Change Activity Level Early
A short-term fix is to decrease the amount of the activity that hurts. For example, if playing volleyball three times per week causes the achilles tendon pain to worsen; try playing one to two times per week. This will allow the body to recover more and let you stay in the game. Also, scaling the activity to a less ballistic form may be another strategy as well. So instead of training with box jumps, performing box step ups, or instead of running, opting for a bike substitution. We are all different and no achilles tendon issue is the same and that can be based on a ton of factors. You may not need to change or cut out everything you are doing all at once in order to help yourself. The key is listening to your body.
Consider A Heel Lift for Achilles Tendon Pain
Overloading your achilles is what makes it hurt, so offloading it in the short-term may give you relief and let you get on with your day. Adding a heel lift to your shoe shortens the achilles, which allows your muscle to work less throughout the day. Pretty simple, less work equals a form of less total load leading to less pain with walking. Most heel lifts come with peel away parts as well so you can slowly return the heel to the ground instead of going from some support to nothing.
Load the Achilles Tendon
In order to get back on track you do in fact need to load your achilles tendon in a progressive and safe manner. How do you do that? By working your calf muscles.Heel raises and bent knee heel raises work the muscles that attach to your achilles tendon. If it hurts in the chord part of the tendon, perform them off a step or ledge. If it hurts more towards the back of your heel, perform them from the floor. Rule of thumb, make sure you can walk without pain before getting too crazy on loading the calf complex up. Start simple three sets of ten. You can progress that by adding reps, sets, or even holding a weight. When progressing do not make leaps and bounds (pun intended), changing it up a little is enough.
2 Point Achilles Tendon Pain Rule
A very simple way to guide any activity is the “Two Point Rule.” This guideline keeps you active, but gives an easy way to tell when to stop. As the name implies, you are allowed an increase of two pain points when performing an activity. So if you start your run at a one out of ten on the pain scale and go up to a three out of ten , you need to stop that activity if the pain goes any higher. But, if you were to finish at two out of ten, you did it! The only numbers you should never touch is a five out of ten or more. So if you start some activity at four out of ten you do not have as much wiggle room. The ratings of a four out of ten or below have been shown to be “safe” in managing symptoms while still being active.
Physical Therapy for Relief
Soft tissue work can help manage some of the discomfort as well and should be done. Decreasing your pain will help you get around more normally, which is always a good thing for musculoskeletal injuries. Dry needling, cupping, and soft tissue massage are all interventions that may be beneficial for you! Just remember, managing symptoms and feeling good does not fix the issue. A tendon problem calls for tendon loading along with these interventions.
Rest Versus Stretch
Resting and stretching are all okay to some extent. But the saying, “Movement is medicine,” really takes the lead with most musculoskeletal injuries, if not all. Stretching should not be first on your list of things to do for this type of injury. Some medical professionals recommend rest as the fix for a tendon strain, but this is poor advice. Staying moving within the guidelines set above will keep you active and get you back to your game sooner rather than later. Too much rest can lead to weakening and no one wants that. Trying to outstretch the pain, or stretch past it, may also just keep it aggravated. Why would you pull on something that is already mad?
When in doubt, Peak Physiotherapy and Performance can help you end achilles tendon pain and get back to doing what you love. Our goal is to help prevent the overuse of medication, injection or surgery,. You can reach us by filling out our contact form or by calling our office at (614) 467-0285.