How To Recover (Fast) From An Achilles Tendon Injury - Paul Gough Physio Rooms

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How To Recover (Fast) From An Achilles Tendon Injury

Some help for runners aged 40+ this week.

And if you’re a footballer whose season has ended and you’re looking to keep fit throughout the summer – I hope you never have to need this advice, but chances are, you will.

See, something happens to Achilles tendons when you run on hard surfaces. More so if you’re aged 40+ and you’ve been used to playing on soft grass all winter and swap to a harsh concrete surface or a hard bounce treadmill.

And so if the inevitable happens, here’s what you need to do. It’s a step by step guide on how to recover from an Achilles injury that the Pro Athlete’s know and use:

First, here’s the signs and symptoms:
Immediate sharp pain in the back and bottom of you leg. Right above the ankle joint. Often happens when running or jumping and gets worse/comes on gradually as you run.

* Week 1
Complete rest. Apply lots of ice. Swap footwear to soft, comfy, high-heeled shoes. No need for strapping or supports other than to apply ice.
Every one hour for 10 minutes is recommend. Typically, a pro athlete suffering with an Achilles tendon issue would be advised to go swimming, take one or two gentle walks (on the flat) and when possible, work on core stability exercises with a balance ball.
The right selection of footwear is important – avoid plimsoles or sandals. Find and wear a pair of trainers with a nice thick “heel” to prevent any tension on the tendon.
From a physio point of view, after about days 2-3, I’d begin some deep massage and very gentle stretching and work on the ankle joint to prevent any stiffness or get rid of any swelling. I’d also massage the calf muscle and check the lower back for any stiffness to rule out any nerve problems that could create more long-term problems.

* Week 2
Ice continues – often until day 10 depending upon how much bleeding has taken place and how badly damaged the muscle tear is. Typically, one of my players would now be exercising on a bike, swimming would continue and towards the end of week 2, I’d be aiming to have the athlete doing some very gentle jogging.
The player or athlete can expect to feel some form of burning sensation, but as long as it isn’t “cramping” or “biting” this is fine – and a good thing.
From a physio point of view, massage is now vital.
It’s now that the scar tissue build up is “dangerous” and if the massage isn’t done, it’s the number 1 reason for an Achilles tearing again in the first two weeks back to running or playing.

* Week 3
Ice has stopped. Now, heat is being used rather than ice in this stage. Stretching is now vital. I’d be recommending the athlete to attend Yoga classes, increase the amount of Pilates exercises and that he or she be working on their balance (using a ball).
Fitness levels are increased significantly. Swimming, cycling, gentle jogging is stepped up (still on the flat). And by the end of this phase, the athlete may or may not be asked to be doing three quarter pace running by now.
From a physio point of view – hands on treatment is vital, massage continues and work on the Achilles, calf, hamstrings, gluteal muscles and lower back is essential to prevent future reoccurrence. Ankle joint and balance work is important too. PNF stretching is also introduced.

* Week 4
Athlete 90% fit. CV work increases and a return to practice and full drills is possible and the goal, by the end of week 4.
Athlete is put through drills that will include sprints, shuttles and plyometric work, including running backwards. Note: Hill running and sand is disqualified for at least 3 more months for this type of injury.
From a physio point of view – hands on massage continues, PNF stretching is vital and passive and active stretching is stepped up.

* Week 5
Athlete returns to sport.
Fitness and performance work increases. From a physio point of view- massage continues to prevent scar tissue build up and stretching is continued before, during and after training sessions.
Note: Daily hands-on massage will be need for approximately another 2-3 weeks to prevent scar tissue (collagen) tightening the muscles.

Review of recovery:
Take it very easy early on, stretch and mobilise the injury at just the right time and no Achilles injury can ever recover fully without deep massage.

Secret Tip(s):
Too much rest in the first few weeks will increase the likelihood of re-injury. Stay off the beach when running for at least 3 months post injury. Don’t be fooled by the lack of pain after two weeks either. It does not mean you are fit to play or run and if you haven’t followed all of the Protocol listed above, you will damage the muscle again sometime soon.

Printed in the Northern Echo. May 2014.

Paul Gough
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