I have reviewed your exam with you doctor and will take into consideration your history of IT band problems prior to the onset of the achilles tendon pain
Goals: Identify mobility deficits that are severely restricted, different on the painful side, movements that reduce your symptoms
Activate muscle groups that have been not been engaging properly: Can you feel the the muscles engage in the same way that they do on the non-painful side? How does it feel different on the involved side?
Become aware of maintaining spinal stability and not compensating in the back as you attempt to isolate glute activation and loading of achilles
Daily Movements: Meant to begin with proper abdominal stabilization and lightly move into restricted directions without increase in symptoms. This initial phase is more of an assessment to find your specific limitations as well as how you respond to certain positions. You need to be able to delineate between what is good and not good for you. As you are doing any of these movements keep the following in mind
It is good to feel tension or pulling as long as it feels the same or easier to do as you do it and you do not have any increase in symptoms afterwards
The first time through any movement do it very lightly, we are going to be stressing some sensitive areas and you will be surprised how this controlled movements can increase pain if done too aggressively, you can always push it a little harder the next time.
If you have soreness try to assess which movement is producing it. Do each very slow and controlled instead of pushing for 20 reps right away
Complete each 5-20x 1 set 1-2x/day as a sequence. You can do many of these lightly throughout the day
Must complete movements above for atleast a week without increase in symptoms during or the following day
This phase is meant to challenge the achilles tendon in a weight bearing position, along with progress glute activation and hip extension
It is very improtant that all standing exercises are done in a pain free range,
If there is any soreness, ice should be used following this sequence
You will incorporate the sequence listed below everyother day and continue to do the phase 1 sequence alone on the opposite days. Movements from phase 1 will be incoporated into the phase 2 sequence
Conitnue with 5 to 20 reps
Some of the movements below will show a progression of an exercise, you can progression to the harder version of the exercise once you are able to get to 20 reps and you no longer feel challenged or have pain
These movements are more stressful on the achilles and should be completed cautiously
I also would not do ths sequence prior to doing alot of standing or sport related activity because in will fatigue your hip and calf.
Heel Raise Progression at Wall (Start with phase 1)
This begins to challenge the achilles, stay in a painfree range, even if you barely lift heel off ground
If this bothers you hand/wrist you can do this with less pressure on the hands by doing it dropping heels off edge of step but I prefer this positon below
Phase 3: Progression to balance involving a lunge and single leg stability
This is a longer list
It will include 8 movements, I recommend doing the first 4 one day, phase 1 movements the following day, the bottom 4 movements the day after. Do this for the first week and if that is alright, you can do all 8 movements on one day.
Criteria to progress to phase 3
Must complete sequence above for 2 weeks with minimal soreness after or the following day that is relieved with ice and goes away within a day
Must be able to complete heelraises at the wall phase 1 through full range of motion15reps without symptoms
Continue with phase 2 until those requirements are met
These movements will challenge coordination of hip, knee, and ankle stability
Make sure you are able to control the position and once again remain in a painfree range
It is better to do slow and controlled reps and do a lower amount rather then pushing quickly to get done
I have some patients, instead of a rep number, set a timer for 30sec to 2 min with 2 min as the goal instead of 20 reps
Phase 3 will incorporate some of the previous movements and should be done everyother day, but continue to do the phase 1 movements on the days in between
Heel Raise Progression at Wall (Start with phase 1)
This begins to challenge the achilles, stay in a painfree range, even if you barely lift heel off ground
If this bothers you hand/wrist you can do this with less pressure on the hands by doing it dropping heels off edge of step but I prefer this positon below
