Achilles tendonitis (sometimes known as Achilles tendonosis or tendinopathy) is a very common injury in those who partake in regular physical activity. An evaluation of runners injuries found that the Achilles and calf area accounted for over 6% of all injuries (Taunton et al., 2002). However, Achilles tendinopathy is common in more than just runners, it is encountered in many sports (Carcia et al., 2010). Therefore, I know that many of you will have had Achilles issues in the past. Accordingly, this article will discuss Achilles tendonitis including background information on the condition, the relevant anatomy and of course the most appropriate rehabilitation exercises.
What Is Achilles Tendonitis?
Achilles tendonitis is a degenerative overuse condition of the Achilles tendon i.e. the tendon of the calf muscles (known as gastrocnemius and soleus). The name tendonitis has recently come under fire as contrary to popular belief it is not an inflammatory condition, but rather a continuum of pathology that results from overuse and degeneration of the Achilles. Therefore, it is now known as Achilles tendinopathy (which means pathology of the tendon, rather than –itis which indicates inflammation).
So… in plain English?
Essentially, what occurs is that repeated contraction of the calf muscles (think walking, jogging or running) can cause small tears in the Achilles tendon which attaches the calf muscles to the heel. As you continue the aggravating activity (whatever physical activity that is) further damage will take place and eventually the tendon will become painful.
The anatomy and foam roller exercises for Achilles tendonitis is further explained below.
Anatomy and Muscular Contributions to Achilles Tendonitis
Research and clinical experience in the sports medicine world has shown reduced range of motion and lack of myo-fascial flexibility contributes to the development of Achilles tendinopathy (Kaufman et al., 1999; Kvist et al., 1991). This includes tightness/reduced flexibility and active trigger points in the:
As well as tightness, Achilles tendonitis is also characterised by reduced strength and control in a number of the lower leg muscles. These include:
- Tibialis Posterior
- Flexor Hallucis Longus
- Gastrocnemius and Soleus
- Intrinsic Foot Muscles (the muscles that support the arch of the foot) (McCrory et al., 1999)
So, what can be done about this condition?
Foam Roller Exercises for Achilles Tendonitis
The most appropriate exercises are those that target the myofascial structures of the:
- Achilles tendon
The videos below displays all of these components:
Achilles Tendonitis Exercises
What Size Will Be Most Useful?
Given that you are going to cover a medium sized area i.e. the calf muscle, the best for this condition would be:
Should I Do Anything Else For Achilles Tendonitis?
Yes! Unfortunately, the roller is only one component of the successful rehabilitation of Achilles tendonitis. To fully resolve this complex problem you should also undertake:
- Regular gastrocnemius and soleus (calf muscle) stretches – shown below
- Eccentric strengthening (example vids shown below)
- Postural foot muscle strengthening, which is to help support the arch of the foot e.g. tibialis posterior and instrinsic foot muscle strengthening
- Adjust other contributing factors – including managing your exercise load, footwear, training environment, footwear
- Be guided by your physiotherapist – who can take you through all of this including a full rehabilitation program
Eccentric Calf Raise Example Videos
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Carcia CR, et al. Achilles pain, stiffness and muscle power deficits: Achilles tendinitis. Journal of Orthopaedic & Sports Physical Therapy. 2010;40:A1.
Kaufman KR, Brodine SK, Shaffer RA, Johnson CW, Cullison TR. The effect of foot structure and range of motion on musculoskeletal overuse injuries. Am J Sports Med. 1999;27:585-593
Kvist M. Achilles tendon injuries in athletes. Ann Chir Gynaecol. 1991;80:188-201
McCrory JL, Martin DF, Lowery RB, et al. Etiologic factors associated with Achilles tendinitis in runners. Med Sci Sports Exerc. 1999;31:1374-1381.
Taunton JE, Ryan MB, Clement DB, et al. A retrospective case–control analysis of 2002 running injuries. Br J Sports Med 2002;36:95 – 101.
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