Is hopping an important rehabilitation exercise for runners with Achilles tendinopathy?
Achilles tendon pain is one of the most common causes of pain for all runners. It’s cause is often difficult to understand, but commonly occurs in a change in load i.e. increasing pace, amount of weekly kms, hill sprints or intensity too fast or too soon. Rest is often patients first go-to when the pain starts, but this alone does not resolve the problem and can lead to deconditioning and reduced fitness making symptoms worse.
There are multiple proposed treatments for Achilles tendinopathy, many evidence based approaches being exercise to increase the tolerance of the tendon and return strength to the calf muscles. Most people who have had achilles tendinopathy may have been given exercises including heel raises or heel raise of a step known as eccentric exercise. These can definitely improve pain and function, however the return to running can often be difficult as these exercises may just be the start of conditioning the body to return to sport.
Hopping has been proposed as a controlled movement that can be used to adapt the Achilles tendon and surrounding muscle to the forces expected during running.
A recent study which has used hopping as a progressive program with strengthening has been conducted to review the addition with education to a program. Researchers incorporated a hop program into a strengthening program over 12 weeks. Patients were guided by pain, and using a hop program 1x per week including:
– Double/Single leg hops on the spot
– Double/Single leg forward/back
– Double/Single leg onto a step
– Double/Single leg hops with stiff knee
After 12 weeks, patients reported improvements, reduced fatigue in hopping, improved hop height and reduced pain during the hop test. This proves an exciting new development and exercise tool for the future of achilles tendinopathy in runners.
For runners returning from achilles pain, an addition of a progressive hop program with strengthening and education may improve outcomes and reduce recurrence of pain and injury. If you have long standing Achilles pain, discuss today with a physiotherapist at The Injury Clinic, if your program is giving you the best chance at return to running.
REFERENCES:
Sancho, I., Morrissey, D., Willy, R. W., Barton, C., & Malliaras, P. (2019). Education and exercise supplemented by a pain-guided hopping intervention for male recreational runners with midportion Achilles tendinopathy: A single cohort feasibility study. Physical Therapy in Sport, 40, 107-116.
