PROGRAM OVERVIEW: Welcome to the Achilles reset program. This is an 8-phase program that will guide you through progressive exercises to strengthen the ankle. The program will begin with mobility, then progress through stability & strength, and finally will build you up for shock absorption in activities like jumping and running.

FOCUS: This program is designed to help you overcome an achilles tendon strain or mild case of tendonitis. It is progressive in nature and initially focuses on pain reduction. As you advance, you will work on your mobility and movements and finally finish with some strengthening and plyometrics for a safe return to sports. 

PROGRAM STRUCTURE: 8 Phases - You will perform the exercise routine from each phase for at least 1 week prior to moving on to the next phase. Follow our guidelines in each phase to know when you are ready to progress on to the next phase.

SESSION STRUCTURE: Each phase of this program is to be repeated multiple times (3-4) throughout a given week on non-consecutive days. Follow each phase for a minimum of 1-week prior to moving onto the next phase.

EQUIPMENT: Foam roller, Yoga Block, Miniband, Dumbbells (light/medium/heavy), Miniband, Long exercise band(s), Bench or chair

This program is for educational purposes only. You should consult your physician prior to engaging in this program.

Education

Tendons can be slow to heal because they have very limited blood supply. It is important not to rush through this reset program and pay close attention to how your achilles is progressing in order to avoid overloading it and experiencing a set back.

Activity Modifications

• Avoid reaching for Ibuprofen as at this point you need inflammation to promote tissue healing. It is a necessary part of the healing process. 

• Avoid/limit activities that are painful. 

• If you are a runner, strongly consider not running during this reset program, as doing so may set you on a path for chronic achilles tendinopathy.

Progression Criteria

1. You have spent at least one week on phase 1 and performed the program for the prescribed amount of times.

2. You have experienced a decrease in pain.

Education

Isometric work when done properly is a great way to work the muscles around the ankle and to stimulate healing by introducing light loading of the injured tissue. It can also help reduce inflammation. For this to happen, it needs to be performed at a pain free range of motion and intensity.

Activity Modification

• Avoid reaching for Ibuprofen as at this point you need inflammation to promote tissue healing. It is a necessary part of the healing process. 

• Avoid/limit activities that are painful.

• If you are a runner, strongly consider not running during this reset program, as doing so may set you on a path for chronic achilles tendinopathy.

Progression Criteria

1. You have spent at least one week on phase 2 and performed the program for the prescribed amount of times.

2. You have experienced a decrease in pain.

3. You can perform all of the exercises without pain and it does not lead to increased pain afterward.

4. You are able to apply more load during the isometrics now than at the beginning of the phase.

Education

Be mindful to not overdo it with the exercises and your daily activities. Sometimes tendon injuries will not let you know that you irritated them until the next day or even later. Gradual progression is key to avoiding setbacks. 

Activity Modification

• Continue to limit or avoid painful activities.

• Avoid reaching for Ibuprofen as at this point you need inflammation to promote tissue healing. It is a necessary part of the healing process.

Progression Criteria

1. You have spent at least one week on phase 3 and performed the program for the prescribed amount of times.

2. You have experienced a decrease in pain.

3. You can perform all of the exercises without pain and it does not lead to increased pain afterward.

4. You are able to perform the banded ankle exercises without pain and with full range of motion.

Education

You may be wondering why we are performing heel raises both seated and standing. That is because the calf complex is made of 3 muscles and to work the deeper one (called the soleus), we need to bend the knee to optimize its recruitment.

Activity Modifications

• Continue to limit or avoid painful activities.

• When considering reintroducing a previously painful activity, always make sure you progress gradually as tendons don’t do well with rapid increase in loading.

Progression Criteria

1. You have spent at least one week on phase 4 and performed the program for the prescribed amount of times.

2. You have experienced a decrease in pain.

3. You can perform all of the exercises without pain and it does not lead to increased pain afterward.

Education

One thing to note is that when working on tendon issues, it can be okay to have a bit of discomfort while doing the rehab exercises as long as there is no significant and/or sharp pain. What seems to matter more is the delayed effect of those exercises. If you do the exercises with some discomfort but it does not linger into the next day, then you are being productive. If on the other hand you experience increased pain or stiffness the next day, then you did a bit too much and should dial back a little. 

Activity Modifications

• When considering reintroducing a previously painful activity, always make sure you progress gradually as tendons don’t do well with rapid increase in loading.

• Be mindful of activities that load your achilles tendon more such as walking or running uphill, jumping, etc.

Progression Criteria

1. You have spent at least one week on phase 5 and performed the program for the prescribed amount of times.

2. Your pain continues to decrease with daily activities.

3. You can perform all of the exercises without pain and it does not lead to increased pain afterward.

Education

When performing the single leg heel drop, be careful not to let your heel drop lower than the box or stair if your achilles pain is primarily located at its attachment to the heel bone. If the pain is located in the body of the tendon, then it is okay to let your heel go lower than the box.

Activity Modifications

• When considering reintroducing a previously painful activity, always make sure you progress gradually as tendons don’t do well with rapid increase in loading.

• Be mindful of activities that load your achilles tendon more such as walking or running uphill, jumping, etc.

Progression Criteria

1. You have spent at least one week on phase 6 and performed the program for the prescribed amount of times.

2. Your pain continues to decrease with daily activities.

3. You can perform all of the exercises without pain and it does not lead to increased pain afterward.

Education

By now your achilles tendon is probably beginning to feel back to normal. When resuming previous activities such as running, it is important to keep your return to activities as gradual as possible and be prepared to slow the progression if you begin to feel a bit of pain or tightness. Doing so will allow your tendon to adapt to the increased load without pushing it to the point of another injury. Be patient in other words.

Activity Modifications

• When reintroducing a previously painful activity, always make sure you progress gradually as tendons don’t do well with rapid increase in loading.

• Be mindful of activities that load your achilles tendon more such as walking or running uphill, jumping, etc.

Progression Criteria

1. You have spent at least one week on phase 7 and performed the program for the prescribed amount of times.

2. Your pain continues to decrease with daily activities.

3. You can perform all of the exercises without pain and it does not lead to increased pain afterward.

Education

Congratulations on reaching the final phase of the Achilles Reset Program. As you return to your activities, do not forget what you have learnt in this program especially regarding progressive loading. That principle should guide you in your return to sport to avoid re-injury.

Activity Modification

• Return to your activities gradually to avoid re-injuring your achilles tendon.

Progression Criteria

1. You have spent at least one week on phase 8 and performed the program for the prescribed amount of times.

2. Your pain continues to decrease with daily activities.

3. You can perform all of the exercises without pain and it does not lead to increased pain afterward.