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Our user asked: "I have had tendonosis of the Achilles for about 6 weeks now. I rested completely for 3 weeks, then started light stretching. Initially, pinching the sides of the achilles was extremely painful. It does not hurt all any more and hasn't for about a week. I just feel a dull ache in the heel now in the morning and at night. I had ultrasound done about 8-10 times and that seemed to help when it was still very tender. I have now been building up to calf raises. I started with 1x10 and have built up to 3x10 eccentric calf raises. I am also using a rolling pin to massage my calfs before any exercise and I am massaging them and the achilles after exercise. If I can continue to do the calf raises 3x10 eccentric, what should I progress to next. I dont want to go back to running too soon without doing enough strengthening and letting it heal fully, but I think working it will help it heal properly. Could you suggest exercises or even reps of exercises that I should progress to. I know that if I experience pain then I should stop and that if it hurts the next day, i did too much."
Ask a PT Response: "Were you getting ultrasound from a PT and if so are you still seeing the PT? How did you develop tendinosis of the achilles? Before getting back to running, the underlying factor which contributed to this condition definitley needs to be addressed. Sounds like you are doing the correct things but strengthening alone will not ensure successful return to running. Stretching, postural training, mechanics correction, somatosensory/proprioceptive training, etc. should also be considered. Without physically examining you, it would be difficult for me to give you specific advice. However, with my patients that may have this condition I would usually have them perform/progress to the higher level activities which are performend after an achilles tendon repair ie: http://www.udel.edu/PT/PT%20Clinical%20Services/RehabGuidelines/AchillesRepair.pdf - http://www.udel.edu/PT/PT%20Clinical%20Services/RehabGuidelines/AchillesRepair.pdf . I hope this helps."
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