Conditioning: Phase 4
The following is the final phase that will guide you from Achilles Tendonitis/osis toward healthy running. Progress from each phase as instructed.
Duration: 2 Weeks
Goal: Plyometrics and functional training, including previous phase exercises (as desired) to maintain muscle balance and strength
Frequency of Exercises: Daily (2-3 days per week)
Warm Up: For at least 5 minutes before activity (e.g. Pre-Run Warm up)
- Single Leg Agility: 3 x 30 seconds (each). Single Leg Hops, Cross Jumps, and Single Leg Balance (On Toes). Purpose: increase dynamic load to the Achilles in different planes.
- Single Leg Calf Thrusts: 2 x 20 reps (each side). Facing a wall in a split squat stance, come up on the front leg and thrust up on your toes, putting more load on your Achilles tendon. You should feel the calf muscles working. Purpose: increase load on the leg muscles and Achilles tendon to improve resilience of the tissue.
- Up & Backs: 3 x 30 seconds. Go up and back in a running pace. This will increase load capacity on the tissue and guide you back toward sprinting-type activities. Add time as endurance improves. Purpose: increase pressure on joints to improve resilience.
- Front Plank: 3 x 30 seconds or until fatigue. On your elbows and knees, bring your knees off the ground and hold. Try to keep your body level throughout this exercises by keeping your hips level and engaging your abdominals and glutes. Keep your elbow below your shoulders and push up to engage your scapular muscles. Purpose: strengthen core and glutes for running form stability.
- Jump Squats: (on box first, then on ground) 3 x 8-10 reps. With your legs shoulder width apart, bend down by bringing your hips back and knees bent, and then come back up. As you land, try to make the landing quiet, which indicates shock absorption. If you’re too loud then you are not landing with enough knee and hip bend. Do this one at a time at first, then do intervals over time (sets of 3, 4, etc.). Purpose: increase load on the leg muscles and Achilles tendon to improve resilience of the tissue.
- Single Leg Calf Raises (With Weight, On Step): 3 x 12-16 reps (each side). Standing on a step with one leg, come down on your heels toward the ground. Go slowly (3 count going down, 3 count going up). There should be no pain at this stage. If too easy, place more weight on the involved side. Purpose: increase load on the tendon to improve resilience.
- Progressive Run/Walk Program
- Calf Stretching:
- Calf: 10 x 10 seconds (into mild stretch) for each side. With shoes on or arch support using a towel, keeping your heel on the ground in a split stance, bring yourself forward keeping your knee straight for 1 minute, and then bend for 1 minute). Purpose: reduce pressure on the calves through increased ankle mobility.
- Soleus: 10 x 10 second holds, each side. In a split stance with shoes on, keep your heel on the ground, bend your knee and get a lower stretch. Purpose: increase ankle mobility to decrease strain on the Achilles.
TO GRADUATE FROM PHASE 4
Pain is minimal and manageable, allowing you to continue your running progression while implementing exercises from previous phases as needed or desired to maintain form.
- No pain with single leg jump ropes for 30 seconds
- No pain with single leg calf raises with weight
- No pain with running on flat ground for 20-30 minutes
Principles of Achilles Tendonitis/osis: A Review
- CAUSE – overloading of the tendon
- NEED – reduce pain and Achilles tendon tension
- PLAN – once pain is managed, gradually reload the tendon to increase strength
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