Achilles Tendinopathy / Tendinitis / Tendinosis | Heel Pain Rehab (Education, Myths, Exercises)

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In this video, I discuss Achilles Tendinopathy, dispel the most common myths associated with the diagnosis, and teach you everything you need to know about managing the condition.
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Intro (0:00)
Anatomy & Function (0:13)
Achilles Tendinopathy (0:37)
Mid-Portion vs Insertional Achilles Tendinopathy (2:24)
Why Did You Get Achilles Tendinopathy? (2:54)
Treat The Donut, Not The Hole (4:11)
Understanding & Monitoring Pain (5:49)
Load Management & Activity Modifications (8:48)
Rehab Stages (11:26)
Stage 0: Isometrics (12:35)
Stage 1: Heavy Slow Resistance (13:50)
Stage 2: Energy Storage & Release (16:37)
Stage 3: Return to Sport (18:08)
Achilles Tendinopathy Programming (18:43)
Do You Have To Stop Running? (20:39)
Other Management Strategies (21:32)
Summary (22:29)
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Disclaimer: The information presented is not intended as medical advice or to be a substitute for medical counseling but intended for entertainment purposes only. If you are experiencing pain, please seek the appropriate healthcare professional.

[@E3Rehab]

Thank you so much for watching! Be sure to check out the blog for all the references! e3rehab.com/blog/achilles-tendinopathy/

[@AfroIndo]

I hereby stop watching any other fitness and rehab channel. This video is excellent, this problem has bothered me for probably 20 years and I've absolutely been following the boom, bust, give up cycle. Better than all physio consultations I've had on the issue too. Thank you

[@nicholastown2779]

thats awesome. Yeah to be honest its the best breakdown I´ve seen for this type of injury. Everyone gas there own way but this just helps us to understand way more without having to worry about how long rather worry about how it feels each session and checking in on the body every session. 20 years..blimey thats long man. hope you get better

[@Chavanun555]

How is it now?

[@blueoct5591]

Due to insertional tendinopathy I’m in bad shape at the moment. I’m in a lot of pain and can’t walk without limping. I finally gave in and went to the ortho walk-in clinic yesterday. Long story short, I need to have my insurance send you money for the appointment because this video was so much more helpful.

[@jys0527]

Literally the ONLY channel anyone needs for rehab. Thank you so much! 🙏🏻🙏🏻

[@nielsvandervelden3063]

I have been running for years with severe Achilles pain. Tried everything from resting to implementing exercises but the pain always came back. What made a real difference was getting a pair of running shoes with very thick heel support. I now run virtually pain free.

[@ravkhabra]

BRILLIANT VIDEO and by far the best rehab programme on the net. Just one suggestion: if you are suffering from insertional tendinopathy then don't perform deficit heel raises off a step/raised platform as this will inflame your tendon even further. Perform your heel raises on flat ground but as stated in the video, try to increase the load on your achilles by performing a single leg heel raise and by adding weight. My achillles tendons were in extremely bad shape. I was not able to run for more than five minutes before they would flare up, forcing me to stop. By following the advice on the video, gradually, over time (3 months) I have managed to increase my runs to the point where I can now run for nearly an hour, jogging at a moderate pace. I play football (soccer) once a week and my goal is to be able to sprint freely without inflaming the tendons. I am not quite there yet but I feel very confident that if I follow this rehab programme I soon will be.

[@EstenSesto]

This was my question regarding insertional and lowering the heel. Sounds like doing everything on a flat surface is best.

[@ravkhabra]

Yes, definitely. Anyway, good luck with your rehab. 🙂@@EstenSesto

[@thermoplastischesaethylend1046]

If you think "flaring up after 5min of running" is bad shape, then what is with mine If I get extreme pain for just a few minutes of walking. Ive been having it for almost a year. It will probably tear sooner or later... Gotta live with it.

[@harveywinks8640]

Did you eventually get there? I have had a chronic tendonopathy for 2.5 years and I am about to stop the raised heel off a step exercise. I just what to get back to tennis

[@ravkhabra]

@@harveywinks8640 Yes, I did get there! I am able to play football pretty normally now. Now and again I do get flare-ups in both Achilles tendons but the pain is very manageable. I try and do heel raises at least twice a week on flat ground. If I am doing single heel raises, I will do 3 x 15 sets. If I am doing double heel raises I will do 3 x 25 sets. Just depends on how my Achilles tendons are feeling. Single heel raises have more load on them, double heel raises less so. Anyway, my improvement in function was very gradual. At worst, I was not able to run for more than a few minutes before my Achilles tendons started flaring up and feeling inflamed. But gradually over the weeks and months, my function improved. Yes, there are still some weeks when my tendons do feel a bit aggravated, but by and large I am nearly back to normal. If you do the heel raises consistently and patiently you should steadily improve. Good luck with your recovery and I hope you're back on the tennis court soon. 🙂

[@FeelgoodThreads]

I wish I saw this video when I had Achilles tendinopothy. Tore my Achilles not understanding why i kept falling in that cycle of inflammation. Now all my rehab exercises are similar to your rehab here. Great content.

[@andrewdemarco6923]

This is the most erudite, most well conceived, and best executed discussion of the topic of Achilles tendinopathy I have come across. As a teaching physician, I intend to share this with both patients and residents. Well done!

[@stephenlever419]

I wish this was the 1st video I had found !! Absolutely the best

[@sibertiger17]

Finally. Someone breaks it down with exact analysis of what happens to me! Mine always hurt the next day...

[@n_k_s_b]

keep doing the exercises after you recover - stop the pain from coming back

[@buttermashpotatoes4617]

The idea to keep the load tolerable instead of completely resting, then going too hard and making things worse is something I've not heard anywhere else, thank you so much for this advice

[@philipkim9779]

I was struggling with Insertional Achilles Tendinopathy on my left Achilles tendon but I'm not too worried anymore thanks to you. Thank you for providing great explanation and making it simple for us. The quality of this video is so good that it's helping me more than doctors. I often get impatient and do too much too soon. I will try to build my load capacity by improving my tolerance to various forms of loading and restore the function slowly without rushing the process. Thank you so much for providing great quality content like always.

[@andrewkreuter3147]

Any updates ?

[@anthonyencarnacion7203]

The time frames are the most shocking part of injury management.. thank you again.. for the critical reminder of living with pain, and when it's too much pain.. your speaking about therapy but it's hitting me like deep philosophy.. I'm 51 years old and am constantly surprised by the length of time it takes to recover.. your channel is the support group critical to the path forward (through) the pain.. I appreciate you..

[@katesel]

THANK YOU. i am having a horrible time getting out of the boom, bust cycle. Incredibly frustrated because I was successful treating this a few years ago. The exercise progress was what i have been trying to find. (p.s. I am a PT ;) )

[@trevorm3181]

Promising video. I’ve been dealing with this sh*t for 5 years.

[@tatianapetrov6206]

Best video on the topic I have come across. Well done!

[@deathbycolor]

Such a well put together and delivered video!

[@cian3299]

This is the most comprehensive video on tendinopathy I've seen. And I've been watching them for years! Thanks!

[@cameron3344]

This is a very well put together video, thank you for making it.

[@Swarrenii]

You got me sold sir. This will help with translating to my patients!!!

[@arivirtanen2568]

Amazing video. This really helps

[@curiousmonkey8485]

Great, thanks! Seems like a pretty comprehensive guide. Feeling confident equipped with this :D

[@simranchandani4796]

Fabulous video! Thank you for putting together a detailed & implementable video.

[@shwetasah8009]

Wow!! This is such an informative video, explaining the whys behind the whats! Thank you so much!!!

[@gaurichess]

This channel is a godsend. Thank you so much! Give me so much hope for a full recovery

[@caninbar]

This is wonderful!!! First video I've found with complete information clearly presented. Thank you! Now I have to get organised!

[@tamasholics]

The best and most complete video. Awesome production quality. Thank you and congrats!

[@seanyar9648]

GREAT JOB, very professionally made

[@jennyjones319]

Amazing video and such detailed and clear advice. Thank you so much for your help.

[@TheRealThilo]

This is honestly the best video on this topic. Thank you.

[@silverpippin9051]

thank you so much. Excellent video, great and clear presentation. Finally found the information that I have been looking for for months.

[@karinjessop1046]

Thank you so much for this quality content! Achilles problems just showed up for the first time in my athletic career - ironically when I got too busy with all the holiday mayhem to do my foot/ankle/post chain work! Back at it again!

[@otgod6694]

thank you so much for this detailed video. for the first time in a long time i'm very hopeful that i can finally heal.

[@christinasmith1598]

Thank you so much. The information you present is so easy and simple to follow. Very much appreciated 💚

[@tarancourchesne1947]

This video is so great man I CAN'T EVEN SAY HOW GREAT! You're just awesome, and I think you know this, but you're killing it.

[@EastTiger32]

This is an excellent video. Very informative and straightforward. Thank you

[@nixsearcy5547]

Wow! thank you for this. Fantastic explanation.

[@UnlimitedUF2]

really love these renewals, i think doing remakes of rehabs videos like these are essential for human evolution, thank you, your content like theses means more than you realize, thank you again for sharing your work with the world.

[@linkchiu007]

great video, very clear and helpful! thank you

[@jamiejones7039]

This has to be the best overall video out there. Yes there are other videos that have bits and pieces of what is mentioned here, but this has everything combined. Excellent work, looking forward to trying some of the exercises myself

[@joaobranco3397]

Thanks man this was very helpful

[@philsteamwork]

after years of tendinosis i can say this is the best description on 'how to proceed' i've ever seen. there is stuff mentioned in this video, that i discovered after long time that worked for me. wish i'd have discovered the channel earlier. top content, big thank you.

[@saifnz5430]

Hi how’s the recovery going I got insertional tendinosis as well, physios say do eccentric loading on flat surfaces not decline step, I did also 6 session of shockwave therapy, def helped a lot. My exercises are 1 towel stretch the calf for lengthening 2 eccentric loading calf single leg flat surface 3 balance on one leg for 90seconds 4 Abduction/addiction exercises as the eccentric loading targets glutes muscles also. 5 calf stretches 6 bent calf raises for soleous muscle. 7 biking for 45 mins Been doing this for 2 months now, I still have 3/10 pain

[@philsteamwork]

I ended up doing a The ACP (Autologous Conditioned Plasma) or PRP (Platelet Rich Plasma) therapy. That was the first thing that had an effect and fortunately the healing was super fast after that. It took only 3 injections (of your own blood into the tendon) and I could feel a significant improvement. The 3 Injections happend over a time period of 6 weeks.

[@philsteamwork]

I ended up doing a The ACP (Autologous Conditioned Plasma) or PRP (Platelet Rich Plasma) therapy. That was the first thing that had an effect and fortunately the healing was super fast after that. It took only 3 injections (of your own blood into the tendon) and I could feel a significant improvement. The 3 Injections happend over a time period of 6 weeks. I tried so many things before to get rid of the achilles tendinopathy but in the end they didn't work for me.@@saifnz5430

[@thermoplastischesaethylend1046]

​@@philsteamwork so you were not able to heal your tendinopathy alone?

[@philsteamwork]

​@@thermoplastischesaethylend1046 There was a process of healing without ACP/PRP but the speed was super super slow. So I searched around if there are other options and found ACP/PRP which really helped.

[@ashishmsukhadia]

Superbly explained and great video! And always great to see these types of videos include actual study results so that we can have confidence in the recommendations! Thank YOU and your channel for the great work and information and guidance.

[@rayalgar]

Excellent evidence-based diagnosis and treatment advice. I’ve just take up Padel tennis which is really loading my achilles so will now be using your staged protocol. It’s also so helpful to know that you can exercise within tolerable levels of pain and that rest is not always best.

[@anrylmediadero2236]

Thank you so much for the enlightenment.

[@juandavidrojasperdomo4303]

Excellent video! It´s very difficult to find people expert about anything. You are expert in this topic! Congraulations"! GO on

[@nicholastown2779]

Thank you so much for this awesome breakdown. It just helps relieve stress caused from injury just looking and being able to set my guidelines accordingly and simply focus without getting anxious about doing too little or too much. Huge thanks. I wish you all the best.

[@adrientalon63]

Incredibly well put ! Thank you so much ! I like how you don't try to give false hope and you give precise explanations with examples and variations for each exercise. Best video on the subject by far 👍

[@nicholastown2779]

agreed

[@petertaylor9763]

Your explanation was great. Now I now what to do. 😊

[@nilouvakil6807]

Lots of information! Thank you for a very thorough presentation with reliable research components. The explanation of exercises are very beneficial 😊

[@arsalanafrakhteh7226]

This is the best video I watched on this subject and I am dealing with this problem on and off for a few months now and it matches my experience as well.

[@davidiagmon]

So much knowledge in such a short time. I love your channel. You helped me overcome multiple injuries. Thanks!

[@James-J-J-J]

Excellent video! Thank you. I’ve fallen into the trap in the past of trying to do too much too soon - too keen to rekindle past running glories. Thank you for grounding me again with this info 👍🏻👍🏻👍🏻

[@shamelesschic9491]

Yes, makes so much sense! Thanks for the detailed, thorough vid, even providing possible weekly schedule. Cause deteriorating into sedentary slug is not desirable 🙂

[@Iaapwm]

Well delivered information. I like visual with a well-informed voice in the background. there were no shaming or doooooom. just a clear plan on how to deal with your problem,,,, and solution driven. Thank you very much from Lismore NSW Australia.

[@Rajasunny188]

Thats a great job sir. Tq for making such a detailed video

[@mushbro10]

Wish I would have watched this months ago. Perfect!

[@ThePhysioCoach]

Thank you! I am a Physio in Germany and I love your videos! You're helping me keeping up to date with your great content.

[@matthewmclaughlin6532]

Excellent video and explanations.

[@lyndonsumbeling6490]

Thumbs up for this video this is the best by far. Been struggling for Tendinopathy for almost 3 years. Playing basketball in a decreased level since then. Hopefully be able to manage capacity through to this process and consistency.

[@Cutest1TheGame]

I love long videos with lots of detail!

[@alperu]

Incredibly helpful video! Thank you for sharing! I am living with bursitis pain on my heel for years and I think this video is more helpful than my previous doctor visits... Thank you.

[@hannahpain3671]

This is the best video I have found for explaining the progression of tendinitis/tendinopathy rehab. Please can you do more for tennis elbow and shoulders? I will be sending these to my clients for sure! Thank you

[@e2d909]

Excellent video. Thank you

[@soulc4ster]

amazing video been strugle with this for some time and first explanation that makes sense in a while hope in a year this problem is solved with your method

[@kdub3562]

Suffering with mid point tendinitis and this is by far the most comprehensive and complete program I've discovered. Several options and the exercises within each stage is very helpful. Definitely gonna subscribe.

[@piotrmusialek5691]

Great video mr Surdykapt!!!

[@yato8940]

Thank you for this. I am experiencing this right now due to increasing LOAD of exercises recently.

[@AceTheFirePunch]

I'm in 7th Week after ACL-Reconstruction, finally able to start doing exercises (mostly mobility). - Your videos are very helpful (especially the ACL-Series..), thank you very much, you've been a great inspiration and ressource of motivation to me ! One thing i miss on your videos (helpful to almost every Ankle / Knee recovery plan) is WALKING BACKWARDS, intentionally rolling of your toes, pushing yourself back more and more as your leg-function allows it. Also doing Tibialis Raises (can be done loaded, so the heel doesn't have to be on the ground, for Heel-Painers) helped me a ton, in regaining control, mobility & muscle-symmetry! Kudos

[@michaelmaldonado9914]

would love another diagnosis, I currently run alot and have been for over almost a year. I stopped running seriously back in 2020 after i was on a long run and was running forefoot and felt sharp pain in my Achilles and turned out to be tendinitis. I have since changed to heel strike and built my weekly mileage slowly. In doing this i barely have any pain but i have found good use of implementing these workouts in my day to day so thank you very much!

[@montgomri6663]

God bless this man. Subscribed. And I rarely ever subscribe.

[@debbiedebbie9473]

Thank you very much.

[@gavinli2013]

Thanks so much for the excellent video, I am a marathoner who ran a time with 2hr51mins, I have been suffering achilles problem for over the past 2 years, I am really confident on breaking my PB after watching your video. I will adjust my training program as well. Thanks and keep up the good work please!!

[@hugomotaprego5268]

my Tendinitis flared up yesterday because I played in a tournament. Today this video pops up on my feed... I will incorporate this advice

[@lauramartinez6060]

This was excellent!! I have been to two doctors within the last year 1/2 and I’m still not healed. Never said anything about these kinds of exercises. Just had laser treatments, Acupunture, and still not 100%. This was so valuable and so easy to follow along with a plan in place. You did an amazing job!

[@Flampo]

Great video.

[@gergojonas828]

Amazing value!

[@aloisification]

This was A video!!! Thx 🙏🏽🙃

[@agrocerygeek1323]

I cannot thank you enough for this video. I have been in excruciating pain and did not understand why, since none of the advice I was seeking addressed SEDENTARY midportion tendinopathy -- they all address runners and other athletes and assume they have overworked the tendons. Meanwhile I literally did *nothing* and was immobilized due to another condition, and I then found I was in so much pain I could not even walk. Ice, anti-inflammatories and stretching were all tried and did not work. At this time, all I can do is sit on the edge of my bed and raise my heels about 1-2 inches, but I already feel a difference. Thank you so much -- you are a lifesaver!!!

[@Warioda]

Now, that's wassup! Learned soooo much right there!

[@liljemark1]

I wish all physios would increase their knowledge like you guys are doing ❤️ Do you have any comments on "surgical cleaning" of Achilles? I hear several track & field or distance running athletes opt for this. I guess you did comment that surgically changing the structure does no good. I'm happy to have taken care of my Achilles tendinopathy with your stage 0 and 1 tips. That gave me enough capacity to do my level of distance running as 40-yo dadbod 🤣

[@paulbbareil6080]

Simply the best video on the subject out there! I would only add that runners should also toe off the hip and knee extended. The soleus endup taking the beating alone if you toe off with the leg bent. The gastroc is slack when the knee is bent.

[@aidanscrooby]

Awesome, easily digestible source of information! - Third year physio student :)

[@giringuha4229]

Thank you!

[@beverleycheshire5437]

The absolute BEST video I have watched for Achilles Tendinopathy. Definitely a keeper and refer to it often as I progress. Thank you 🙏🏽

[@user-vb1yp4qf9z]

3rd scenario do all the eccentric loading, but Plateau, when it comes to, to do dynamic exercise for fear of snapping something.

[@zsofipapp]

This is just what I needed. Have been struggling with heel pain at the insertion point for about 3 months. I have been doing the Stage 0-1 exercises and I completely stopped running (ultrarunner here). Now I feel confident that I can incorporate a little jog into my rehab, and proceed to later Stages. Thank you!

[@bikerdude6119]

I'm also an ultra runner and I felt some sharp pain out of nowhere during one of my trail runs and it been lingering since. Not as sharp but it's still there but transitions around my ankle so I'm not sure what it is. I got an xray but no fractures. I have physical therapy next week and I'm getting a mri next

[@ShinChan-ry4nm]

How are you this time your fully ready for running

[@ralphjones4583]

Thank you for this very informational video. In 2007 at age 43 while playing basketball I tore an achilles and had it surgically repaired. I woke up a couple weeks ago feeling similar pain in the other achilles after seemingly doing normal day to activities such as walking and climbing ladders. I started resistance training about 10 days ago and its working! This video is very detailed and I’ll be using this information to help further my recovery. Thank you. so much.

[@debbiedebbie9473]

What exactly are you doing for resistance training ?

[@oguzaliekinci1250]

Great video, I have been running regularly for last 3-4 years. I bought carbon plated shoes and after my first run, boom… I pushed for my 1k pr on first day. Now I have a problem 😢 I will try those recommendations, video contain all answers to my questions 🙏 thanks a lot 🙏

[@natom1385]

This video is extremely helpful and pragmatic, love the citations. Also with calves like that i am pretty sure your Achilles are pain free😮

[@wayneh8767]

Heels down the best video for my insertinal achilles issues. Get it, heels down?! All this information I need for sure. One thing I know for sure and it can't be overstated, diet is a major contributing factor in your recovery. Example, if your consuming too much refined and added sugar, your inflammatory response is more, lay off the junk and feel the difference 😉. At least its obvious for me.

[@nilouvakil6807]

Very promising. I have been dealing with this for a year now. Have gone through laser, injection, and shock wave therapy with $$$. Relief has not been significant but my podiatrist is optimistic

[@chuckwallagaming]

Great video

[@sidoirm]

Everyday I wake up to let my dogs out the walk down my stairs is very rough on my Achilles but after that and my showe I feel no pain at all. No pain for the rest of the day that includes an 8 hour work day, Many of those hours on my feet, and a 3-6 mile run that I also never feel pain during or after. But if I sit on the couch for an hour plus my Achilles get stiff again and need to “warm up”. I’ve been consistently running 3-5x/ week for going on two years now and this is a recent phenomenon with me in the past 6months or so. I did just take my first week off running since then and have no pain currently after having done my first run

[@jacintolozada4867]

Amazing video

[@blancamenjivar8200]

Thanks good information ❤

[@peterreid9769]

Good information.

[@laszlokovacs9596]

thank you!

[@dineshsuryavanshi584]

NICE CALFS MUSCLES AND THANK YOU FOR THIS DETAILED VIDEO.