Achilles Tendon Rehabilitation Part 2

Now it's time to add some intensity to the range of motion exercises. The aim here gradually re-introduces some strength back into the injured muscles, ligaments and tendons through a series of stretches.

When attempting to increase the strength of your Achilles, be sure to approach this in a gradual, systematic way of lightly over-loading the muscles and tendons. Be careful not to over-do this type of training. Patience is always a requirement for any stretching routine.

An effective and relatively safe way to start is to begin with isometric exercises. These are exercise where the ankle joint itself does not move, yet force is applied and the calf muscles and contracts Achilles.

For example, imagine sitting in a chair while facing a wall and then placing the ball of your foot against the wall. In this position, you push against the wall with your foot and at the same time keep your ankle joint from moving. The muscles contract but the ankle joint does not move. This is an isometric exercise.

The above example strengthens the Achilles and ankle joint in all directions. Pushing your foot to the left or right against something immoveable, and pushing down (as above) and pulling up.

It's also important at this stage to introduce some gentle stretching exercise. These will help to further increase your range of motion and prepare your Achilles for more strenuous activity to come. While working on increasing the flexibility of your Achilles, it's also important to increase the flexibility of the muscle groups around the injured area. These include the calf muscles, and the anterior muscles of your shin.

Stretching is one of the most under-utilized techniques for improving athletic performance, preventing sports injury and properly rehabilitating sprain and strain injury. Don't make the mistake of thinking that something as simple as stretching won't be effective.

Balance and Proprioception

This phase of the rehabilitation process, often overlooked, is one of the main reasons why old injuries keep re-occurring. Once you feel some strength returning to your Achilles it's time to incorporate some balancing drills and exercises.

When muscles and tendons are torn, nerves sustain damaged. These nerves send vital information to the brain about the specific position and location of the Achilles tendon and ankle joint in relation to the rest of your body.

Without this information the muscles, tendons and ligaments are constantly second-guessing the position of the Achilles and ankle joint. This lack of awareness about the position of the lower leg can lead to a re-occurrence of the same injury long after you thought it had completely healed.

Balancing exercises are important to help re-train the damaged nerves around your lower leg and ankle joint. Start with simple balancing exercises like walking along a straight line, or balancing on a beam. Progress to one-leg exercises like balancing on one foot, and then try the same exercises with your eyes closed.

When you're comfortable with the above activities, try some of the more advanced exercises like wobble or rocker boards, Swiss balls, stability cushions and foam rollers.

Plyometrics and Sports Specific ExercisesThis last part of the rehabilitation process will aim to return your Achilles to a pre-injury state. By the end of this process your Achilles should be as strong, if not stronger, than it was before you injured it.

This is the time to incorporate some dynamic or explosive exercises to really strengthen up your Achilles tendon and improve your proprioception. Start by working through all the exercises you did above, but with more intensity.

For example, if you were using light isometric exercises to help strengthen your Achilles and calf muscles, start to apply more force, or start to use some weighted exercises.

From here, gradually incorporate some more intense exercises. Exercises that relate specifically to your chosen sport are a good place to start. Things like skill drills and training exercises are a great way to gauge your fitness level and the strength of your Achilles and lower leg.

To put the finishing touches on your Achilles recovery, I always like to do a few plyometric drills. Plyometric exercises are explosive exercises that both lengthen and contract a muscle at the same time. These are called eccentric muscle contractions and involve activities like jumping, hoping, skipping and bounding.

These activities are quite intense, so remember to always start off easy and gradually apply more and more force with each stretch. Don't get too excited and over-do-it, you've come too far to do something silly and re-injure your Achilles.

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