We’ve all heard the legend of Achilles, who was killed with an arrow that was shot into his namesake tendon. And just like him,  Achilles’ tendon injuries can take you out of doing the things you love to do.

Having pain in your Achilles’ tendon isn’t uncommon. At one point or another most athletes, dancers and weekend warriors will have some form of Achilles pain. It can be caused by a variety of different things from poor biomechanics of the foot, ankle or hip to soft tissue restrictions or tightness in the plantar fascia, the foot, and/or calf. Regardless of why Achilles’ tendon injuries happen, don’t ignore it, it’s something that needs to be addressed. 

Before we get to how to address the issues, let’s discuss what is the Achilles’ tendon? It’s actually two tendons in one. The gastrocnemius (the calf muscle we all see) and the soleus (the larger muscle underneath the gastrocnemius) wrap around each other as they reach the ankle and heel. 

The soleus makes up 2/3 of the Achilles so it will be a big player in treatment of Achilles’ tendon injuries.

Your best bet is to first get assessed by a physical therapist to get an idea of what exactly is going on, but if that’s not an option right now, here are three things you need to know if you have pain.

Keep moving

A misconception of Achilles tendinopathy is that if it hurts, you should rest it, but that’s not the case. Tendons get stronger through loading them, so the key to treating Achilles’ tendinopathy is loading the tendon. 

Some things you’re going to want to do: 

• Roll out the calf
• Stretch the calf
• Strengthen the calf

Pain isn’t necessarily bad

With strengthening and re-educating the muscles of the calf and foot, some pain is okay. Anything less than a 5/10 on the pain scale is going to be fine. 

Here is an exercise to roll out the soft tissue of the calf

• Soft Tissue Mobilization of the Soleus

Here are some stretches you can do for the calf and Achilles tendon.

• Calf Stretch Against the Wall
• Triplanar Calf Stretch
• Progression – Calf Stretch in End Range Dorsiflexion with Hip Extension

Here are some exercises you can do to help strengthen the Achilles tendon.

• Double leg heel raise
• Progression – Double leg heel raises on a step
• Progression – Single leg heel raise
• Strength with Plantar Fascia Stretch – Hallux elevated heel raise

Other considerations

You’ll also need to remember a few things when dealing with Achilles’ tendinopathy. Watch your gait – and steer clear of hills. This will put more stress on the forefoot, which will put more tension on the plantar fascia and the Achilles. If you are a forefoot striker, you’ll want to adopt a more midfoot strike.

You will also need to reevaluate your footwear. You’ll want to initially use a shoe with about a 3-5 millimeter drop from heel to toe. This equates to about a ¼ inch heel. You don’t want too big of a heel, which can exacerbate the issue by shortening the tendon, but you also don’t want a total zero drop shoe that can put the tendon on constant stretch while it’s healing. 

Beacon Physical Therapy

At Beacon Physical Therapy, we want to keep you healthy and pain- and injury-free. Don’t push through Achilles’ tendon pain. If you are having an issue, make an appointment today. We’d love to meet you and get you back to doing what you love.