How Quickly Can you Progress your Achilles Rehab?

It's natural to think that the more you exercise and the harder you push your rehab exercises, the quicker your injury will heal ... but that is unfortunately not the case. If you progress your Achilles rehab exercises too quickly, you will very likely end up flaring your tendon pain back up. In this video, Maryke explains why you have to take your time and how to safely progress your rehab.

📽️ Another video you may find useful:

Chapters:
00:00:00 Introduction
00:00:24 How long does Achilles rehab take?
00:00:46 Why you should not rush your Achilles rehab
00:02:37 Example of how to progress an Achilles rehab programme
00:03:55 How to add and progress weight in Achilles rehab
00:05:45 How the Achilles tendon responds to rehab exercises
00:07:07 Rest days are important in an Achilles rehab programme
00:08:03 How we can help

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References
Cook, J. and S. Docking (2015). "“Rehabilitation will increase the ‘capacity’ of your …insert musculoskeletal tissue here….” Defining ‘tissue capacity’: a core concept for clinicians." British Journal of Sports Medicine 49(23): 1484-1485.

[charliezachariades]

Just want to say that you guys are so much more helpful than any PT I've been to (I'm on my third, none of them give a comprehensive rehab plan like you)

[wendyhutchinson]

This was so helpful. The part where you said tendons won’t let you know until 24 hours later if you did too much was spot on. I’m 3 weeks post op so I’m non weight bearing right now. But I will refer back to this video when I begin physical therapy. 👍😊

[urbanchaos]

Thanks, this was exactly what I needed to hear. I’m recovering from a surgically repaired Achilles, I am feeling very impatient and wanted to just push harder to speed things up.

[pauljoyce]

Great video Maryke. This is my favourite video that you've made. Very clear about a tricky point.

[novicetheaf]

I just want to say, your advice is invaluable, thank you so much 🙏😊

[amandaball]

Perfect timing, we can use this video as a base for our video call Tuesday morning.

[totallyraw]

Love that South African accent, Maryke!! 👍

[faustastraskevicius]

Such an informative and helpful video. I've been fighting with my achilles pain around 3.5 years now. The long story short, I sprained my ankle playing amateur football during summer. (one of 3 ligaments on the lateral side was ruptured completelly). At that time let's say, i didn;t get real guidance how to recovery properly so I was rushing with my exerscises right away after immobilization period which was around 4/6 to six weeks. Then maybe a month after, I stepped on the pitch again with obvious right calf atrophy. ( surpise, surprise....). Since then I was on and off the pitch. I was making breaks and doing some recovry exercises untill the pain went away and then I used to step back on the pitch. So it's probably obvious why it progressed to tendonitis.

I really, liked ur point that you cannot rush the recovery with rushing exercise and you always have to progress slowly cause tendons heal very slow and you cannot go against biology. ( you might've said that in another video, cause I watched a few with this topic since last week).

It's been a week since I started recovery by limiting my walking as much as I can, also lifting my heel with a heel raiser. ( to eliminate the irritation and pain completely) Today I also insterted 3 sets of 5 reps of double leg raises in a pain free ROM ( legs spread pretty wide ). I will track my reps in excel and will be increasing the load progressevly all the way up to plyometrics because I want to play without pain so badly and just be doing what I love).

[HtwoOwe]

This was really really useful and interesting. Thank you.

[lyndapryor]

Thanks for all your informative videos, it's very helpful. I've had a change of rehab which seems to be helping my sensitive tendon. I've been given double leg raises with slow progression: 2 sets x 10, for a week, then 3 sets of 8, 3 x 9, 3 x 10 then with weight (5% of bodyweight) I did upset the plan when I carried my 5 year old grandson up the stairs ;/ so I went from approx 4 kg to 22 kg. Didn't have any pain at the time but I had a limp next day for sure. I then rested for 3 days and started exercise plan all over again.. Does other exercise such as walking/steps etc weaken the tendon if you aren't strengthening at the same time? I have had scans and there are no tears or bone spurs- I do have a blood vessel (?) in the tendon- probably got that bit wrong sorry- but because of this it is called tendonosis..

[cdahl]

The idea that there are no shortcuts is very clear to people with this condition 😁 It took me over a year to heal my left achilles, and now it’s been 6 months and I’m only just starting to recover on my right.

[LYR]

Great help. Thanks so much for sharing your in depth knowledge. I’m currently nursing an Achilles injury in the mid section of the Achilles and trying to push along the recovery while still playing ultimate frisbee but realizing quickly it cannot be rushed. All I’m doing is prolonging the recovery and likely causing more damage. At the moment, my Achilles’ tendon is swollen and is forming a bit of a lump in the mid section.

I’m doing some rehab exercises at home but I’m at the point that I should see a specialist to really know what’s going on and get referred to a PT for the proper rehab.

[keithscott]

really good advice presented well. thank you for this geat info

[johnphan]

Thanks so much for the videos. May I ask once full weight bearing, did you walk on it everyday? Did you have rest days? How did you process in number of steps per day? I keep one having set backs.

[vickitiel]

Helpful video. Very grateful for the way you explained how the achilles heals differently after exercise and needs a bit more time. I am still trying to heal my tendon myself after a partial tear 3 years ago and multiple setbacks along the way. I never sought out immediate treatment but eventually did get ultrasounds and an MRI, physio and a specialist. I have degeneration and tendonosis just above the insert. Specialist has talked about non-invasive surgery to take out scar tissue as my tendon has thickened above the insert... but I am very hesitant about this, I don't want to make it any worse but fear the longer this goes on, the less chance I will have for recovery. I am still in pain 24/7 and flare-ups can be immobilizing. Used to run and walk a lot, can only do small amounts of walking at present.

[vladiordache]

Hello Doc, i'm almost 80 days after my Achilles surgery and i have recovered almost all my plantar flexion and my dorsiflexion through therapy, but in the last couple of days, when i shift the weight from my heel towards the tip of the foot, i get some sort of pain on the Achilles tendon area, is that normal?i had my last orthopedic visit 10 daus ago and he told me the healing is good, i have strong push but naturally the muscles aren't there yet. Thank you

[vw]

I suffered achillies tear last Sept.. I am now currently lifting weights while I do my heel raises and rehab, I feel like I can return to running, would you recommend that I attempt to run 3k

[gregoryshaw]

These are such good videos, thank you. I understand the 3/10 on pain whilst running - is there a similar scale for the hobble factor in the first steps of the day? The flare up and tendon pain is directly related to an increase in hill running in recent weeks, but the hobbling has been going on for months - it's a standard way of life...

[swed_kengoth]

Thanks for the info, very helpful. I had a full rapture when it came off the bone in August last year, and didn't understand how long the process for recovery was. I understand that most of the pain I have had lately comes from pushing myself too hard. So now I take time to rest in between hard workouts. Now I sometimes get pain from around the bone where they attached the tendon, I hope that will also pass.

[stevenarzu]

Generally speaking when can I start bearing weight after an Achilles tendon repair surgery?