Blog 2: Understanding Achilles Tendinopathy

Part 2: How to Treat Achilles Tendinopathy: Your Recovery Game Plan

So you read Part 1 and realized your Achilles tendon isn't just "getting old"—it's actually got tendinopathy and needs some TLC. Great! Acknowledging the problem is half the battle.

Now let's talk about the fun part: how to fix it and get back to your happy place (which I'm guessing involves moving your body in ways that make you smile).

As your Oakville chiropractor who's helped countless athletes through this exact situation, I'm here to give you the real deal on what actually works—no fluff, no false promises, just practical steps that get results.

First Things First: Ditch the Old-School Approach

Remember when everyone said "RICE" (Rest, Ice, Compression, Elevation) was the answer to everything? Yeah, that's about as outdated as flip phones for Achilles tendinopathy.

Here's the modern truth: Your tendon needs the RIGHT kind of activity to heal properly. Complete rest actually makes things worse because tendons get weaker and more dramatic when they don't have structure and purpose.The magic word is controlled loading—giving your tendon just enough challenge to stimulate healing without making it angrier.

Here is a 5-Phase "Get Your Bounce Back" Protocol:

Phase 1: Calm the Drama

Think of this as negotiating with a cranky toddler. We need to get the pain to a manageable level while keeping you moving.

Pain Management That Actually Works:

- Modify activities to stay below the pain threshold (not eliminate them!)

- Use pain as your guide—some discomfort is okay, sharp pain is not

- Try heel lifts temporarily to take pressure off the tendon

- Ice AFTER activities if it feels good (emphasis on "if")

Keep Moving (Smartly):

- Cut your training volume by 50-75% (I know, I know...)

- Switch to pain-free alternatives like swimming or cycling

- Walking is your friend—boring but effective

- Maintain your fitness through cross-training adventures

Hands-On Help:

- Soft tissue work on those tight calf muscles

- Get your ankle moving better with gentle mobilization

- Address any compensation patterns you've developed

This is where having a good manual therapist (like me!) helps

Phase 2: Gentle Wake-Up Call

Once your tendon stops screaming at you, we start having polite conversations with it.

Isometric Exercises (Hold Still and Get Strong):

- Calf raises where you hold the position for 45-60 seconds

- Single-leg standing holds (balance + strength = winning combo)

- Wall push holds against a wall

These exercises actually help reduce pain while building strength!

Mobility Work (Movement is Medicine):

- Gentle calf stretching

- Ankle circles and gentle range-of-motion exercises (this ABCs)

- Hip and pelvis mobility (because everything's connected)

- Full-body movement to keep the system happy

Progressive Loading (Baby Steps):

- Start with double-leg calf raises

- Progress to single-leg when it feels comfortable

- Use just your body weight initially

- Quality over quantity always

Phase 3: Building Back Better

This is where the real magic happens! We're going to make your tendon stronger and more resilient than before.

Eccentric Strengthening (The Gold Standard):

- Single-leg eccentric calf raises (going down slowly from tippy-toes)

- Start with 3 sets of 15 reps, twice daily

- Progress by adding weight (backpack with books works great)

- These specifically target tendon re-modeling and healing

Concentric Strengthening:

- Regular calf raises progressing from double-leg to single-leg

- Straight-leg and bent-knee variations (different muscles, different benefits)

- Start adding some bouncy movements as tolerated

- Functional patterns that mimic your sport

Return to Impact (Gradually!):

- Walking progresses to easy jogging

- Start with short durations on softer surfaces

- Listen to your body's feedback

- Use the 24-48 hour rule (monitor after activity to make sure it doesn't flare after)

Phase 4: Sport-Specific Prep:

Time to get back to the activities that make your heart happy!

Advanced Strengthening:

- Heavy, slow resistance training

- Sport-specific loading patterns

- Plyometric exercises (jumping/bouncing stuff)

- Endurance-based tendon challenges

Movement Quality:

- Running form analysis and tweaks

- Address any underlying movement issues

- Strengthen the weak links in your kinetic chain

- Optimize efficiency to prevent future problems

Graduated Return Protocol:

- Start with short, easy efforts

- Increase duration before intensity

- Monitor symptoms like a hawk

Patience is your secret weapon here

Phase 5: Bulletproof Your Future

The goal isn't just to get better—it's to stay better!

Maintenance Program:

- Continue eccentric exercises 3x/week (consistency is key!)

- Regular strength and mobility work

- Ongoing maintenance treatment

- Smart training load management

Coming up in Part 3, learn how Dr. Keirstyn builds a Plan of Management based on a thorough assessment. This allows for the best results of getting rid of this stubborn injury and say goodbye to it for good!

Ready to tackle your Achilles tendinopathy? Dr. Keirstyn can help guide you through this frustrating time to get you back to what you love to do! Visit our Oakville location today!