The Achilles tendon, also called the calcaneal tendon, attaches the calf muscles -- the gastrocnemius and soleus -- to the back of the calcaneus, or heel bone. A strain or tear of the tendon requires appropriate rehabilitation to prevent disability and recurring issues. Along with taking steps to alleviate the immediate symptoms, such as discomfort and inflammation, your rehabilitation program should include physical therapy -- exercises designed to restore your range of motion and strength. Consult a physical therapist to develop a comprehensive and individualized program.
Initial Treatment
Immediately after suffering an Achilles tendon injury, rest your affected leg for a time period that coincides with the severity of your injury, which may range from 24 hours for a minor strain to much longer, depending on your doctor's orders, for a complete tear. Your doctor may also require that you wear a protective boot for several days or weeks. Cold treatments, electrical stimulation and soft tissue massage may also help attenuate the healing process. Consider taking over-the-counter anti-inflammatory and pain medications as well, but consult with your physician first, who may choose to prescribe medications instead.
Range-of-Motion Exercises
Restoring your ankle-joint range of motion is the first goal of a physical therapy program for an Achilles tendon injury. Since the tendon lengthens when you dorsiflex your foot, or decrease the angle between your foot and lower leg, the calf stretch is most appropriate. Lean against a wall with your injured foot about 2 feet away and your opposite foot farther forward, so your feet are staggered. Press your heel toward the floor with your knee fully extended until you feel light tension, then hold for 10 to 30 seconds. Next, flex your knee slightly and repeat the stretch. Progressively increase your range of motion over time.
Strengthening Exercises
Performing resistance exercises through dorsiflexion and plantar flexion ranges of motion helps strengthen your Achilles tendon and the calf muscles to which it's attached. Start on a flat surface and repeatedly lift your heels and lower them back down. Eventually, perform the same exercise on a step so you can lower your heels below your toes during the downward-movement phase. Hold weighted objects in your hands to increase the resistance. Don't begin a strengthening program until you have clearance from your doctor, as starting too early may impede your progress.
Functional Exercises
Perform functional exercises, such as jogging, running, walking and other activities that you want to do regularly, after restoring your flexibility and strength to pre-injury levels. Do plyometric exercises, which require intense, high-velocity muscle contractions, if you're an athlete and gradually return to sport-specific activities. Continue performing the aforementioned stretching and strengthening exercises on a regular basis as well. Consult your physician if you suffer any setbacks.
References
- "Essentials of Athletic Injury Management"; William Prentice and Daniel Arnheim; 2008
- American Chiropractic Association Rehab Council; Rehab of the Achille Tendon; K.D. Christensen
- The Stone Clinic: Achilles Tendon Repair
- American Council on Exercise: Standing Dorsiflexion
- American Council on Exercise: Standing Calf Raises
