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Written by: David Burnett, BScH, MScPT, Registered Physiotherapist
(*Best evaluated by a Physiotherapist*)
(*Best evaluated by a Physiotherapist*)
***Note: These are not recipe exercises but rather examples – see your Physiotherapist for an individually tailored, appropriately graded exercise program!
Above table taken from Tom Groom Running Repairs course
Focus will be on tendon loading in a position that limits tendon compression (plantar flexion). These exercises should have an analgesic effect but make sure pain is never above 2-3/10 and settles within 24 hours. Start with 5 sets of 30-45 sec at 70% max voluntary contraction. Repeat as needed throughout the day.
With straight knees, push up onto your toes around mid-range focusing weight through your big toe. Use support if needed initially. Hold for 30-45 sec. Can progress to one leg only.
Place knee against wall with a towel in between. With a bent knee push up onto your toes around mid-range focusing weight through your big toe. Use support if needed initially. Hold for 30-45 sec. Can progress by putting more weight through affected leg.
Focus will be on the eccentric movement and heavy slow load (HSR) meaning exercise will be performed at a slow fatiguing pace – pain never above 2-3/10 and should settle in 24 hrs. Start with 3 sets of 15 max reps (MR). Increase load gradually until 3 sets of 8 max reps (MR) is achieved. Repeat Daily.
Place both feet on the front of a step. With straight knees, push up onto your toes focusing weight through your big toe. Use support if needed initially. Hold for 2-3 sec at the top. Take ‘good’ foot off the step. Slowly lower affected foot to a count of 5 sec.
Similar to a straight leg calf raise but bend your knee to around 30 degrees. Hold for 2-3 sec at the top. Take ‘good’ foot off the step. Slowly lower ‘bad’ foot to a count of 5 sec.
David joined GRSM in July 2016. David graduated with his MScPT from Leeds Beckett University and B.Sc. Biomedical Sciences from the University of Waterloo, while playing for the Warriors Men’s basketball team.
He has been working in hospital and multi-disciplinary clinic environments in the UK since graduating.
Dave previously worked as a Sport and Fitness Director in Sydney, Australia. In his free time, Dave enjoys keeping active through the gym, playing any and all sports and enjoying the outdoors.
Resources
Almonroeder, T., Willson, J. D., & Kernozek, T. W. (2013). The effect of foot strike pattern on Achilles tendon load during running. Annals of Biomedical Engineering, 41(8), 1758-1766.
Beyer, R., Kongsgaard, M., Hougs Kjær, B., Øhlenschlæger, T., Kjær, M., & Magnusson, S. P. (2015). Heavy slow resistance versus eccentric training as treatment for Achilles tendinopathy: a randomized controlled trial. The American journal of sports medicine, 43(7), 1704-1711.
Esculier, J. F., Dubois, B., Bouyer, L. J., McFadyen, B. J., & Roy, J. S. (2017). Footwear characteristics are related to running mechanics in runners with patellofemoral pain. Gait & posture, 54, 144-147.
Lyght, M., Nockerts, M., Kernozek, T. W., & Ragan, R. (2016). Effects of foot strike and step frequency on Achilles tendon stress during running. Journal of applied biomechanics, 32(4), 365-372.
Rice, H., & Patel, M. (2017). Manipulation of foot strike and footwear increases Achilles tendon loading during running. The American journal of sports medicine, 45(10), 2411-2417.
Tam, N., Wilson, J. L. A., Noakes, T. D., & Tucker, R. (2014). Barefoot running: an evaluation of current hypothesis, future research and clinical applications. Br J Sports Med, 48(5), 349-355.
Taunton, J. E., Ryan, M. B., Clement, D. B., McKenzie, D. C., Lloyd-Smith, D. R., & Zumbo, B. D. (2002). A retrospective case-control analysis of 2002 running injuries. British journal of sports medicine, 36(2), 95-101.
Willy, R. W., Halsey, L., Hayek, A., Johnson, H., & Willson, J. D. (2016). Patellofemoral joint and Achilles tendon loads during overground and treadmill running. Journal of orthopaedic & sports physical therapy, 46(8), 664-672.
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