Why Exercise Progression is Important for Achilles Rehab

Sports physio Alison Gould explains why exercise progression - gradually making them more difficult - is important for Achilles injury rehab. She also explains why progression should be tailored to the individual and can't be one-size-fits all, and how the patient's activity goals influence our choice of rehab exercises.

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📚Chapters in this video:
00:00:00 Introduction
00:00:51 Why rehab progression is important
00:04:14 Your exercises must be tailored to you
00:04:53 What guides exercise choice?
00:10:37 Study limitations
00:13:04 How we can help

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References
Demangeot Y, Whiteley R, Gremeaux V, Degache F. The load borne by the Achilles tendon during exercise: A systematic review of normative values. Scand J Med Sci Sports. 2023 Feb;33(2):110-126. doi: 10.1111/sms.14242. Epub 2022 Nov 9. PMID: 36278501.

[ThomasHayes-pk]

Very many thanks Alison for your most welcome reminder of the importance of progressing my lengthy exercise programme to return to comfortable walking. My left heel tendonosis came completely out of the blue but as a 78 year old, 70 Kg male, after 18 months of benefitting well from your invaluable videos my recovery had frustratingly plateaued at I would guess about 85%. But after your reminder I firstly added one 4Kg then after 3 weeks two 4Kg weights to my backpack before doing my routine single leg heel raises and progress was thankfully resumed... It's probably now nearing 98% - probably even better if I had the courage to return to the longer distance walking I had previously taken in my stride for many years!

[simont]

Just to avoid confusion, you say 1.25%, but it's really 1.25 times, or 125% of body-weight, for seated raises. So if you weigh 50kg, you load 62.5kg. Similarly for standing raises, if it says 1 leg 125% bw, that means you use your body weight (100%) plus 25%, so if you weigh 50kg you add a backpack with 12.5kg.
Otherwise excellent content you provide! Very useful.

[PRASADMEGHAWARNA]

Does the lump on the heel disappear with the successful treatments?

[allama]

I just found your channel (actually the algorithm found it for me). Can you recommend how the information on Achilles rehab be applied to forearm extensor tendinopathy? If yes, what videos would be the best to watch? Thanks :)

[zakiakondo]

I had achilles injury now three months but my achilles is still swollen what exercises should I do Madam

[bushkilla]

Do you have any advice or videos for people who have ruptured their Achilles?

[johnsands]

Hi. I think my Achilles has been getting better with your help. Thx. I can run 10+ miles without excessive pain. Sometimes I hardly feel it at all but other times it will hurt for just a second before calming down again. I also bike. I notice after 10-15 miles my Achilles will start aching some. It doesn’t get much worse though. I end up compensating the pedal stroke to ensure it doesn’t get too bad.

My question is - do I need to compensate my pedal strokes for an achy Achilles? If I was running I might walk uphill or slow down a little but otherwise it doesn’t get worse. If I was running I would assign the pain level at 2-3. I would walk or stop at 5 if it lasts too long. When I exit the bike I walk gingerly like just getting out of bed with stiff Achilles. It’s fine the rest of day and next day.

[iuliafesteu]

Bună sunt Iulia, pur și simplu ma-m trezit cu o durere in spatele calcaiului, nu am ridicat greutăți, nu am stat pe tocuri, ce poate fii, dimineata e cel mai rău, nu pot calcă pe calcai, am 54 de ai și 55 kg.

[johnsands]

Can running itself be one of the exercises?

[AndrB]

One thing I find frustrating about rehab is that once I have an issue it's like I suddenly need to get the strength of Superman in that area to recover. I know that most of my friends who run couldn't do nearly as many weighted heel lifts as I now can but they don't have any problem running. Indeed the same would have applied to me say a few weeks before I did the overuse that caused my achilles problem. Do you have any thoughts about this?

[Shivanna.c-xo]

mam i got accident by bike and it tore my tendon achilles and i got operation and 6 months over ican only walk but i can't run how to recover fast please reply mam from india.

[jegadishmathias]

Any thoughts on shock wave therapy for insertional tendinopathy