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.
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, they will:
- Review your medical history
- Conduct a series of tests to help develop an accurate diagnosis and to determine why your injury happened
- 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
The time you’ll need to spend in PT depends on how bad your injury is. A grade I injury may require 2-4 weeks of treatment versus a grade III, which may mean several months of PT. Your treatment plan may last for a few months. Some people need up to 6 months of therapy before they feel better. During that time, you may meet with your physical therapist once or twice per week.
Typical Goals of PT
Whether you want to run marathons or simply walk the dog without Achilles pain, physical therapy can help get you there. There are a few basic goals of treatment:
Pain relief. Your physical therapist may use ice, recommend a leg brace, give you ultrasound therapy, or use other ways to ease your pain.
Proper movement. For different reasons, your ankle, foot, or knee joints may not move the way they should. This can strain your Achilles tendon. To correct these problems, a physical therapist may show you stretching exercises or use hands-on techniques to ease the tension.
Muscle strength and balance. Weak muscles or a muscle imbalance can take a toll on your Achilles tendon. In physical therapy, expect strength-building exercises tailored for you.
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 they tell you it’s safe to do them on your own. They can harm your Achilles tendon if you do them incorrectly.
3 Common Questions about PT
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. They also have 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 physical therapist 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.