're still worried about this, perhaps consulting one of our team can help - our team of physios can assess you and provide a rehab plan via video call. You can read more about how the online consultations work here: www.treatmyachilles.com
Great video! I weight 60KG, what weight do you recommend i do my single leg heel raises with please?
That will depend on your tendon's tolerance and what activities you want to get back to and what type of rehab plan you are following. It is usually best to start with no weight and then slowly build it up. If you're a runner we usually build it up to at least 20% of your bodyweight e.g. 12kg in your case but it depends - if we've found that a more high load plan is better then you may be working at a 8 rep max (so a weight that fatigues your within 8 reps), but building to that over 12 weeks and starting only with 15 rep max during initial weeks - it really just depends on how your tendon is responding to different approaches.
Really great advice, thank you
You're welcome!
Hi Marika, wow what informative information you’ve provided ! So I have “Insertional Calcification tendinosis of the Achilles tendon. The Proximal Achilles tendon demonstrates loss of tendon fibres striation suggestive of degeneration or partial tear.
Mild distension of the retrocalcaneal Bursa, measuring 2 x 4 mm. Does this info suggest miner or serious injury……. Playing paddle ball 🙈many Thanks
It means that it likely:
1. Doesn't like being stretched and will feel worse if you walk around in flat shoes or barefoot
2. You may be at increased risk of tearing it further if you play sports that involve quick movements like paddle ball because it may not be strong enough to handle it.
So, make sure you strengthen it properly before going back to paddle ball.
Good review. I had the bad luck in having a hematoma along with calcific tendonitis (not sure if there was a connection, or how!), but definitely lost some strength in my right calf. We are conservatively treating the hematoma with compression, and I am seeing a PT next week, but have been doing the eccentric heel raises... Have you ever seen these two things happen simultaneously?
Hematomas can cause calcifications in muscles but I am not sure about tendons - it's not something that I've come across but I think it is just more rare to get a hematoma in a tendon. We generally knock or hit our muscles.
Thank you for your reply- the hematoma is in the medial head of the gastrocnemius, but it happened as I was dealing with the tendonosis, I wonder if I overdid my rehab for the tendon issue and caused the hematoma. Makes the rehab a little more tricky!
Should you use compression/compression socks and at what point in rehab? Compression is about increasing blood flow, right? Which is needed to heal?
Hi there,
Here are two videos of ours that may answer your questions:
Compression socks: th-cam.com/video/CJm5wynYdS0/w-d-xo.html
Blood flow: th-cam.com/video/lh0IBZmq7kk/w-d-xo.html
Hope it helps!
Thank you very much!
Welcome!
Great video! Question: you mention 12-24 weeks to even a year. I’ve dealt with insertional tendonitis before that was manageable during American football season by heel wedges, warming up, and ibuprofen., plus rehabbing during the season. Rest after was necessary but I never had to stop all running for 12-24 weeks to heal.
Is this healthy or was I putting myself in high danger of a rupture? I’m now getting the same pain from recreational basketball. Have taken two weeks off with rehab and hoping to reintroduce with wedges, cushier shoes, continued strength training, and less total playing.
Give it a go or stay shut down for 12+ weeks no matter what?
I do not want to lose all my sport specific conditioning and skills.
It sounds like you managed your insertional tendinopathy very well. It is absolutely fine to keep as active as possible as long as your symptoms are improving over time and you don't find the sport you do is aggravating it further. The rule with rehab and exercise is usually that it is OK to do as long as:
1. It only causes a slight discomfort while doing it, AND
2. It does not cause an increase in your pain and swelling that lasts for more than 24 hours
It is only when you continue to aggravate it to a level that it hurts more for several days and just push through pain while training etc. that you end up increasing risk of tearing.
@@TreatMyAchilles thank you so much! What I find is more than a little but not a lot of pain when I play, but by 24 hours it is back to just discomfort. So I think I need to take some time off but probably can ease back in as you say. Thank you again!
Very helpful!
Very helpful. Thanks
Glad it was helpful!
I couldn't find the link for more information about the insertional Achilles Tendonitis. Is it in the comments?
It's in the video's Description, but here it is for you: th-cam.com/video/mWUzsQILzWA/w-d-xo.html
I can't access your website, how could I get an online appointment?
I'm sorry that you couldn't access our website. Could you please try again? www.treatmyachilles.com/
Yes, very useful video, thanks for it. But also i have a question. I have problem with that parts only while i stand for a long time in my work, on the other hand i can easly walk 15k or more steps and dont feel any pain. So on which part of exercise i must focus on? Thanks
I would look first at what shoes you wear for work and if you can change them to be more like your shoes that you can walk in. Placing heel lifts in may help th-cam.com/video/crzrN0KseWg/w-d-xo.html
Is it OK to do Pilates with Achillies rehabilitation? Thank you
It is, but you need to avoid the positions that stretch or work the tendon - Ali has just made a video about how to adapt yoga poses that will be released early in March and the same concepts apply to Pilates as well.
Hi Maryke, amazing helpful video, best among what I search 😊👍 Can I ask, how long should I wait for my tendons to recover from exercises if my tendon pain stated after using 3 pills of ciprofloxacine?
It really depends on how your body reacts so go on what you observe but often in case of Cipro it is best to only train x2 a week with x2 days between sessions. However, it the exercises are still low load, then x3 a week with at least 1 full recovery day can sometimes be OK.
@@TreatMyAchilles Thank you Maryke, I'm so grateful. :)
Wow this is super super helpful. Appreciate your hard work. Love from korea
Glad it was helpful!
Thank you! I'm a runner and I want to have some aerobic trainings while recovering. Is it safe to add cycling (easy intensity)? Can I do it after/before the strength session or it should be a separate day?
It really depends on how sensitive your tendon is - most people with mid-portion Achilles tendonitis are OK with cycling but some cases of inserional tendonitis can get more painful through it. So best is to test a gentle session and see. If it is an easy session and you don't feel that it works your calves much, then you can do it on the same day as your exercises. Although, I would recommend that when you do it the first time, do it on its own, otherwise you wont know if it is the cycling or the exercises that irritate your tendon if it increases pain.
Thanks for all the informations, I've watch most of your videos. I've been struggling with Achilles tendon pain and soreness for 3 months now. As of now, I'm able to do single leg raise with 20% extra body weight, 45 sec jump rope x3 with 2 mins rest and 8 by 3 squat jump at 60-80% effort in a single session fine, and I feel 'relatively' pain free after 24 hrs. I did try getting back to playing basketball at 70% effort while playing 1/3 - 2/3 of my original duration(20- 50 mins actual playing time). I feel a little sore after 24 hours, but my Achilles feels a lot better 48 hrs after my basketball session.
Two questions:
Am I at risk of rupturing my tendon going back too soon with my routine?
I have heard you say pain is a bad assessment on the condition. How do I know how damage is my Achilles is or what stage of the healing process I am at?
It actually sounds as if you're pitching everything at a very good level:
1. Your Achilles is strong if that is the rehab you have built up to = rupture risk is super low, especially since you are sensible with easing into basketball
2. The way your pain is reacting, it is showing us that your pain system is still getting sensitized for 24 hours but that you're actually doing it good because you then feel better. So pain is getting triggered but it is not causing injury.
Bear in mind that I don't know you and your situation fully and my advice may thus not be correct, but I think if you continue at the same level for a couple of weeks and not increase training intensity or frequency too quickly (allow it to settle into it) then you will make a good recovery from here. Try to picture the training load in your rehab session vs. how much your body has to do in your training session - the jump is quite large = why the body will take a bit of time to adapt to it even at 70%.
If you ever did want more tailored advice for your situation, you are welcome to consult one of the team via video call - you can read more about it here: www.treatmyachilles.com/
@@TreatMyAchilles hmmmmm, thanks for the reply and all the work that you guys have done. I will try to reach out. Thank you so much.
Was wonderful thanks❤❤❤❤❤❤❤❤❤❤❤❤❤❤❤❤❤
You're welcome 😊
Hey I love your videos! I'm a marathon runner and usually run 70km per week, have been for months now.
I had a normal run week, did a park run sprint and then was on a long road trip sitting in a car for up to 9hrs. The next day I had excruciating pain in my left Achilles. The pain has improved and to be honest I haven't stopped running as it feels good when I run. I do have a 'rubbing' sensation when I do calf raises and the tendon feels very hard. Have you had patients with this sensation before?
Yes, those are all signs of Achilles tendinopathy or tendonitis. It is typical for the tendon during the early stages to feel better with exercise but then often more uncomfortable later - I've discussed it in more detail in this video: th-cam.com/video/cNOxd3w37K0/w-d-xo.html
So a question I have is you talk about high load exercises vs. low load exercises (high volume but low weight), do you do a mixture of both? Would you have somebody do a high load (low volume high weight) session twice a week but also do low load daily?
Yes, for some patients we do that because it makes them feel more comfortable. But not everyone tolerates that protocol - some people do better just doing the high load twice a week and then doing other activities like walking or swimming or cycling on other days
About doing the load exercises should we do it in the end of the day and then go to bed to rest , because doing it... let's say, in the morning and then go to work and walk etc can aggravate? And then in the next day if we feel pain we can't really say if it was the load exercise itself or if I just walked to much
If you feel pain the next day it means that the total load (exercises + walking) was too much the previous day. It does not matter what time of day you do the exercises because the load is added together. So you have to reduce either your walking or the exercises or both a little until you find the correct balance.
Hi Marika...how often do you recommend icing the tendon? Upon rising, after walking, or just throughout the day? I have been putting my foot I to the cold swimming pool . But because of inflammation I never use heat. Is that ok? Thanks so much...
Icing is actually not something we recommend to do routinely. I find that using gentle movements work better first thing in the morning to get the tendon going and then during the day using the right shoes and load management. If a patient do have to ice for pain management, it is usually only twice a day but there is no best time - it depends on when then feel they need it. I've discussed ice and heat in this video: th-cam.com/video/WXRbl7XZG50/w-d-xo.html
@@TreatMyAchilles Once again thank you so much…such great information that I really appreciate😀
I have had pain for a decade, and it has slowly increased. I am a waiter 5 days a week, so reduced load really isnt an option. I started cycling, and that seems to be helping, but I gotta do much more with the calf raises. Its definitely insertional tendonitis too.
Thanks for sharing. Here's our article with some tips for people whose job makes it difficult for them to reduce the load on their tendon.
www.treatmyachilles.com/post/achilles-tendonitis-rehab-what-if-you-can-t-rest-your-tendon
Wow cycling actually helps? I never would have guessed. Thanks for the tip.
Hello, thank you for this informative video! I've had insertional Achilles tendonitis for just under 2 weeks now. My range of motion and dorsiflexion is terrible at this stage, so much so that I can't attempt these stretches, even isometric, without severe pain. I cannot even keep my feet parallel and pain free without my affected foot having its heel completely raised off the ground. What would you recommend I do to get to a place where I can do these stretches without any pain? For now I'm using the RICE method, taking NSAIDs, and using crutches to not put any extra load on the tendon when I attempt to walk, but otherwise feel like a sitting duck. Any advice is appreciated, thank you!
Cases like yours usually does best with a individualized approach to rehab where the exercises are adapted to what suits you. It also sounds as if you can benefit from wearing shoes that have a raised heel + heel lift inserts - Alison discusses them here: th-cam.com/video/crzrN0KseWg/w-d-xo.html
If you wanted help with figuring out your rehab and getting back to your normal activities, this is something that our team of physios can help you with via video call. You can read more about how the online consultations work here: www.treatmyachilles.com/
I am doing 50 kg (110 lbs) 1 leg bench press.
I am not sure if it's too much to start with. the pain level the next day stays the same (sore to touch).
insertional achilles tendonitis - self diagnose
The rule for rehab and any activity when recovering from this injury is usually that it is OK to do as long as:
1. It doesn't cause a significant increase in your symptoms during or in the 24 hours after the workout or activity
2. And any increased pain or discomfort should settle within about 24 hours
@@TreatMyAchilles Thank you.
"At low rates of loading, tendons are more viscous or ductile and, consequently, can absorb more energy compared to high loading rates. At high rates of loading, tendons become more brittle and absorb less energy, but they are more effective at transferring loads.Therefore, tendon load can be increased in 2 ways when prescribing exercise: by the external load or by the speed of movement"
How do I make sure I'm not starting with way too much of a weight for it to be built viscous ductile?
Sever Achilles insertional tendonitis can be recovered totally? If I do the physiotherapy shown in the video, approximately how many days it will take to recover? after recovery can I start running?
It's not possible to know what is right for your case without assessing you. The exercises has to be tailored to your specific case and severity - otherwise they can make your pain worse.
If you wanted tailored rehab advice and help with getting back to your normal activities, this is something that our team of physios can help you with via video call. You can read more about how the online consultations work here: www.treatmyachilles.com
Hi. Do you think it is too risky to shadow box on my toes during the recovery period after Achilles tendonitis? It has been 2 months and I have no pain unless I climb stairs at a fast pace.
You need to check with your physio because it depends on what you've built up to with your rehab.
I understand the rehab part, but what about normal walking around causing pain and being stiff throughout the day while at work and at home? Unfortunately I can’t rest as much as I would like.
Not sure if you will see my other comment, so also leaving it here:
It can really help to change to a shoe with a small heel on it or place heel lifting inserts into your shoes to take the strain off your Achilles while you walk. This video explains about it: th-cam.com/video/crzrN0KseWg/w-d-xo.html
Maybe you can also benefit from this video where I summarize the best treatment options: th-cam.com/video/H1nfgU1amvg/w-d-xo.html
If you wanted help figuring it out, this is something that our team of physios can help you with via video call. You can read more about how the online consultations work here: www.treatmyachilles.com/
Is there anything nutritional or hormonal that contributes to Achilles tendinitis
Hormonal yes - Menopause causes issues: th-cam.com/video/nhsErPtAVz0/w-d-xo.html
I also recently found an article that showed that testosterone replacement therapy may increase risk of tendon injuries but I've not had time to review it properly.
Hi, i had broken my fibula 10weeks ago..now it's already healed and the doctor told me that i can begin with walking.. my ankle is stif and i try all your exercise and my ankle is getting a little looser. My question is. Is it normal that my ankle is still swollen. Thank you for your videos.
Yes, ankles can swell for several months after a fracture - these exercises are for Achilles tendonitis so they may not actually be enough or correct ones for your fractures ankle. I would suggest you get a correct rehab plan from a physio.
@@TreatMyAchilles thank you for the feedback.
I have started doing rehab exercises and my tendon feels stronger. However the more calf raises and isometric exercises I do the more then left Achilles tendon (the injured one) feels how I would describe as stiff, rigid and fluidy (there’s a weird sensation which feels like a build up of fluid)
There’s no pain other than mild discomfort. Should I keep doing exercises or stop until tendon is no longer thicker and stiffer than the other?
Thanks
It is difficult to advise without actually assessing you but here are 2 thoughts that spring to mind:
1. No, you should not wait for the tendon to be the same as the other before doing exercise because it is the exercises that will get it to be the same
2. However, to be helpful the exercises should be pitched at the right level for your tendon and it sounds as if yours may be a bit too much (either how often you do them, or how many, or with how much weight) so I do think you likely need to adjust your rehab programme to be less intense or perhaps follow a different patter.
So I would suggest that you book a review with your physio to have it assessed and adjusted. Creating plans are not an exact science and they have to be adjusted according to how the tendon reacts.
If you wanted more specific rehab advice and help with getting back to your normal activities, this is something that our team of physios can help you with via video call. You can read more about how the online consultations work here: www.treatmyachilles.com/
@@TreatMyAchilles thank you!
Thank you for great videos. I thought I had typical symptoms of achilles tendonitis (from sudden increase of running). During last run slight pain in achilles tendon. Next day I can felt quite bug pain even when walking (in mid-portion area - in the middle to the inner part of tendon). But tendon is not painful on pressing and it is OK in the morning and it is getting worse with more load during the day. It is very painfull during heel rises.
Could it be something else than achilles tendonitis?
I would get it checked out - it does not sound like a tendinopathy but it may be a partial tear or referred pain from somewhere else.
@@TreatMyAchilles Thank you for response :-) So for those who might be interested. Ultrasound scan showed small achilles tendonitis. So if it's caught early, it can probably show these symptoms. Recommendation from doctor is rest and 8x ultra sound treatment. I will apply relative rest and slowly start with proggresive loading with excercises from your videos.
You are the best
Are this exercises valid for insertional tendinitis where I feel pain on my heels
Hi there,
The treatment for insertional Achilles tendinitis is somewhat different. Here's our video about it: th-cam.com/video/mWUzsQILzWA/w-d-xo.html
Can you use this for Retrocalcaneal bursitis? If not, what would be the modification? Thank you!
Not really - you can find more information about treatment for bursitis here: th-cam.com/video/B1LMKwEZ5mo/w-d-xo.html
@@TreatMyAchilles That is an excellent vlog on the basics of retrocalcaneal bursa. So there is really no exercises to help it along, but I understand. What are your thought about PRP injections for the bursa? Seems like it would be much safer than cortisone.
As far as I know PRP is used for regenerating things that don't want to heal (kickstarts healing process) but with bursitis it is usually chronic inflammation that is the problem so I am not sure it will be of much use. However, I am not an expert on PRP so best to ask this question to a doctor who is.
Is it safe to do these exercises when there is swelling in the achilles tendon?
This video contains lots of different exercises and some of them will be safe and others not. It is usually safe to start calf raises while your Achilles is still swollen but they have to be at the correct level for your current strength which can only be established through getting you do movement tests and also listening to how your tendon reacts to normal daily tasks. So it is always best to have your exercises prescribed by a physio or similar who has assessed you.
If you wanted more specific rehab advice and help with getting back to your normal activities, this is something that our team of physios can help you with via video call. You can read more about how the online consultations work here: www.treatmyachilles.com/
I've had Achilles Tendonopathy for about 16 months. I've progressed definately (considering walking even 50M seems like HELL at first). I stopped doing Alfredson's Protocol and am doing one leg heel raise/drop (with 12.5kg of weight, am able to tolerate it with a pain level of 2 out of 10). However, when I tried to go up to 15kg of weight it got me a flare up so I rested for about a week and it seemed fine again. Than I tried slowly to work it up to 15kg again but the flare up comes back again. Should I just stop attempting to go to 15kg of weight? (I'm about 75kg male). I can currently also do one legged hopping on injured leg for 20 reps with just a niggle. I want to able to safely return to running but I felt like it would be neccesary to be able to do heel raise/drop with 25% of my weight added before doing so. Also does colder climate make the pain feel worse? I feel like I get more flare up in winter than in warmer seasons.
There are plenty of different ways to get back to running and the 20% target doesn't work for everyone. It sounds like you already have a pretty strong Achilles but that it gets sensitive when you load it heavy.
1. It may be that yours does better from this point by simply easing slowly back into sport
2. or it may be that you need to simply spend a lot more time working on using 12.5kg
3. or that you should perhaps start with a lot fewer reps when going to 15kg.
4. Or another option is to switch to doing more plyometric exercises instead.
5. It may also be that you are simply trying too hard with the exercises and forcing it too low over the step etc. hence annoying it.
Hope those options give you some ideas to try. If you want more specific rehab advice and help with getting back to your normal activities, this is something that our team of physios can assess and help you with via video call. You can read more about how the online consultations work here: www.treatmyachilles.com/treatment-packages
To give you an example - my colleague Steph also found the high load stuff just made hers worse - here's how she managed the final part of getting back to running www.treatmyachilles.com/post/i-treated-hundreds-of-patients-for-a-painful-achilles-and-then-it-happened-to-me
Hello I have Tendonitis and Bursitis in the ankle . Is it more difficult having both.
Unfortunately it's not possible to say without knowing which bursa is involved - there are quite a few of them in the ankle.
How do know if it’s Achilles tendinitis or a soleus issue?
For Achilles the pain has to be on the Achilles tendon - it can also refer into the soleus but if the tendon is not painful when pressed or squeezed it is likely not going to be the Achilles. Remember to compare it to the other leg because squeezing the tendon is usually a bit tender - so check how it feels compared to the uninjured side. But the only way to know for sure is to have a scan - ultrasound is usually good
One thing I haven't seen touched on: are squats and deadlifts dangerous to the tendon? I'd like to keep strength training while I've cut running to stay somewhat in shape, but I don't want to risk setting myself back.
My guess is that squats could potentially irritate my insertional tendonitis, since the knees go out over the toes at bottom. Deadlifts I'm not sure about.
Hi there,
Here's our video on squats while having an Achilles tendon injury: th-cam.com/video/gi-tvosxA8g/w-d-xo.html
Thanks!
My Achilles tendon is really sore after doing 6 mile walks. I’ve started strengthening exercises but they are really sore, is this normal? I’m not sure if I’m doing the right thing or not. I’m still waiting for a physio appointment….I am in the UK so getting a physio appointment will be months away. Thanks…I walk a lot and I don’t know what to do to get this better.
Sounds like you're likely overdoing your strength exercises - if they are not pitched at the correct level, they aren't useful. They should not cause pain while doing them. This video may have more appropriate advice: th-cam.com/video/2str9FtRTKc/w-d-xo.html If you want more specific rehab advice and help with getting back to your normal activities, this is something that our team of physios can help you with via video call. You can read more about how the online consultations work here: www.treatmyachilles.com
Nobody ever addresses issues with being obese. When I do the calf raise exercise, I have 100 extra pounds I'm moving. How do I compensate for that?
That's why, when we set targets for our patients' rehab exercises we use % of bodyweight. So we will for instance get them to strengthen until they can do their exercises with a weight that is equal to 10% of their bodyweight (that would be 6kg for a person who weighs 60kg and 10kg for a person who weighs 100kg) but their targets are also influenced by the type of sport they want to get back to.
It's impossible for her to cover everyone's differences. She mentioned seated calf raises with possible addition of weights.
I wake up with no pain in my achillis, then when i walk a little I feel some burning. Then when I sit I feel like it settles down. Is this a good time to start strength training on it ?
I think you first need to get it properly diagnosed because what you are describing does not sound like typical Achilles tendonitis/tendinopathy symptoms. It sounds more like a nerve that is irritated.
How is your achilles? Was it nerve? I think that I have the same problem. Tendon is OK in the morning, pain while walking, which settles down. But my injury occured at the end of run (mild pain, which was worse the day after)
Great video and channel!
I'll make my story brief:
I'm 37, I am a tennis player and I've been dealing with my left achilles for 2 years now. I've been doing physiotherapy, heel raising exercises and I got it to a point where I can play again an average of 10hrs a week without any pain. My problem though, is that the affected area is still pretty sensitive at touch and I'm scared to get it worse again, do you have any suggestions? I've been using a massage gun in the last month as well but it doesn't help too much.
Thanks for your time!
In my experience that extra sensitivity when you touch it remains for long after it has healed - it is not related to the injury but actually just a hangover from it - if you can play tennis for 10 hours your Achilles is strong and there is truly no reason to worry about it. I often have to tell patients to stop poking their tendons because it just makes you anxious and the more anxious your become the longer it will stay sensitive for - it's related to this video about how pain is created: th-cam.com/video/FAKBWWYUfqU/w-d-xo.html
Fantastic,very informative.Obviously a trained professional.But being a NZr ,we will beat SA in the Rugby WC
.😂😂😂😂
Oh you are funny 🤣
Sorry you were saying something about beating SA in the RWC ……….!!😅
Thanks very much for this valuable information! Quick question, will the lump/nodule on my achillies which is painful when pressed ever dissapear with rehab or is it permanent? Thanks
The pain usually disappears but the lump may or may not disappear.
I am 14 years old. and I injured my achilles tendon playing soccer. I haven't played football for 5 months. I used to go to physical therapy and the pain decreased. now I'm just resting my achilles tendon. I still feel pain in my achilles tendon, but it doesn't hurt too much. when will I return to football and will I be allowed to play football?
Hi Jole,
Unfortunately it is not possible to tell when someone can return to playing their sport without having done an in-depth assessment of their injury and surrounding circumstances.
My pain goes through the roof for weeks when I do calf raises. This is depressing. It's like the cure is the cause of aggravating the problem.
That likely means that you are trying calf raises that are too hard or in a too aggravating position for it. Test what it does if you do only 3x8 of double heel raises in shoes (with heels on them like trainer). If that causes pain reduce it for next test. If it is OK either stick to that for another session or start to slowly increase it. You have to start really easy to find the lower baseline of what it wants to do.
Merci !
Thank you for your support!
Great video! Thank you so much
You're very welcome!
Thanks for this video. Very helpful
Glad it was helpful!