Why do eccentric heel drops help with achilles tendinosis?

Precious Roy wrote:

Except when you have a problem down in the insertion of the achilles. In that case, you need to be very careful not to overstretch it. I was almost 100% cured after a bout with my achilles and set myself back in a big way when I over stretched and re-aggrevated the tendon at the insertion. Also, you should very gradually work your way into the protocol of high reps. I also mangled my calf by diving head first into too many reps. But, once you stop being a dummy like me and carefully work through the protocol, it does work.

How many reps is "high reps"? I'm just doing 3 x 15 straight leg, 3 x 15 bent leg. Mine is not at the insertion point though. It started in the pretty standard place (a couple of inches above the heel) and migrated a bit off-center later on.

I usually find them a little painful for the first set or two, but by the third I feel pretty good.

Hi Rocky,

I'm pretty sure you didn't have surgery to the actual tendon itself then ran a marathon a month later; I would guess that you had tendinopathy and had surgery to the paratenon and blood supply to the tendon. This often releases the tissues which cause the pain and allow rapid return to sport.

MOst UK surgeons and HAkan Alfredson who is an internationally recognised expert in the field will usually NOT do this sort of surgery unless someone has tried 3 months on the eccentric exercise programme unsuccessfully, as the protocol has such a high sucess rate and is non-invasive.

Hi Rocky,

I'm pretty sure you didn't have surgery to the actual tendon itself then ran a marathon a month later; I would guess that you had tendinopathy and had surgery to the paratenon and blood supply to the tendon. This often releases the tissues which cause the pain and allow rapid return to sport.

Most UK surgeons and Hakan Alfredson who is an internationally recognised expert in the field will usually NOT do this sort of surgery unless someone has tried 3 months on the eccentric exercise programme unsuccessfully, as the protocol has such a high success rate and is non-invasive.

To other readers- make sure you get a proper diagnosis first from a suitably experienced physio or medic, and proper instruction on TRUE eccentric exercises; 80% of people who use them for mid tendon tendonosis return to sport very well.

To the OP.

Good article on mechanism of effect for the exercises.

http://www.runningwritings.com/2013/11/achilles-tendonitis-in-runners.html

To others who have followed the protocol did your achilles start hurting worse when you started doing these? i just started doing them and after getting up after sitting for a while, my achilles hurts worse than before i started doing them. Is this normal? It it loosens up when i run and i don't feel it at all but it worries me that i feel it when i'm not doing anything but walking around.

I think some discomfort is normal but I've had a lot of pain and seem to get worse doing these. I've battled Achilles problems for years now. I've tried eccentrics multiple times using different protocols (including flat surface since mine is insertionall). Every time I do, my Achilles gets progressively more sore. One time I stuck with it for 6 weeks but by the end it was so painful that I had trouble walking. I was literally hobbling around all day and I had to quit. Anyone else had similar experiences? Am I doing something wrong? I know everyone says it's supposed to hurt but for me it just gets worse and worse.

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To the OP.

Good article on mechanism of effect for the exercises.

http://www.runningwritings.com/2013/11/achilles-tendonitis-in-runners.html

To others who have followed the protocol did your achilles start hurting worse when you started doing these? i just started doing them and after getting up after sitting for a while, my achilles hurts worse than before i started doing them. Is this normal? It it loosens up when i run and i don't feel it at all but it worries me that i feel it when i'm not doing anything but walking around.[/quote]

This article says that for insertion problem you must do isometric exercices?www.running-physio.com/insertional-achilles-tendinopathy/

Precious Roy wrote:

Except when you have a problem down in the insertion of the achilles. In that case, you need to be very careful not to overstretch it. I was almost 100% cured after a bout with my achilles and set myself back in a big way when I over stretched and re-aggrevated the tendon at the insertion. Also, you should very gradually work your way into the protocol of high reps. I also mangled my calf by diving head first into too many reps. But, once you stop being a dummy like me and carefully work through the protocol, it does work.

I remember reading the treatment was first noticed by someone intentionally trying to worsen their Achilles tendonitis, to qualify for time off work. They weighted up a backpack and did heel drops but ended up curing it instead. So it's one of those things where we're not sure why it works, but it's an easy, safe and effective treatment and I do them after every run as a preventative.

yviyvviyv wrote:

I remember reading the treatment was first noticed by someone intentionally trying to worsen their Achilles tendonitis, to qualify for time off work. They weighted up a backpack and did heel drops but ended up curing it instead. So it's one of those things where we're not sure why it works, but it's an easy, safe and effective treatment and I do them after every run as a preventative.

That was Håkan Alfredsson.