Achilles tendon inflammation, pain, and related injuries are common in sports, particularly in running. There are many factors that can lead to achilles stress, but a mainstay of any treatment or prevention program should be the eccentric calf stretch. The key is to create a slow stretch as the muscle and tendon lengthen, then off load the tissues completely to return to the start position. When done correctly, you will spare the muscle the work of lifting the body weight, while creating a stretch and load response to trigger the tissue remodeling and healing needed to overcome nagging pain.
This video demonstrates the exercise execution:
Perform the movement slow and steady, controlling you balance. Hold on to whatever you need to make sure that your heel travels a vertical line with as little wobble as possible.
Shoot for high rep sets 15-25, a couple of sets at a time with a couple minutes rest between, a couple of times a day.
The goal is to give a loading stimulus to the connective tissue elements without creating excessive fatigue on the contractile elements of the muscle tendon unit. It works best for achilles issues, but also relevant to plantar fascia and calf problems. We want to create the appropriate amount of load to stimulate tissue repair and the remodeling of scar tissue. Scar tissue is the initial ‘bridge’ for tying together injured tissues. However scar tissue does not have the strength and fiber orientation of normal tissue. By applying a slow steady load under stretch, we are trying to help create strength in the new tissue and orient the fibers in the optimal direction for the loads they have to handle.
Friction massage, applied in a direction that is perpendicular to the muscle/tendon orientation can also be useful for stimulating tissue remodeling. It is ok to create a bit of discomfort, but it should have a ‘good’ hurt feeling. If you find yourself tightening up or withdrawing from the pressure, it is either too much or you are doing the massage too soon after the initial injury.
Tissue release work from massage, foam roller, sticks, balls, etc. in all of the areas around the injured area is almost always helpful. Use the pressure guideline from above and go after it. The entire structure of the calf muscles, achilles tendon and plantar fascia all work as one unit to spring load from foot strike to mid stance when your weight is fully on the foot. As you move forward of the foot, the spring load releases the held tension to help propel you forward. Too much tension can strain and tear tissue, but too little tension can rob efficiency of gait. As with most things related to running form, there is a just right ‘Goldilocks’ point that is unique for every runner.