RMS: Achilles Tendinopathy: Week 2 (1-15-18)

  • Week 2
    • All the same rules apply as we enter week 2 in regards to what you should feel and what you should not
    • This week the movements will get a little more challenging, so the first time you attempt a new movement…error on the side of caution. Let it be too easy as opposed to too hard. You can always push it a little farther the next time you do it
    • This week we will separate out strength movements from daily movements
    • Daily movements will be mostly the stuff that you did week 1
      • These can be done 1-2x per day
      • Should be used as a warm up or cool down as your activity level increases
      • Should not be incredibly challenging
    • Strength circuits will be designed to challenge you and should be done every other day
      • The goal with each movement will be for time (30sec-2 min) or reps (5-20reps)
      • You are trying to push yourself to some amount of fatigue without necessarily increasing pain
      • Initially in doing some of these movements, pain may be what happens as you get fatigued, that is your cue to stop
      • Ideally the more you do this stuff, and you stop short of significant pain, the pain will become less and less and you will feel more muscle fatigue and less pain
    • Daily Sequence
      • Self MFR Calf VIDEO
        • use a tennis ball or lacrosse ball
        • Hit 2-3 spots on the calf, NOT ON THE TENDON for 30to 60sec
      • Band Plantarflexion/Gastroc Activation VIDEO
        • There are a variety of band resistances
        • Try to start with something that allows you to get through as much ROM as possible
        • If you have significant pain with any motion, try to start with just an isometric hold for 30sec-2 minutes
        • If you are able go through as much range as possible with minimal pain, go really slow on the negative 4-5 sec as you slowly load into the stretch
      • Self MFR Hamstring VIDEO
        • Same concept as above
      • Hamstring Isometric with Contralateral Leg Raise VIDEO
        • This can be done with an exercise ball of feet up on couch/chair
        • Try not to push directly onto heel as it is likely tender
        • Push more so into the calf
        • hold each 5sec, 8-20 reps
      • NEW :Bear to Plank Push Off Loading DNS VIDEO
        • This is to replace the position on your hands and knees
        • Very similar but done in standing
        • Make sure you maintain abdominal control as you rock forward towards your hands and don’t over do it with the stretch
      • Quadruped with Physio Ball Hip Extension VIDEO
        • Focus on keeping your low back relaxed
        • can use an exercise ball or an ottoman
        • 8-20 reps
    • Strength Circuit #1
      • Heelraise Loading Overview Isometric to Increased Range VIDEO
        • This outlines a very specific loading progression for your achilles
        • I am very interested to know as you progress, at what point you experience pain
        • Really try to keep the feeling in the calf
        • Goal is 30sec to 2 min as I discuss in the video
        • It provides 3 positional options so you should be able to find one that fits
        • DON’T GO TOO DEEP INTO A STRETCH TOO FAST…PLEASE!!!
      • Band Around Knees Bridge Progression VIDEO
        • Keep tension in the stomach as you raise up
        • 8-20 reps slow and controlled
        • If you have any knee pain bend your knees less as discussed in the video
      • Squat Pulses In Short Range VIDEO
        • 30sec to 2 min is the goal
        • You can keep the band around your knees with this one as well similar to the bridge