Eccentric Strengthening and Treatment of Achilles Tendonitis

The achilles tendon plays a foundational role in the structure of the leg. As such, this tendon is subjected to a lot of strain. Over time, especially for athletes, repeated strain to the tendon can cause it to break down. This breakdown is known as tendonitis. In order to stay active and avoid pain, it is necessary to treat pain in your tendon, and this is where eccentric strengthening can play a key role. 


When your tendon first starts to act up, you will need to act quickly and appropriately in order to avoid further injury, which can lead to long-term problems with your tendon. The acronym to remember here is RICE, which stands for rest, ice, compression, and elevation. Resting for a couple of days, weeks, or any length of time specified by a medical professional may put your participation in sports on hold, but it is better to rest immediately than to cause further injury, which could interfere with your ability to participate in sports for years to come. Thus, rest is the first key to dealing with tendon pain. The rest of the acronym—ice, compression, and elevation—help to deal with pain management and to reduce swelling. However, while taking these steps will limit damage to the tendon and speed recovery, they do nothing to strengthen the tendon; in other words, they do nothing to prevent future injury. 

Eccentric Strengthening

To prevent future injuries, you need to make your tendon strong enough to withstand the stresses placed on it. This is where a physical therapy program is key. While there are many exercises that can help to strengthen a tendon, studies have shown that eccentric strengthening shows some promise in reducing the likelihood of future injuries. What is eccentric strengthening? When you raise your heel, your calf muscles and achilles tendon contract. When you lower your heel, especially when you lower your heel below the plane on which your toes rest, you lengthen the tendon. Eccentric strengthening has to do with lengthening the tendon while it is under weight. For example, you might use your good leg to rise up on to your toes, then use your injured leg to lower your heel back to the ground. If you are on stairs, you can put your toes on a stair and lower your heel beyond the lip of the stairs. 

While the exercise described above sounds easy enough, it is easy to overload the tendon and cause damage, so especially in the early stages of recovery, you should work with a physical therapist, such as one from Advanced Physical Therapy, to make sure you don't further injure your tendon. However, when done correctly, eccentric strengthening can not only help you return to your regular activities but also help you avoid future injuries.