• Achilles Tendinopathy Rehabilitation (Achilles Tendonitis)

    Eccentric Strengthening

    An eccentric contraction is defined as a contraction where the muscle is lengthening, as opposed to a concentric contraction where the muscle is shortening, or an isometric contraction where there is no change in the muscle length.

    There is nothing magical about eccentric muscle strengthening in the role of alleviating tendon problems. The key is the controlled progression of exercise, which elicits an adaptation in the tendon that produces increased tensile strength. Research has shown that eccentric muscle contractions generate more tension than isometric or concentric contractions and it is often a neglected component of strength training. By using just eccentric work this variable can be controlled.

    It is important to note that the load and number of repetitions must be carefully recorded and progressively increased. This ensures that the overload on the tendon is carefully controlled and gradually the speed of the exercise is increased, making the exercises more sports specific.

    IMPORTANT: These exercises should only be started once the pain has settled. There should be no pain during or following these exercises. These exercises should be carried out under the supervision of a Chartered Physiotherapist.

    Double Leg Calf Raises

    The patient starts with double legged calf raises, thus sharing the load with the ‘good’ leg. The eccentric component is the lowering phase, which should be done slowly.

    Progression Schedule

    Day
    1
    2
    3
    4
    5
    6
    7
    8
    9
    10
    11
    12
    13
    14
    15
    16
    17
    18
    19
    20
    21
    Load
    2 x 6 repetitions
    2 x 8 repetitions
    2 x 10 repetitions
    Rest
    3 x 8 repetitions
    3 x 10 repetitions
    4 x 8 repetitions
    3 x 12 repetitions
    Rest
    4 x 10 repetitions
    4 x 12 repetitions
    4 x 14 repetitions
    4 x 16 repetitions
    Rest
    4 x 18 repetitions
    4 x 20 repetitions
    4 x 22 repetitions
    4 x 24 repetitions
    4 x 26 repetitions
    4 x 28 repetitions
    4 x 30 repetitions

     

     

     

     

     

     

     

     

     

     

     

     

     

    Single Leg Calf Raises

    The progression is to do the exercise on the affected leg and gradually increase
    the load by introducing weights. Then the speed of the exercise is increased.

    Progression Schedule

    Day
    22
    23
    24
    25
    26
    27
    28
    29
    30
    31
    32
    33
    34
    35
    36
    37
    38
    39
    40
    41
    42
    43
    44
    45
    46
    47
    48
    49
    50
    51
    52
    53
    54
    55
    56
    Load
    2 x 6 repetitions
    2 x 8 repetitions
    2 x 10 repetitions
    2 x 10 repetitions
    3 x 8 repetitions
    Rest
    3 x 10 repetitions
    4 x 8 repetitions
    3 x 12 repetitions
    4 x 10 repetitions
    Rest
    4 x 12 repetitions
    4 x 14 repetitions
    4 x 16 repetitions
    4 x 18 repetitions
    4 x 20 repetitions
    Rest
    4 x 22 repetitions
    4 x 24 repetitions
    4 x 26 repetitions
    4 x 28 repetitions
    4 x 30 repetitions
    Rest
    4 x 30 repetitions
    4 x 30 repetitions
    4 x 30 repetitions
    4 x 30 repetitions
    4 x 30 repetitions
    4 x 30 repetitions
    4 x 30 repetitions
    4 x 30 repetitions
    4 x 30 repetitions
    4 x 30 repetitions
    4 x 30 repetitions
    4 x 30 repetitions
    Added Load
    None
    None
    None
    None

    None  
    None
    None
    None

    None  
    None
    None
    None
    None
    None  

    None
    None
    None
    None
    None  

    2 x 2.5kg dumbells
    2 x 2.5kg dumbells
    2 x 2.5kg dumbells
    2 x 5kg dumbells
    2 x 5kg dumbells
    2 x 5kg dumbells
    2 x 7.5kg dumbells
    2 x 7.5kg dumbells
    2 x 7.5kg dumbells
    2 x 10kg dumbells
    2 x 10kg dumbells
    2 x 10kg dumbells
    Speed
    Slow
    Slow
    Slow

    Slow
    Slow  
    Medium
    Medium

    Medium
    Medium  
    Medium
    Medium
    Medium
    Medium

    Medium  
    Medium
    Medium
    Medium
    Medium
    Medium  

    Slow
    Medium
    Fast
    Slow
    Medium
    Fast
    Slow
    Medium
    Fast
    Slow
    Medium
    Fast

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