Easy Achilles tendonitis stretches and other exercises for Pain Relief

If you have pain in the back of the ankle just above the heel then chances are it is due to Achilles tendinopathy. It affects athletes and non-athletes alike. However, it can be managed conservatively by following simple Achilles tendonitis stretches. The sufferer often complains of discomfort after walking through a distance. Pain increases with step climbing, running, and jumping.

Conservative or physical therapies are generally accepted as the first-line approach for managing Achilles tendonitis and can be used in isolation or in conjunction with pharmacological and injectable agents. Surgical approaches are usually reserved for the most recalcitrant cases (1). In this article, we will cover exercises and other conservative methods to cure this problem.

Achilles tendonitis stretches

Achilles Tendonitis is the pain in Tendo Achilles presents just behind the ankle. It is a degenerative, not an inflammatory, condition. Most patients respond to conservative measures if the condition is recognised early(2). Tendo Achilles is the largest and strongest tendon of the human body connecting the Calf muscle and calcaneum bone of the ankle. It is present on the back side of the lower leg just above the ankle.

Excessive loading of the tendon during vigorous training activities is regarded as the main cause of this tendinopathy. When the Achilles tendon is repetitively subjected to excessive overload it responds by either inflammation of its sheath or degeneration of its body, or by a combination of the two(2).

Achilles tendinopathy has been attributed to various intrinsic and extrinsic factors. The Intrinsic factors include disabilities like tight Tendo Achilles, Hamstring tightness, Genu valgum, Tibial torsion and Hallux valgus. External cause or Extrinsic factor includes activities which involve excessive jumping and running, dancing, cycling, trauma/ injury, gastrocsoleous muscle weakness/inefficiency.

All these factors cause excessive stress on the tendon leading to microtrauma and pain.

Achilles Tendonitis signs and symptoms

1. Pain during running, prolonged jumping.
2. Strenuous activity/athletic activity on hilly surfaces.
3. Inability to participate in athletic activities.
4. As it progresses further one complains of pain & stiffness resolving with movement and activities.
5. Restriction of Dorsi Flexion of the ankle.  
6. Localised nodule/ swelling.
7. Strong resisted plantar flexion is painful.

Easy stretching exercise for Achilles tendonitis

Eccentric exercise is effective in managing Achilles tendonitis. We will come to this exercise, however, there are a few other exercises such as stretching and strengthening exercises which are surely going to benefit the sufferer. So, let us start with Achilles tendinitis stretches. It would be best to take the help of your physical therapist for stretching, here I’m going to explain to you the self-stretching.

There are two different ways to stretch it and it is very easy and anyone can learn it and perform it at home. For the first exercise, you will need a towel or a bedsheet. Sit in a long sitting position and hold two ends of the towel and place the mid part over the ball of toes of the leg to be stretched as shown in the figure. Now, gently pull the towel towards yourself and bend the ankle passively. Pull it to a point where you would feel a gentle pull behind your ankle. Hold this stretched position for 30 seconds and then let it relax. Repeat this 2 to 3 times in a session.

In the second way of Achilles tendonitis stretch, you have to stand facing the wall at a distance of one hand. Place your hand on the wall at shoulder level. Now, place your sound side leg closer to the wall and take your affected side leg a little backwards. In this position lean yourself towards the wall, while doing so, keep your foot flat on the floor. You would feel a comfortable stretch on your TA. Maintain this position for 30 seconds and then repeat it 2 to 3 times in a session.

Achilles Tendonitis Strengthening exercise

Ankle flexion-extension: It is also done in the long string position. In the sitting position, perform ankle flexion and extension as many times as possible.

For eccentric exercise stand on the edge of the step. Now raise yourself to the maximum and stand on your toes. Now, slowly lower yourself to the end range of ankle dorsiflexion. Perform this exercise for two to three sets of 10–20 repetitions, once daily, seven days per week.

Physiotherapy for Achilles tendinopathy

Conservative management and physiotherapy are the first lines of management and research found that a number of physical therapies may be effective in improving pain and function in those with Achilles tendonitis. They advocate for eccentric exercises in conjunction with Laser Therapy and Shock Wave Therapy (2). The physiotherapy treatment is aimed to prevent further damage, resolution of inflammation, prevent reoccurrence. Physiotherapy treatment can be categorised under the Acute phase and Chronic phases.

Acute phase

• Rest
• Avoid precipitating activities like running, and jumping.
• Cryotherapy/ ice therapy:  Icing is done for 10-15 minutes twice daily at the painful area for which an ice pack can be used.

Subacute / chronic phase

• DTFM: It is a Deep Transverse Friction Massage given by a well-qualified physiotherapist.
• Ultrasonic therapy: It is given directly over the tender points and surrounding region.
• Ice therapy or cryotherapy

Other home tips

Footwear modification: Sometimes appropriate footwear modification is done. Footwear modification includes a Flexible sole Heel rise by 2-3 mm Rigid heel counter to maintain the verticality of the calcaneus.

Sunit. S. Ekka

Dr Sunit Sanjay Ekka is a physiotherapist in practice for the last 15 years. He has done his BPT from one of the premium Central Government physiotherapy colleges, ie, SVNIRTAR. The patient is his best teacher and whatever he gets to learn he loves to share it on his Youtube channel and blog.