Achilles Tendonitis Exercises That Actually Work (Strengthen, Don't Stretch!) — Transcript

Full transcript

1. 0:00If you have pain in your Achilles
2. 0:02tendon, that keeps coming back and won't
3. 0:04go away, I want to show you how to fix
4. 0:06it permanently with the exercises in
5. 0:09this video. And in order to do that, I
6. 0:11just need you to understand three key
7. 0:14concepts. First of all, why do you get
8. 0:16pain in your Achilles tendon? Key
9. 0:19concept number one, it's not a range of
10. 0:22motion issue, it's a load capacity
11. 0:25issue. Now, what does that mean? You
12. 0:27don't get Achilles tendon pain because
13. 0:29your calves are too tight or your
14. 0:31tendons are too short. You get this
15. 0:34because the load, what you ask of the
16. 0:37tendon, exceeds the capacity or what the
17. 0:40tendon is capable of. Let me show you
18. 0:43exactly what I mean. Think of the load
19. 0:45like your steps and your reps or your
20. 0:48miles or your time. As long as the load
21. 0:51is less than the capacity, you're
22. 0:54pain-free and you feel great. It's when
23. 0:56this load, your steps, your reps, your
24. 0:59time, your miles, starts to exceed the
25. 1:01capacity of the tendon that you start to
26. 1:04become painful. And so, here's why this
27. 1:07is important. Taking time off and
28. 1:10stretching doesn't do anything to
29. 1:13increase the capacity of the tendon, and
30. 1:15that's why pain always comes back if
31. 1:18that's all that you do to treat it. And
32. 1:21so, question number two then, how do you
33. 1:23treat Achilles tendon pain so that it
34. 1:26gets better over time and you can avoid
35. 1:30these regular flare-ups? Well, key
36. 1:32concept number two is we need to
37. 1:35increase the tendon capacity with
38. 1:38appropriately dosed exercises. As a
39. 1:41physical therapist, I prescribe
40. 1:44exercises to people to help them to feel
41. 1:47better. If we can do the right exercises
42. 1:50in the appropriate dose and then stick
43. 1:53with that for a long enough period of
44. 1:55time, you'll start to experience major
45. 1:58improvement. And so, what are those
46. 2:00exercises? Well, that's the whole reason
47. 2:03you're here. That's key concept number
48. 2:05three. What I want to do now is take you
49. 2:07through a progression of exercises to
50. 2:10help heal and improve your Achilles
51. 2:13tendon, to fix it forever, and to get
52. 2:15you back to doing those things that you
53. 2:17love.
54. 2:18Now, when I treat this problem in my
55. 2:20physical therapy clinic, I like to start
56. 2:23with some massage and some light
57. 2:25stretching. Those aren't the most
58. 2:27effective things that we can do to fix
59. 2:29this pain long-term, but they typically
60. 2:31feel really good in the moment and can
61. 2:34eliminate some pain and get you ready
62. 2:36for some of those exercises that are
63. 2:38coming. So, you might try this. And so,
64. 2:41the massage that I like, I'm going to
65. 2:43have you cross the affected leg over
66. 2:45your knee. I like to introduce just a
67. 2:47little bit of a stretch into that
68. 2:49Achilles. I don't want your toe pointed
69. 2:51down. I want you to use your hand to
70. 2:53keep your foot in a more neutral foot
71. 2:56position. And so, then from there, um
72. 2:59we're going to grab some lubricant. You
73. 3:00can grab some lotion. I prefer cocoa
74. 3:02butter. It tends to stay on the skin a
75. 3:04little bit better. I do have that one
76. 3:06linked in the description down below.
77. 3:08But, you're going to grab some of that,
78. 3:09put it on your Achilles tendon, and then
79. 3:12use your thumb and your forefinger to
80. 3:14massage up and down that tendon. Be
81. 3:18pretty aggressive with this. You might
82. 3:20find some areas that are a little more
83. 3:22tender than the others. That's a sign
84. 3:24that we might need to spend a little
85. 3:25more time in that spot, work it over a
86. 3:27little bit more. But, I typically
87. 3:29recommend about two to three minutes on
88. 3:32this massage. Another option, if it's
89. 3:35uncomfortable for you to cross your leg
90. 3:37into that position, is to bring your
91. 3:39foot, when you're seated in a chair, to
92. 3:41bring your foot into this position right
93. 3:43here. That's going to keep your foot in
94. 3:45that neutral position. Now, with my
95. 3:47hand, I can massage that tendon right
96. 3:50here. So, pick whichever one works.
97. 3:53Usually about 2 to 3 minutes once a day
98. 3:55is the recommendation there. And then I
99. 3:57like to follow that up with some super
100. 4:00gentle stretching. Caveat here,
101. 4:02stretching needs to be pain-free.
102. 4:05Typically, your tendon doesn't like the
103. 4:07extreme range of motion in a stretch.
104. 4:10And so we're going to keep it in a
105. 4:12comfortable position. And so the
106. 4:14stretches that I like, we've got a
107. 4:15gastrocnemius stretch. You're going to
108. 4:18put the affected foot behind you in this
109. 4:20a stagger stance, hands up here against
110. 4:22the wall, and then as you lean towards
111. 4:24the wall, put your weight on that front
112. 4:27foot, you're going to feel a stretch in
113. 4:29your calf. And I want you to do that
114. 4:31with the knee straight, but again, zero
115. 4:34pain, keep [music] it as comfortable as
116. 4:36possible. Hold that for 20 seconds and
117. 4:39repeat three times. And then the soleus
118. 4:42stretch, it's the second muscle in your
119. 4:44calf. We're going to get into a very
120. 4:46similar position, but now I just need
121. 4:48you to unlock your knee slightly. And
122. 4:51what you'll get with that is a much
123. 4:53deeper stretch lower down in your calf,
124. 4:56even down into your Achilles tendon.
125. 4:58Again, hold it in a very comfortable
126. 5:01range for about 20 seconds and repeat
127. 5:03that three times.
128. 5:05Which brings us now to the most
129. 5:07important exercises that I'm going to
130. 5:09show you in this video because this is
131. 5:11where we start to influence the tendon
132. 5:14directly and start to work on increasing
133. 5:17its capacity to [music] keep you out of
134. 5:19pain long-term. When I demonstrate these
135. 5:22exercises in the clinic, I'll take
136. 5:23people through a progression. Basically,
137. 5:26we start at step one. And when you can
138. 5:28do all the sets and all the reps with a
139. 5:30zero pain or even like a one to two out
140. 5:33of 10 pain level, that's when we
141. 5:35progress to step two and so on and so
142. 5:38forth. If you experience pain
143. 5:40immediately after doing these or 24
144. 5:43hours later, that's a sign that you
145. 5:45might have progressed a little too fast,
146. 5:47you need to bump back down to the
147. 5:50previous step. Of course, if you get
148. 5:53some relief from this, if you enjoy this
149. 5:55video, leave me a comment down below,
150. 5:57hit the thumbs up button. That tells
151. 5:59YouTube it's a good video, and YouTube
152. 6:01shows it to more people, and we help
153. 6:03their Achilles out as well. So, thank
154. 6:04you so much for doing that. Okay, let's
155. 6:06get into this. Step one is going to be
156. 6:09an isometric hold. Isometric means
157. 6:12contraction without movement. Really
158. 6:14simply, what I need you to do is raise
159. 6:16up onto your toes, or raise up onto the
160. 6:18balls of your feet, and then hold it.
161. 6:21We're just going to stay upright, or
162. 6:23we're just going to stay up in this
163. 6:24heels elevated position with that calf
164. 6:27contracted for 45 seconds. Now, this
165. 6:31isometric contraction, it might be a
166. 6:33little uncomfortable at first, but the
167. 6:36longer you hold it, it actually has an
168. 6:38analgesic effect. It might actually
169. 6:41eliminate a lot of the pain that you're
170. 6:43experiencing as you continue to hold
171. 6:46this isometric. Again, 45 seconds, we're
172. 6:50going to repeat that three times, and I
173. 6:52need you to do that one to two times a
174. 6:54day. Another option on the isometric is
175. 6:57going to be to stand on a stair with
176. 7:00just the balls of your feet up on the
177. 7:02stair, and your heels unsupported.
178. 7:05That's another great way to perform that
179. 7:07isometric. You might try both of those
180. 7:10out to see which one works the best for
181. 7:12you. Three times 45 second holds. When
182. 7:16that becomes tolerable, when you can do
183. 7:18that without pain, or with only a little
184. 7:19bit of pain,
185. 7:21we move to step two, which is slow heel
186. 7:24raises. Now, we're just going to add
187. 7:25some motion to it. I want you to count
188. 7:27to three. So, one, two, three seconds
189. 7:30up, but then we're also going to go one,
190. 7:33two, three seconds down. So, we're
191. 7:35adding some motion, but we're going to
192. 7:37keep it very slow and very in control.
193. 7:41Tendon pain tends to spike with
194. 7:44increasing rates of contraction. The
195. 7:47faster you go, the more painful it will
196. 7:49be. So, if we keep it in this 3 second
197. 7:51up, 3 second down range, most people can
198. 7:55tolerate that. About 15 repetitions
199. 7:58repeated three times, one to two times a
200. 8:01day is the recommendation there. Now,
201. 8:03let's work into step three would be
202. 8:06increasing your range of motion. And so,
203. 8:09now we're going to do slow controlled
204. 8:11deficit heel raises. And so, we're going
205. 8:13to come to a stair. We're going to go 3
206. 8:16seconds up. Now, on the lowering phase,
207. 8:18I want you to go as low as you can
208. 8:21pain-free. So, our heels can start to
209. 8:23fall down below the level of our toes. I
210. 8:27want you to take it as low as you can
211. 8:28without pain. A lot of times, if you
212. 8:31bottom out or get all the way down here
213. 8:33in the very lowest position, that might
214. 8:35cause some pain, but that's a goal that
215. 8:37we can gradually work up to as we
216. 8:40perform these slow deficit heel raises.
217. 8:43Three sets of 15, one to two times a
218. 8:46day. Then that moves us to step four
219. 8:48would be eccentrics. And so, eccentrics
220. 8:51is we're just going to focus on the
221. 8:53lowering phase of that contraction.
222. 8:56I'm going to use both my feet to raise
223. 8:58up. I'm going to shift my weight onto
224. 9:00that painful foot, and then I'm going to
225. 9:03ride that down as low as I can
226. 9:06pain-free. Bring my other foot back,
227. 9:08help up with two, and then just ride the
228. 9:11one down. It's that eccentric
229. 9:13lengthening phase, lowering phase that
230. 9:16is great at healing tendons. For most
231. 9:20people, this is the goal. This is where
232. 9:22we want to get to is about step four. If
233. 9:24you want to take it further, step five
234. 9:26would be a single leg heel raise. And
235. 9:28so, now we're going to perform the
236. 9:30concentric or raising phase and the
237. 9:33eccentric lowering phase just on one
238. 9:35foot, nice and slow, nice and in
239. 9:38control, three sets of about 15 reps.
240. 9:41And then finally, step six, for those
241. 9:44athletes out there looking to return to
242. 9:46sport, that's where we need to get into
243. 9:48some plyometrics. So, I like forward and
244. 9:51backwards jumping about 15 reps. I like
245. 9:53side to side jumping about 15 reps. And
246. 9:56then we can repeat that three times. I
247. 9:59hope these help to eliminate your
248. 10:01Achilles tendon pain, and thank you so
249. 10:03much for watching.