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THE EXERCISE YOU MUST DO IF YOU ARE OVER 30 YEARS OLD.


According to Greek Mythology, Achilles was a Greek hero of the Trojan War.  He was said to be invulnerable, except for his heel.  The term Achilles Heel has come to be known as a person's point of weakness.  In today's society, achilles tendon injuries are as debilitating for someone  as it was for a Greek hero.  Achilles tendon injuries affect everyone from active to sedentary and professional to recreational athletes.  About 80% of achilles ruptures occur during recreational activities.  Typically, achilles ruptures occur in recreational runners aged 35 to 45 years old.(1)

The achilles tendon is located on the back of the lower leg attaching the calf muscle to  the heel.   The calf muscle contracts pulling through the achilles tendon to produce plantar-flexion of the foot for push off during walking, running, and jumping. (2)(3).  Achilles tendon injuries cause pain, aching, stiffness, soreness, and tenderness to the tendon.   Achilles tendon injuries cause significant disability, as it will limit all activity involving the legs, including walking, standing, running, jumping, and driving.

According to the Journal of Orthopaedic and Sports Physical Therapy Clinical Practice Guidelines interventions targeting achilles tendon include:  soft tissue mobilization, taping, heel lift, stretching, orthoses, low-level laser, iontophoresis, and eccentric loading to the tendon.  Only eccentric loading to the tendon showed strong evidence for positive outcomes for achilles tendon injuries.(1)(2)(4)

The severity of disability that comes with achilles tendon injury and the increased risk of achilles tendon injury in the age group of 35 to 45 years of age makes the Eccentric Calf Raise, the one exercise you must do if you're over 30 years old.

How to do eccentric calf raises:
1.  Standing with your toes on a step and heels off the step.  Raise up on to your toes using both feet.
2.  Slowly lower down on one foot until the heel drops below the height of the step.  The important part of this exercise is to lower down SLOWLY.
3.  Perform 3 sets of 15 repetitions on each leg with the knee straight and 3 sets of 15 repetitions on each leg with the knee slightly flexed.  Perform both exercises twice a day.
4.  Once the exercise becomes easy to perform, use weight to increase the intensity of the exercise.

Avoid your achilles heel from becoming your achilles heel.  Start performing Eccentric Calf Raises, especially if you are over 30 years old.


-- Scott Matsuura, PT, OCS



Resources:

1. Alfredson H, Lorentzon R., Chronic Achilles tendinosis: recommendations for treatment and prevention. Sports Med 2000; 29:135.
2. Carcia CR et al., Clinical Practice Guidelines Linked to ICF.  Achilles Pain, Stiffness and Muscle Power Deficits:  Achilles Tendinitis.  JOSPT, 2010.
3. Khan KM, et al., Histopathology of common tendinopathies. Update and implications for clinical management. Sports Med. 1999;27:393–408.
4. Fahlström M, et al., Chronic Achilles tendon pain treated with eccentric calf-muscle training. Knee Surg Sports Traumatol Arthrosc 2003; 11:327.