RMS: Achilles Tendinopathy: Week 5 (2-5-18)

  • Email Follow Up
    • Pain has improved in the 6-8 range from the 7-10 range
    • Has been taking aleve on and off and has noticed a significant impact when you take it
      • I think an anti-inflammatory can be very beneficial to keep pain under control
      • Typically the combination of doing the right type of exercise and using an anti-inflammatory can be very helpful to keep symptoms more under control
      • This may be a good topic to discuss with Dr. Rothenberg as I typically can’t give much advice in regards to medication
    • Exercises
      • sidelying leg raise: 3×12
      • squat pulse 75sec x2
      • Bridge: 3×12
      • Band plantarflexion 3:15
    • Taping
      • There is no absolute rule book here, so if you guys brainstorm a way that gives that area more support, that works
    • Stationary bike
      • That is a good cardio choice as it is non weight bearing with very little achilles stress
      • Will eventually progress to other weight bearing cardio options but other weight bearing exercises should be attempted first
      • The elliptical would be the next thing to try
        • I usually recommend a gradual integration
        • Lets say ideally you would do 20 min of cardio
          • work your way up to 20 min on the bike
          • If that goes fine…try 2-3 min elliptical followed by 17-18min bike trying to gradually lessen the bike and increase elliptical
          • I wouldn’t jump to this quite yet though…maybe work on ramping up the bike for a little longer time
    • Hamstring isometric with leg raise is still on there
    • I included a couple strength progressions down below…only progress to them if you feel comfortable
    • Try adding only one new change to your current strength sequence each day to make sure you don’t have a bad reaction to each change
    • Week 5 Updates
      • 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
        • Cross Leg Contract Relax Posterior Hip VIDEO
          • This is to activate the posterolateral glute in a lengthened position
          • This will be important as we progress into single leg stance
          • Hold each 5 seconds and complete 8-15 reps each leg
      • Strength Sequence