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All About Physical Therapy for an Achilles Injury

If you hurt your Achilles tendon — the band of tissue that connects your calf muscle to your heel bone — you may need physical therapy (PT). It usually involves exercises, stretches, and other techniques to get you back on your feet.
One common cause of Achilles pain is tendinitis. Sports — especially running — are often to blame. In mild cases, home remedies such as rest, ice, and anti-inflammatory pain medicine (like ibuprofen or naproxen) may be all you need. But if the pain doesn’t get better, PT can be very helpful.

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Physical Therapy 101

– Your doctor can write you a prescription for PT. You can also bypass the doctor and go straight to a physical therapist for an evaluation. In general, she will:

– Review your medical history

– Figure out how much the injury affects you (by watching you move, listening to your concerns, and more)

– Make a PT plan for you, including your goals for the therapy

– Have you do exercises and stretches

– Use different techniques and tools to help you heal
– Monitor and record your progress, changing your plan as needed

Gold-Standard PT Exercises

If your Achilles pain lasts longer than a few weeks, it may be a sign that your tendon has a build-up of many small injuries that aren’t healing properly, which doctors call tendinosis. “Eccentric strengthening” exercises are considered the gold standard for this problem. Two of these kinds of moves are:

Bilateral heel drop: Stand at the edge of a step and hold on to a handrail. Only the front half of your feet should be touching the stair. Using your arms to support you, raise up onto the balls of your feet. Pause, then without leaning on your arms, slowly lower your heels down below step height. Do this 12-20 times.

Single leg heel drop: After you’ve mastered the bilateral heel drop on two legs, try rising up onto the balls of both feet, then lift one foot off the step and lower yourself using just one leg.

These exercises work well, but it may take 3-6 months until you feel major improvement. You should do them with your physical therapist; at least until she tells you it’s safe to do them on your own. They can harm your Achilles tendon if you do them incorrectly.

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3 Common Questions about PT

Does insurance cover physical therapy? The only way to know for sure is to find out directly from your insurance company. However, most plans will cover at least some physical physiotherapy.

Can I just do exercises at home? There are several reasons it’s best to see a physical therapist instead of only doing exercises on your own. For one, a physical therapist can ensure your form is correct, so you won’t make your injury even worse. She also has the expertise and tools to treat your specific injury and meet your unique needs. That means your recovery may take less time.

Will PT hurt? One survey found that 71% of people who have never visited a physiotherarpist think that PT is painful. The number was a lot lower among those who had PT in the past year. While some of the exercises may be uncomfortable, they shouldn’t hurt. Physical therapy is designed to improve your pain, not cause more.


Peter Simpson

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