Stretch me! Need your best Achilles Tendon stretches please

September 16, 2009 11:05 AM

Runners/others - any tips for stretching my Achilles? Right - I am a runner. I have one leg longer than the other and an orthotic to balance it. Due to the leg issue I have been attending the Orthopaedic Hospital on the NHS (they have been brilliant). I am female, late 30s, 140lbs, 5'2". Since ramping up training, a bit of pain/discomfort in the instep on the short leg. Sometimes wen running, sometimes after running if I don't support the instep by wearing trainers after my shower. Referred self back to Orth. Hosp. Orthotist said it is a tight Achilles Tendon, apparently it wraps round the ankle and joins the instep. Both tight but this tightest. I need to get more movement and range in the Achilles. Anyone know/ can point me in the direction of some good stretches?

You are not my doctor or my physio. I have no more free treatment available and don't have spare money to pay. I know this is the advice of internet folks and not professionals etc etc etc.

Don't worry about my general health, running with uneven leg length (am careful, look after self, shock absorbing insoles etc etc, orthotist checked my gait-analysed trainers and is happy with them)

Because it is really only an issue when I run, the Orthop. Hosp. don't want to offer me physio on the NHS (which is fair enough) and suggested I went private (which I can't afford right now if it's not affecting my walking)

posted by LyzzyBee to health & fitness (12 comments total)

Let me get this straight, you have pain in your arch? or you have pain in your achilles tendon? Or both?
posted by robokevin at 11:23 AM on September 16

go to a stair, put your balls of you feet on the stair so your foot is only halfway on the stair, and your heel is hanging off the edge. allow your weight to transfer from the balls of your feet to your heels, causing your heels to drop below the level of the stair. use the handrail. repeat as necessary.
posted by lester at 11:30 AM on September 16

I have Achilles tendonitis; the main stretches my PT has me do at home are:

1. Stand next to wall, with hands on wall and affected leg back, bent at knee. Lean forward, hold 30 seconds, repeat 3 times. (Soleus stretch.)

2. Same thing but with the back leg straight rather than bent. (Gastroc stretch.)

3. Hamstring stretches.

I have no idea if any of this would be helpful for you, as I have a bunch of other issues, but I thought I'd throw it out there.
posted by sineala at 12:02 PM on September 16

keep a tennis ball on your bedside table. Before you stand up in the morning, sit on the edge of the bed, put the ball on the floor, and roll it back and forth under your arch for at least two minutes. I did this to treat plantar fasciitis, and it made a huge difference in how my arch felt for most of the day.
posted by Mayor Curley at 12:03 PM on September 16

Ooh thanks so far for all these

Robokevin - pain in arch only. Well, I get a bit of ache in the calf that side which is due to it having to work a little harder due to my foot being in the right position now (no bad pain, just a "I have worked" ache which is diminishing with time). No pain in achilles but he was definite that the tightness there is acting on the arch.

Oh and in question I meant both Achilles are tight but the one in my left (shorter) leg is tightest.

I don't even ever wear high heels!
posted by LyzzyBee at 12:12 PM on September 16

(note: I'm going to recommend a couple of products here, I do not have financial interest in them.)

After googling around and figuring out that instep = arch, I am about 80% sure that you have Plantar Fasciitis.

Your orthotist had a good thing going about the achilles tendon, with a minor correction: the cause of the pain is actually a tight soleus muscle, which lives near the achilles tendon and connects to the plantar fascia, not the achilles tendon itself.

The soleus muscle is what allows your foot to dorsiflex, and when your soleus muscle becomes chronically tight, your foot can't move around freely and your arch loses the ability to act as a natural shock absorber.

Stretch #5 here is what you want: http://www.halhigdon.com/15Ktraining/Stretch.htm , it works very well. I actually use a specialized device to help with this stretch, and recommend it ( http://prostretch.com/ ).

In addition you would serve yourself well by doing strengthening and proprioception physical therapy exercises. I could write 20 pages on this but you'd be better served just by following Pete Magill's routine here: http://petemagill.blogspot.com/2009/02/petes-home-remedies-plantar-fasciitis.html

A routine of stretching, strengthening, and proprioception exercises should go a long way to manage the injury and keep you running. However this is an insidious mother bitch of an injury. There is no quick fix. DO NOT TAKE CORTICOSTEROIDS (this will severely weaken the tissue, while making the pain go away -- which can allow you to do an incredible amount of damage to your foot without feeling it).

Another thing that really helped me is deep tissue massage, specifically trigger point therapy. I have a sports masseuse but I also do self-massage from this book: http://triggerpointbook.com . I believe the PF massage instructions are on their website.

If you have had chronic plantar fasciitis for a long period of time, you may have to deal with scar tissue that has gone necrotic, even after you have alleviated the inflammation and the injury itself. This will cause the same pain that the injury does. To deal with this you need to simply massage your instep very hard. A lot of people like standing on golf balls or tennis balls, personally I find a lacross ball to work the best. I'm currently testing a new product called The Foot Log ( http://www.footlog.com/ ) and I find it to work pretty well for this, despite their marketing being complete nonsense.

If it's PF, I'm very sorry if you have this. I would rather have a stress fracture than PF. I have had it twice and one case lasted longer than two years. The key is being as vigilant as you can about managing it, and one day it will just magically go away. The good thing about it is that you can keep your mileage up and run through it (I ran 70 mpw throughout mine), and if you're good about the exercises it's not too painful, the bad thing about it is that it sucks away your will to run.
posted by robokevin at 12:16 PM on September 16

Sorry for not linkifying, I am new to metafilter.

The stretch that lester posted is also a good one.
posted by robokevin at 12:17 PM on September 16

This is going to be way out of left-field, but here goes:

I have incredibly, incredibly inflexible ankles (and also don't even wear high heels), and I have done a huge amount of internet research on stretches to lengthen the achilles tendon. Pretty much everything I have found (in terms of peer-reviewed studies) has said that there are no stretches that really do much good. Note that I am trying to increase my flexibility for other sport reasons, not to relieve pain. I have one of robokevin's prostretch things, did no good. Used a tennis ball on my foot (actually had someone recommend a golf ball instead of a tennis ball, which would probably work better) and that feels really good and might very well help your pain, but it is probably not going to increase your flexibility. You may still get benefits from stretching for pain relief, and if it is the soleus instead of the actual achilles causing the tightness maybe you can stretch it out, but I am still waiting for the stretch that does a damn thing to a really tight/short achilles.

Now, all of that being said, how do you run? Do you run with a heel strike or do you do more of a pose-style, leaning forward and hitting with the ball of the foot? If you do heel strike-based running, you might look into pose. I have never actually gone to a seminar or anything for it, but I do find that since trying to keep my running with the strike on the ball of the foot instead of the heel, I have less foot pain. Now, I don't really run more than 5K so my experience may not help you much, but it might be something to consider if stretching and massage don't help you out much.
posted by ch1x0r at 12:36 PM on September 16

You cannot stretch a tendon. Think of tendons like ropes. At the end of the rope, there is a muscle that pulls it (in this case the soleus). That muscle can become shortened by repetitive motion (running), increasing the tightness on the tendon, and then that muscle can be stretched, increasing it's range of motion and allowing it to give more slack to the tendon.

I know this sounds like a technicality, but it is actually very important here.
posted by robokevin at 12:42 PM on September 16

Read 'Born to Run'

the case of your legs being unequal might make your situation unique and require orthotics to balance the lengths, but it's fairly established that stretching prior to exercise is useless; and modern shoes do more harm than good.
posted by OHenryPacey at 12:45 PM on September 16

Thanks everyone so far!

I'm not sure if it's the plantar fascia as a) it's not as vile as I know plantar fasciitis (sorry about spelling) can be, and b) it's not underneath the foot so much as at the side at the top of the instep (I think the instep is the side of the arch not underneath it anyway, though didn't realise that wasn't a common term)

It's not a big pain (otherwise I would stop running - having lived with unequal legs for years bfore getting them sorted out, I'm not going to mess around with them) and it seems odd it usually flares up more when I'm relaxing after exercise - is this common (with anything?)

I have a mid-strike. I've looked at chi running but the thing hurts more when I am relaxed and flappy with my feet as chi running seems to imply.

Cheers for the info on tendons/muscles; that makes sense and if I'd thought, I would have queried how you stretch a tendon!

OHenry I have to use the orthotic all the time (even in my slippers) so no option not to, it took months of pain and discomfort to get used to the thing (see some of my previous posts!) and I wouldn't want to go back to having oddly sized legs and calf muscles but thanks for the link.

Best go and get a tennis ball then!
posted by LyzzyBee at 1:27 PM on September 16

The gastroc stretch eliminated a similar problem for me. Not immediately, but over a few weeks. My pain was in my instep and right in the middle of the foot. Intermittent, and sometimes very sharp. It was the only time I've been to a podiatrist. He measured my dorsiflexion, and told me I had much tighter gastrocs than is normal. He recommended I stretch one leg, then the other, for 30 seconds each, then repeat twice with a slightly longer stretch each time. Two sets per day. Don't stretch more than is comfortable. You can probably find more detailed instructions on the web somewhere. I think it will work for you!
posted by Snerd at 6:28 PM on September 16