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Achilles Tendon Injury

The Achilles tendon is the largest tendon in the body, connecting the calf muscles to the heel bone. This tendon is used when walking, jumping, and running and can be prone to overuse injuries. An increase in activity level, tight calf muscles, or trauma can cause inflammation and irritation on the tendon leading to pain during activities.

Treatment

Put ice packs on the Achilles tendon for 20–30 minutes every 3–4 hours for the first 2–3 days, or until the pain goes away.

  • Raise your lower leg on a pillow when you are lying down
  • Take anti-inflammatory medication as prescribed by your health care provider
  • If a heel lift insert was prescribed for your shoe, wear it at least until you can walk without pain, and possibly longer (the lift prevents extra stretching of your Achilles tendon)
  • While you are recovering from your injury, change your sport or activity to one that does not make your condition worse (for example, you may need to swim instead of run)
  • Do all exercises to stretch and strengthen your Achilles tendon once you can walk without a limp.
  • If you over-pronate, your health care provider may prescribe custom made shoe inserts (called orthotics) to help keep your foot stable
  • In severe cases of Achilles tendonitis, your foot may be put in a cast for several weeks
  • A tear of the Achilles tendon may require surgical repair, OR your foot may have to be put in a cast for 6–10 weeks

As soon as you can tolerate pressure on the ball of your foot, begin stretching your ankle using the towel stretch. When this stretch is too easy, try the standing calf stretch and the soleus stretch. When your ankle swelling has stopped increasing, try ankle range of motion. You may move on to Phase II stretches when you can stand on your injured ankle without pain.

Phase 1: Stretching

Towel Stretch
Sit on a hard surface with your injured leg stretched out in front of you. Loop a towel around the ball of your foot, and pull the towel toward your body. Be sure to keep your knee straight. Hold this position for 30 seconds and repeat 3 times.

Standing Calf Stretch
Facing a wall, put your hands against the wall at about eye level. Keep the injured leg back, and the heel of your injured leg on the floor. Turn your injured foot slightly inward as you slowly lean into the wall, until you can feel a stretch in the back of your calf. Hold for 30 seconds. Do this several times a day.

Standing Soleus Stretch
Stand facing a wall with your hands on the wall at about chest level. With both knees slightly bent and the injured foot back, gently lean into the wall until you feel a stretch in your lower calf. Once again, slightly toe in with the injured foot and keep your heel down on the floor. Hold this for 30 seconds. Return to the starting position, and repeat 3 times.

Ankle Range of Motion
You can do this exercise sitting or lying down. Pretend you are writing each of the letters of the alphabet with your foot. This will move your ankle in all directions. Do this twice.

Phase 2: Strengthening

Double Heel Raises
Holding onto a table, with both feet lift heels off of the ground. Do this 10 times twice a day. When you can easily do this without pain move on to single heel raises.

Single Heel Raises
Holding onto a table, balancing on your injured side, lift your heel off the ground. Do this 10 times, twice a day. Once this exercise can be done without pain, proceed to single heel raises without holding onto anything.

Lunges
Overall strengthening will help prevent future injuries. Lunges help strengthen the thigh and hip muscles. Stand with the left foot behind the right foot, slightly bending the right leg to make a 90 degree angle with the right knee. Keeping the back straight, bend the left leg lowering yourself to the ground. You should feel a stretch in the left groin. Hold for 5 seconds, and switch legs. Repeat 10 times.