Have you ever heard someone say that after they hurt such and such body part that all of a sudden a whole slew of other injuries started?
I hear this all the time, and there is a lot of truth behind it. Especially when it comes to the foot and achilles tendon!
You see the foot is the body’s first line of defense to absorb and transmit force, your achilles tendon plays a major role in this. The foot hits the ground first thing in the morning and with every step you take during the day it must absorb and transmit force. However, when injured this capability becomes impaired.
So what happens when you have achilles pain? The body says “next man up”. Meaning your knee, hip, and back on either side start to take the brunt of the impact. If you do this repetitively, there is a pretty good chance something will start getting a little cranky.
I’ve treated a variety of Achilles injuries. Runners with chronic Achilles pain, partial tears, and post-surgical clients. I can tell you from firsthand experience that individuals who have been dealing with this for a prolonged period of time tend to have other issues as well. Most common tends to be the opposite hip from working overtime, but it could manifest itself in other forms as well.
Often times the problem with these individuals is that they have been performing the same stretches over and over again for months on end without much improvement in symptoms or overall ability because that is what their doctor, PT, or Chiropractor told them to do.
Stretching could be part of the solution. However, chances are if you have not made improvement by now, then that is not the answer. Remember how I said the Achilles tendon's job is to absorb and transmit forces? Well stretching does not necessarily accomplish this mechanism. Think about a rubber band. The more you stretch it, the more it becomes loose and decreases its ability to create force or tension. The same concept applies to your tendons. Don't get me wrong, they need a baseline level of flexibility, but more does not necessarily mean better.
The solution? Creating useful stiffness and strength in the tendon so that it has the resiliency to absorb force all day long when you are walking, going up/down stairs, jogging, or playing a sport.
You have probably seen a calf raise before. This exercise, especially done at particular tempos and angles proves to be effective for a lot of people. However, a lot of times people will have pain with this activity so it makes it really hard to progressively load the tendon.
At On Track Physical Therapy we also utilize a method called blood flow restriction training. This allows us to make strength gains with very low loads of resistance. Research has also shown how it can increase human growth hormone (this hormone has been known to improve tendon recovery).
Another method for pain reduction used is Dry Needling. Which has been shown to improve pain in the short term. Allowing us to effectively strength train the tendon in a more pain free environment.
Finally, if you are an athlete, you need to progressively start including dynamic exercises and drills that will ultimately translate to sport by improving your body’s ability to efficiently transmit forces. Such as the exercises below:
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About the Author: Dr. Greg Schaible is a physical therapist and strength coach specializing in athletic performance. He attended The University of Findlay as a student athlete. As an athlete he competed in both Indoor and Outdoor Track & Field where he earned honors as a 5x Division II All-American and 6x Division II Academic All-American. In 2013 he completed Graduate School earning his Doctorate of Physical Therapy (DPT). Greg is the owner of On Track Physical Therapy in Ann Arbor, Mi. Follow On Track PT and Performance on Facebook.