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Achilles Tendon Exercises

by Jane Hodgson 15 September 2010


Eccentric Achilles tendon exercises have been constistantly shown by many research studies to provide the most effective treatment for Achilles tendonopathy.

Achilles tendon exercises are an effective treatment for many causes of Achilles tendon pain. The Achilles tendon is the strongest tendon in the human body, but is frequently the source of injury and pain. Tendonopathy is the most common cause of pain from the Achilles tendon accounting for around 60% of the problems here. Achilles tendonopathy used to be known as Achilles tendonitis, however "itis" is a suffix meaning inflammation and it is now recognised that inflammation has a limited role to play in Achilles tendon pain hence Achilles tendonopathy is the more correct terminology.

Achilles tendonopathy is especially common in middle to long distance runners with some pieces of research showing that up to 10% of club runners have signs of Achilles tendonopathy. However people who do no sports whatsoever can also suffer from Achilles tendonopathy.

Although many treatments have been proposed over the years to treat Achilles tendonopathy, consistently research shows that Achilles tendon exercises are the most effective form of treatment.

Achilles Tendon Exercises

The goals of an Achilles tendon exercise programme is to promote healing of the tendon as well as increasing strength, endurance and function with a consequent reduction in pain. Exercises for Achilles tendon pain can be broadly split into three categories:

  • Stretches: The Achilles tendon and calf muscles are put on a stretch. Controversy surrounds this form of exercise with debate as the whether a tendon with such a high tensile strength can be effectively stretched by exercise.
  • Concentric exercises: strengthening exercises that work by making the muscle contract or shorten. Thinking of the Achilles tendon a concentric exercise would be to stand on the floor then raise up onto the toes lifting the heels off the floor. To do this the calf muscles, which are attached to the Achilles tendon have to contract and shorten thus lifting the heels up.
  • Eccentric exercises:  strengthening exercises where the muscle lengthens or pays out. An example of an eccentric exercise for the calf would be standing on tip toes then slowly lowering the heels to the floor. Research has shown that an eccentric exercise programme is the most effective treatment for curing achilles tendonopathy.

An exercise programme requires no special equipment, but, because the remodeling of tendons occurs slowly, the exercises will have to be followed with commitment for three to six months to gain recovery. Many quality research studies show that by following an eccentric exercise programme around 80% of Achilles tendonopathy problems will achieve full recovery.

Other Achilles Tendon Pain Treatments

Other treatments which are known to be less effective than eccentric Achilles tendon exercises in treating Achilles tendonopathy are:

  • Injection
  • Surgery
  • Anti inflammatory drugs
  • Electrical treatments

Disclaimer: The information on this page is written to help you understand the background to Achilles tendon exercises. There are many possible causes for achilles tendon pain and should you have any concerns you should always seek advice from a qualified health professional such as a Chartered Physiotherapist or your GP.

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About the author

Jane Hodgson - Chartered Physiotherapist Jane Hodgson Jane specialises in lower body injuries and has raced competitively in running, orienteering and adventure racing.

Did you know

Causes of Achilles tendonopathy in runners include a rapid increase in mileage, a single intense run beyond normal training capacity, increasing interval training, and running on sloping or slippery roads. (Achilles Tendon Study Group 2010)

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