Achilles tendinopathy
It is likely that you have pain related to small “micro-tears” within the Achilles tendon. This structure connects your calf muscle to your heel and allows you to jump and push off your foot during walking/running. Try pressing on the long “rope like” structure just above your heel. If this is tender the diagnosis is highly likely to be Achilles tedinopathy. Tendinopathies are usually caused by “overloading” the tendon with an increase in activities. For detailed information on Achilles tendinopathy see here noting that the correct physiotherapy treatment is highly effective in almost all cases (surgery or injections are rarely required).
If your pain is relatively low (less than 4/10 on average) and not having a major impact on your life consider the following effective physiotherapy treatments you can do on your own:
For a short period of time, stop doing anything (eg running, jumping or long walks) that significantly increases your pain by more than 2/10 during the activity or that results in more than 2/10 pain for more than 30 minutes after the activity
Read these resources on “pacing” and “more on pacing” to ensure you have the right balance between activity and rest to optimise recovery
Walking is a simple but very effective treatment for Achilles tendonopathy. Generally walk a minimum of 2 times a day starting at an amount of time and speed that doesn’t significantly increase the symptoms as described in the above bullet point (for example walking 5 minutes twice a day). This can then be then slowly increased over a number of weeks (for example up to 30 minutes twice a day)
A graduated series of exercises (click on the links below to see a video description) to build up the strength of the calf and Achilles tendon is a very important strategy. Work your way through the list below step by step. The exercises should be done 2 times a day starting with 2 sets of 5 (no hold) and progressing to 2 x 12 over 3-6 days making sure there is no significant increase in pain (see bullet point above). Once mastered move to the next exercise in the list, starting again at 2 x 5 progressing to 2 x 12 over 3-6 days.
Start with calf raises on both legs as described here
Progress to single leg calf raises as described here
Next is single leg calf raises on a step
Progress to single leg calf raises with a “catch”
Final progression is single leg calf raises with a “catch” and “rebound”
When you can do 15 single leg calf raises on a step without a significant increase in pain, you should be able to also start grading up your activities by following the principles of rehabilitation described here. Running and other impact sports should not be graded up until you can comfortably do 15 single leg calf raises with a catch.
Negotiating the above exercise and rehabilitation program can be complex. Or you may not be noticing any improvement over a two week period. If this is the case why not try a free telehealth consultation with one of our expert practitioners by clicking the button below. Ongoing treatment by telehealth or face to face can also be provided if needed to guide your recovery.