This post follows on from “Achilles tendon injury – from tendinopathy to rupture“. We suggest you read it first.
Recent evidence has outdated the old approaches such as repetitive heel raises (Alfredson program) and variable load heel raises (Curwin & Stanish program). Both have been previously tested in research studies and were proven to be quite effective, however these approaches are now quite outdated.
Two Aussie researchers, Cook and Purdham, have recently published research that is seen at the forefront of Achilles tendon rehab. It uses isometric holds as a way of not only modulating pain in tendinopathies, but to strengthen the tendon and get the person back to full health.
The isometric program works on strengthening the calf, trying to disrupt the process of blood vessel proliferation and improving the quality of the tendon. These programs are a great guide but a visit to your local health professional is still very worthwhile. They’ll be able to modify the program for your specific injury and circumstances, monitor the early response to the program and to identify the likely causes and additional management strategies to recover faster. Long term treatment is generally not needed once the condition starts to show a consistent response.
The chronicity that plagues many Achilles tendinopathy sufferers can be due to either poor rehab or not correcting the underlying cause. Poor rehab includes denial (the “ignore it and it’ll go away” approach, common in the males of the species), stretching alone, a reliance on hands-on treatment or trying to cover the symptoms with medication. Unfortunately some of the underlying causes are not able to be corrected (age, systemic conditions, etc) but can be offset with a well-designed rehab program. Other contributing factors, such as a little extra weight, should be minimised before returning to your full running program.