Achilles Tendinopathy: Stretching, Mobility and Massage (Part 5)

This Part 5 of a multi-part series.  A quick recap:

1. Part 1 talked about the injury cycle and the 4 stages of diagnosing your injury. 
2. Part 2 explained why regular strength training does not work, and why you need to do heavy load eccentric contractions.  Part 2 video showed the Heel Drop exercise.
3. Part 3 video showed the Eccentric Squat and Reach. 
4. Part 4 discusses stabilization exercises and stabilizing the ankle joint.

There isn’t a great blood supply to the Achilles, which is one reason why you may have a slow recovery.  Hyperbaric chambers help if you have access to it.

Everyone knows to stretch the Achilles, even distance runners. You’ll see them leaning on a stop sign, wall or car.

The problem with stretching (in general) is that the muscle and tendon length can return to “normal” homeostasis in as little as 4 hours.  And you don’t want to stretch every 4 hours.  As well, when you sleep, you probably don’t sleep dorsiflexed, so you sleep with your toes pointing down which shortens your Achilles.

There are a couple of things you can do to help maintain the overall suppleness of the tendon.

For example, Stretching, Massage and Mobility exercises and but please, whatever you do, NO heel lifts!

1. slant boards
2. demi-lunes
3. night splints (similarities to plantar fasciitis)
4. Strassburg Sock
5. deep tissue massage
6. ankle mobility

Slant boards and Demi-lunes

To stretch the Achilles, you can lean against a wall flat-footed, or you can prop the ball of feet on a wall with the heel as the only contact to the ground and stretch.  I find using a door frame entrance as the best grip and support.

However, I like using a slant board that’s made from hard foam, and not wood.  I picked mine up at Stanford’s SMI over a decade ago and I still have it, but you can find these at Amazon or any advanced running store.

Since the slant board is a fixed angle, which you can simply adjust by your forward lean, another good product is the “demi-lunes” or half moon Achilles stretcher.  These devices have a curved rocker “boot” style allows a greater range of motion.

>> OPTP Slant – One Pair – #412
>> Medi-Dyne ProStretch Unilateral Stretching System

Night Splints and Strassburg Socks

These are more common for use with people suffering from Plantar Fasciitis.  However, they are beneficial for those with tight Achilles or tight calves in general.  I tried these in the past and it took me a long time to sleep with it.  I would wake up at 1:00am and rip the damn thing off my leg.

These devices used to be very expensive 10 years ago, but thanks to mass production they have come down in price dramatically, like under 20 bucks.

>> Bird & Cronin Plantar Fascitis Splint Large
>> JT Enterprises Strassburg Sock Large (16-21 in.calf) Injury Recovery

Deep Tissue Massage

This may be a challenge once you hit Stage 2 of the injury as the pain will be intolerable.

Both Achilles and Calves.

One thing the video misses is how to go even deeper in the calf muscle, and that is to go on all fours “doggie style” (on hands and knees only) and prop several pillows under your belly for support.  That relaxes your calves even further.

Ankle Mobility Exercises

You’ll be surprised how stiff your ankles are simply by sitting on a high bed or bench, crossing your legs like a man (not a woman), and doing circle rotations with your ankles.  Then after a few clockwise and counter clockwise rotations with your hands assisting the movement, they will loosen up.  Having someone assist you to force the rotations will result in a much better range.

You can even do the ankle pump.  That is simply elevating your foot on a chair and bench and pumping your ankles back and forth.  Pretend you are driving in city traffic.

And if you have time, you spell the alphabet with your big toe.  Upper case or lower case, it does not matter.  Heh heh.