Helen Doherty on Achilles Tendonitis

Swedish Moves Improve Achilles Problems Achilles Tendonitis.

Two words that strike fear into the heart of many a runner for the following reasons:- - it interrupts training programmes

• it ruins plans for PBs
• it is the most common injury in athletes over the age of 40
• approximately 25 per cent of athletes who suffer from chronic achilles tendinitis end up undergoing surgery -
• and (worst of all) it is a problem that does not go away very quickly Traditional treatments of rest, NSAIDs, orthotics, cortisone injections, icing, ultrasound, and conventional physical therapy are not particularly successful in settling down troublesome achilles.

How can Achilles tendonitis be prevented - or cured once it develops?

It has long been accepted that calf muscle strength is involved but the traditional up and down on the toes really did not produce the necessary increase in calf muscle strength and decrease in achilles problems. Until now that is Recently published research carried out at the Sports Medicine Unit of the University Hospital of Northern Sweden in Umea found the following strengthening moves were the most effective for Achilles problems. Do your usual warm up before the strengthening work and cool down after the strengthening work. Remember never to do any strengthening work or stretching on cold muscles as this will result in tearing the muscles – something to be avoided at all times!

Swedish Move 1 – strengthen the gastrocnemius (major calf muscle)

Stand on a step with the leg straight and the front edge of the step touching the soles of your shoes about one-third of the way from the toes to the heel (so that the heels hover in mid-air). Body position is upright, legs are straight, and all body weight is supported by the forefeet. Then, using your good calf muscle (the one not associated with a hurting Achilles) lift your body upward by bringing the heels upward whilst the forefeet remains in contact with the step. Then, the healthy leg and foot are removed from contact with the step, and the one with the Achilles problem remains on the step. Now slowly lower the heel of the unhealthy leg to below the level of the step, eccentrically loading the calf muscle attached to the throbbing Achilles tendon. That constitutes one rep

Swedish Move 2 – strengthen the soleus (minor calf muscle)

Stand on a step with the leg bent and the front edge of the step touching the soles of your shoes about one-third of the way from the toes to the heel (so that the heels hover in mid-air). Body position is upright, legs are bent, and all body weight is supported by the forefeet. Then, using your good calf muscle (the one not associated with a hurting Achilles) lift your body upward by bringing the heels upward whilst the forefeet remains in contact with the step Then, the healthy leg and foot are removed from contact with the step, and the one with the Achilles problem remains on the step. Now slowly lower the heel of the unhealthy leg to below the level of the step, eccentrically loading the calf muscle attached to the throbbing Achilles tendon. That constitutes one rep. These moves may sound complicated but they really could not be simpler.

REMEMBER TO ALWAYS PUSH UP WITH THE GOOD LEG AND RELAX DOWN WITH THE BAD LEG.

Keep movements slow and controlled through both the push up and the stretch down. Your aim is to perform three sets of 15 reps. At first you may only be able to do three sets of six. If so, don’t feel bad about it. Just use it at the starting point. The next day you might be able to do three sets of seven or three sets of eight. You are looking to gradually increase the number of reps you do.

These straight-leg and bent-leg series of sets, which really don’t take long to carry out, are to be performed twice a day, seven days a week, for twelve weeks but only pushing up with the good leg and relaxing down with the injured leg. You will experience soreness in the calf muscles during the first few weeks of the exercises but this will pass as the muscles become stronger.

Perform these exercises without added weight and, as you grow stronger, add in hand weights or weighted backpacks starting at just a few pounds and building up to a greater load as your strength increases. Once your calves and achilles are really strong you can use weight machines to provide additional resistance.

How do the Swedish Moves work?

It is all to do with concentric muscle activity versus eccentric muscle activity. A more indepth version of this research together with a third strengthening move can be read at http://www.pponline.co.uk/encyc/0031.htm

Basically, concentric contractions are those in which muscles shorten while they are contracting (i.e. the muscle activity required to bring the heels back up above the level of the step and up onto the toes prior to another rep). Eccentric contractions are ones in which muscles elongate while they are contracting (i.e. the muscle activity required to the heel attached to the ailing achilles below the level of the step).

After 12 weeks performing the Swedish strengthening moves, the following improvements were noted:

• stronger calf muscles, both eccentrically and concentrically
• reduced pain while running
• and (best of all) the research participants went back to their normal work schedules, training successfully without further achilles problems so long as they performed maintenance exercises a couple of times per week.

For the research control group not performing the Swedish strengthening moves, the outlook was not as promising with all research participants undergoing surgery. Six months post surgery (using traditional physio methods of achilles rehab) they were unable to rebuild calf muscle strength, making future achilles problems more likely

Conclusion

Traditionally it has been accepted that calf muscle strength played a role in achilles problems, the research carried out at the Sports Medicine Unit of the University Hospital of Northern Sweden in Umea is the first to confirm the link between calf muscle strength and toughening of the achilles.

Once you get through the twelve week achilles programme, just continue to do the exercises twice a week as maintenance. A few minutes spent on the exercises will keep the calf muscles functionally strong, lowering the risk of injury and promoting healing. A few minutes well worth spending in order to gain the benefits of trouble free Achilles in the future