What it Takes to Recover From an Achilles Injury

May 9, 2013 | Mo Skelton

Must See Sports Injuries Videos

One injury that consistently makes athletes cringe is an Achilles tear—and rightfully so. Achilles injuries are no joke. Just ask Kobe Bryant for his thoughts on this potentially "career ending" injury. According to his doctor, Dr. Neal ElAttrache, Bryant's surgery (performed on April 13) went well. However, repairing a tendon is nothing like replacing a ligament. "They usually tear in a little bit of a shredded fashion, like two ends of a mop," Dr. ElAttrache told the LA Times. (Learn how to prevent an Achilles injury.)

Due to the complexity of an Achilles injury, recovery is a slow and tenuous process. Many reports say that Bryant will be able to return in six to nine months, but full recovery in normal circumstances takes closer to a year. In fact, a study by Dr. Rohit Garg, presented at a recent meeting of the American Academy of Orthopedic Surgeons, noted that 40% of NBA players do not return from this injury, and those who do exhibit inferior performance and play fewer minutes per game.

The Challenge

The Achilles is a unique structure in the body. According to the Hospital for Joint Diseases, it's the largest tendon in the body, attaching the calf muscles to the heel of the foot. Achilles injuries most commonly happen to men in their thirties and forties (Bryant is 35) who play sports occasionally.

Overuse or repetitive use can cause micro-trauma within the tendon, gradually weakening the tissue. It encounters extreme forces during jumping, sprinting and decelerating, so there are many opportunities for an injury to occur.

Road to Recovery

Recovering from an Achilles tendon tear and subsequent surgery takes patience and dedication. It's not like an ACL rehab (not to discount the difficulty of an ACL rehab). It cannot be rushed due to the location of the tissue, the risk of complications and the limited amount of weight bearing permitted in the early phase of recovery. It is common to remain on crutches and in a boot for up to six weeks.

Once the boot comes off, the focus turns to soft-tissue remodeling, which is the process of converting scar tissue to fully functional and mobile tissue. To regain mobility and loosen scar tissue, it's crucial to receive a high level of care from someone who understands soft tissue injuries and has skilled hands.

Restoration of Activity

Early weight-bearing activity is best performed in an aquatic environment using a Hydroworx pool, or on an anti-gravity treadmill such as the AlterG.

Mobility can be improved by modifying "normal" exercises, such as Leg Presses, by placing wedges under the heels to limit tension. As mobility improves, the wedge can be placed under the ball of the foot to increase dorsiflexion to stretch the Achilles.

Balance must also be restored. Simply balancing on one leg at a time is a good starting point. Once this is mastered, it's common to progress to instability exercises using a BOSU ball, Theradisc or Biodex Balance Trainer. It's possible to bowl, play tennis or even play Nintendo Wii while standing on a foam pad to enhance the balance challenge.

Single-Leg Training

Strengthening begins with stable two-leg exercises. However, it's critical to progress to single-leg exercises. One leg has been virtually immobile for over a month, so strength needs to be developed on each side separately to eliminate imbalances. Effective exercises include Bulgarian Split-Squats, Single-Leg RDLs and Single-Leg Goodmornings.

Plyometrics

Plyometrics place a great deal of tension on the Achilles, so proper care must be taken when reintroducing them into a rehab program. Start with stationary two-leg activities, such as two-leg hops and jumping rope. Progress to Box Jumps, Ladder Drills, single-leg drills and lateral movements. (Try Paul Rabil's Hurdle Hops.)

CNS Excitement

The final step in the recovery process is to re-teach the central nervous system to properly fire all large and small muscle groups. Do a heavy exercise, such as a Squat or Deadlift, and immediately follow it with a max effort plyometric movement with the same movement pattern. This will help restore normal strength, power and quickness. (Learn more about complex training.)

Mo Skelton
- Mo Skelton is a physical therapist at McCurtain Memorial Hospital (Idabel, Okla.) and is the founder of F.A.S.T. Sports Performance. He also serves as...
Mo Skelton
- Mo Skelton is a physical therapist at McCurtain Memorial Hospital (Idabel, Okla.) and is the founder of F.A.S.T. Sports Performance. He also serves as...

Featured Videos

Tim Tebow's NFL Off-Season Workout Tim Tebow's NFL Off-Season Workout Views: 152,523
Path to the Pros 2015: Trae Waynes Path to the Pros 2015: Trae Waynes Views: 80,168
Path to the Pros 2015: Marcus Mariota Path to the Pros 2015: Marcus Mariota Views: 1,267,361
Load More

Resources

STACK Fitness

Everything you need to be fitter than ever

STACK Conditioning

Sport-specific conditioning programs

Coaches and Trainers

Tips and advice for coaches and trainers

Magazine

Latest issues of STACK Magazine

STACK 4W

Women's sports workout, nutrition and lifestyle advice

Gamer

Gaming, entertainment and tech news

Basic Training

Military-style training for athletes

News

Find the latest news relevant to athletes

Most Popular Videos

Peyton Manning Dumbbell Bench With 80+ Pounds Peyton Manning Dumbbell Bench With 80+ Pounds
Views: 43,450,145
Drew Brees Will Not Be Denied Drew Brees Will Not Be Denied
Views: 12,117,693
Colin Kaepernick's Core Workout Colin Kaepernick's Core Workout
Views: 895,904
Robert Griffin III Pocket Presence QB Drill Robert Griffin III Pocket Presence QB Drill
Views: 6,866,217
Ohio State Football Open Field Plyo Drill Ohio State Football Open Field Plyo Drill
Views: 9,501,255

Load More
More Cool Stuff You'll Like
6 Simple Tips to Prevent Knee Injuries

6 Simple Tips to Prevent Knee Injuries

Tips for Preventing Knee Injuries During the New School Sports Year By Jim Carpentier, CSCS Watching an athlete grab their painful knee on the turf,...

Reducing Low-Back Pain: What You Need to Know

Reducing Low-Back Pain: What You Need to Know

4 Tips to Relieve Muscle Stiffness

4 Tips to Relieve Muscle Stiffness

2 Ways to Fix Anterior Pelvic Tilt

2 Ways to Fix Anterior Pelvic Tilt

3 Steps to Alleviate a Sore Neck

3 Steps to Alleviate a Sore Neck

5 Tips to Intelligently Train Through Lower Back Pain

5 Tips to Intelligently Train Through Lower Back Pain

Fix 3 Common Ankle Problems to Prevent Injury

Fix 3 Common Ankle Problems to Prevent Injury

How to Treat Piriformis Syndrome

How to Treat Piriformis Syndrome

6 Ways to Prevent Common Sports Injuries

6 Ways to Prevent Common Sports Injuries

STUDY: Female Athletes Are at Higher Risk of Overuse Injuries

STUDY: Female Athletes Are at Higher Risk of Overuse Injuries

6 Steps for Recovering From a Season-Ending Injury

6 Steps for Recovering From a Season-Ending Injury

Avoid Low-Back Pain With These 7 In-Season Exercises

Avoid Low-Back Pain With These 7 In-Season Exercises

4 Sports Massage Techniques to Relieve Tight Muscles

4 Sports Massage Techniques to Relieve Tight Muscles

How to Prevent Baseball Injuries During the Off-Season

How to Prevent Baseball Injuries During the Off-Season

8 of the Most Ridiculous Off-Field Athlete Injuries of All Time

8 of the Most Ridiculous Off-Field Athlete Injuries of All Time

Dry Needling: Powerful, Drug-Free Pain Relief for Athletes

Dry Needling: Powerful, Drug-Free Pain Relief for Athletes

The Secret Weapon Powering Stephen Curry's Resurgence

The Secret Weapon Powering Stephen Curry's Resurgence

How to Prevent In-Season Volleyball Injuries

How to Prevent In-Season Volleyball Injuries

How to Keep Your Feet Healthy On and Off the Field

How to Keep Your Feet Healthy On and Off the Field

Avoid ACL Injuries in Softball with PREP

Avoid ACL Injuries in Softball with PREP

5 Things You Can Do to Prevent Muscle Injuries

5 Things You Can Do to Prevent Muscle Injuries

6 Stretches to Alleviate Lower-Back Pain

6 Stretches to Alleviate Lower-Back Pain

Eliminate Elbow Pain with These 3 Methods

Eliminate Elbow Pain with These 3 Methods

STUDY: Imaginary Exercise Helps You Recover Faster From Injury

STUDY: Imaginary Exercise Helps You Recover Faster From Injury

10 Ways to Fix Back Pain

10 Ways to Fix Back Pain

Achilles Tendon Ruptures: Prevention and Recovery

Achilles Tendon Ruptures: Prevention and Recovery

3 Steps to Prevent Soccer ACL Injuries

3 Steps to Prevent Soccer ACL Injuries

What’s With the Stethoscope? Heart Murmurs in Athletes

What's With the Stethoscope? Heart Murmurs in Athletes

Sports Hernias: What You Need to Know

Sports Hernias: What You Need to Know

Coaches: Prevent Injuries With the Recovery Management Tool

Coaches: Prevent Injuries With the Recovery Management Tool

Impressive Advances in ACL Rehab

Impressive Advances in ACL Rehab

5 Bodyweight Exercises to Prevent Baseball Injuries

5 Bodyweight Exercises to Prevent Baseball Injuries

Megan Rapinoe’s Secret to Staying Healthy

Megan Rapinoe's Secret to Staying Healthy

Quarterbacks: 4 Tips to Keep Your Throwing Shoulder Healthy

Quarterbacks: 4 Tips to Keep Your Throwing Shoulder Healthy

Prevent ACL Injuries With This Hamstring-Focused Workout

Prevent ACL Injuries With This Hamstring-Focused Workout

Predicting the Impact of DeMarco Murray's Hand Injury

Predicting the Impact of DeMarco Murray's Hand Injury

Preventing ACL Injuries in Soccer Players

Preventing ACL Injuries in Soccer Players

Basketball Players: Prevent Ankle Sprains With These 3 Exercises

Basketball Players: Prevent Ankle Sprains With These 3 Exercises

The Future of Sports Injury Rehabilitation

The Future of Sports Injury Rehabilitation

How to Train With Running Blisters

How to Train With Running Blisters

7 Ways to Fix Back Pain

7 Ways to Fix Back Pain

Evan Gattis's Protection-Enhanced Catcher's Helmet

Evan Gattis's Protection-Enhanced Catcher's Helmet

Why Tommy John Surgery Is Ruining Pitchers

Why Tommy John Surgery Is Ruining Pitchers

Connective Tissue: The Key to Preventing ACL Injuries

Connective Tissue: The Key to Preventing ACL Injuries

How to Prevent Hamstring Injuries

How to Prevent Hamstring Injuries

YardBarker