The condition you have called Achilles’ tendinopathy is characterized by a painful thickness in the mid-portion of the Achilles’ tendon. If this problem has been present for more than three months, then it is considered a chronic problem.
Ultrasound studies show that thickening of the tendon and irregularities in the tendon are seen with a tendinopathy. The most commonly prescribed treatment is with eccentric exercise. The muscle is put in a shortened position and then lengthened.
The reason these exercises work still isn’t entirely clear. It’s possible the action of the muscle helps break adhesions. Adhesions are places where tiny bits of the tendon fibers have gotten stuck together. If the fibers don’t glide smoothly during motion, they get bunched up and form a lump. Exercise may also help improve blood flow to the area, which helps restore normal cell structure and function.
In the case of the Achilles’ tendon, the patient starts in a position raised up on toes. Then the foot is lowered to a position with the heel below the toes. This can be done best while standing on a stair facing the stair case as if walking up the stairs. The toes and ball of the foot are on the stair, the heel is not supported by the surface.
Although this exercise is recommended for Achilles’ tendinopathy, the best progression of exercise is unknown. Some experts advise doing the exercises everyday for 12 weeks. The exercises should be done while wearing a stable, supportive shoe.
The exercises are carried out with the knee straight. Then the same set of exercises are repeated with the knee slightly bent. Later, weight can be added by wearing a back pack with increasing weights added inside.