Research on strengthening the achilles tendon and calves

I’ve been doing quite a bit of research on how to strengthen the achilles tendon and the calves.  Since I’ve had an ATR I know I’m always going to have a question in the back of my mind as to whether it will happen again.  Although I’m pretty sure my injury was caused because I seriously overloaded the tendon to its breaking point, I can’t be sure of this.  Most ruptures I see people are doing what they’ve been doing in sports for years and it suddenly just snaps.  So is there anything we can do to help make our tendons stronger so that we have a better chance of this not happening again?

It appears that there is.  It also appears that strengthening the achilles and strengthening the calf are not the same thing.  At the bottom of the post I’ll copy in some of the URLs to the studies that gave me the info I’m summarising.

So, starting with the tendon …

Published studies indicate that a lack of eccentric strength is what causes both micro-tears in the tendon (which cause tendinitis and eventually tendinosis) and acute ruptures.  One article I read showed that in a group of runners, all the runners who had tendinitis had less eccentric strength than the runners who didn’t.  There is a lot of evidence that achilles tendinitis and tendinosis can be cured by following a 12 week eccentric strengthening program.  This means that eccentric strengthening heals the tendon and improves strength so that future micro-tears are prevented.

I have read other studies which showed that the way a tendon works, the more elastic the tendon the more ability it has to store energy.  The more energy it can store, the stronger it is and the less likely to fail (i.e. rupture).  Static stretching does not improve tendon elasticity but eccentric strengthening and ballistic stretching do.

So by doing eccentric exercises every day, we are healing micro-tears, improving eccentric strength and improving tendon elasticity.  All very good things that should leave us with healthier and stronger tendons that hopefully will not rupture again so easily.

The downside it that eccentric strengthening is dead boring and a LOT of reps are required.  The 12 week program is 3×15 straight & 3×15 bent eccentric lowers done twice a day and adding load as tolerated.  And since the key is to slowly lower from the very top to the very bottom, there’s no way to get them done quickly.  Still, I’d rather be bored and knock these out than be back in the ER!

Now we get to the calf …

Unfortunately, just knocking out 180 eccentrics a day isn’t going to build us back our calf strength.  It will help but since our calf atrophied while our tendon was knitting back together, it’s going to need a lot more work to get its strength back.  Where better to find out how to build up calves than in the world of body building?!

What I’ve found out is something we are all experiencing - the calf is a very difficult muscle to build.  Apparently Arnold Schwarzenegger (aka Mr Olympia) said that it takes 500 hours to build good calves - that’s 3 years of 4 45min sessions per week!  Thank goodness we don’t need calves like Arnie’s!

The consensus seems to be that calves cannot be built in the same way as other muscle groups.  Usually for strength training a muscle group performs best if it’s worked with heavy weights at low reps and then given 2 days to rest before repeating, meaning that you usually only work a muscle group twice a week.  Calves however don’t respond to this.  Instead, calves need to be worked about 4-5 times a week and they need high reps and not too much load (since you have to do high reps).

Additionally (although this applies to all muscle groups) a full range of motion is very important.  Quite a few tips I’ve read recommend that you hold for two seconds right at the top really squeezing and again right at the bottom for a full stretch.

I’ve found one 8 week training program that is supposed to really work the calves which I’m thinking of starting in a couple of weeks.  You do 15 slow calf raises on a step or block really stretching the bottom and squeezing at the top, then you shake your calves out for 5 seconds each twice, then 8 slow raises and shake and then another 8.  Immediately you start doing fast bouncy mid-range calf raises not trying to go all the way down or up but just going fast and trying to explode upward.  You do these until you can’t take the burning pain in your calves anymore.  As soon as you stop the fast calf raises you do eccentrics, going up on both then down very slowly on one, then up on both and down slowly on the other.  You aim to do 10-20 eccentrics on each leg.  Then you rest for 3-5min and walk and stretch (apparently this will burn but stretching is important).  Then you repeat the whole thing!  They say after 2-3 weeks you should add another set of the fast raises and eccentrics.  The idea is to absolutely burn out your calves, they should be on fire.

So I think I’m going to give the above a try and will report back on progress.  I’m a bit wary as I don’t want to hurt the achilles.  Obviously if I start and it does hurt the tendon I will stop and wait until the tendon is ready for calf prime time.  I’ve been lucky in that my Physio gave me eccentrics to the floor at 12 weeks and then over a step from 16 weeks, so I have been tendon strengthening for a while now which is great.  I’m also pretty happy with my calf strength, it is definitely returning and I’m even starting to see the soleus muscle again which has been missing since the op.  But I’d like to get it strong as quickly as possible because I don’t want to run hard until that calf is able to absorb some of the heavy impact of running.  My OS told me that while the calf was weak the achilles would pick up the force instead.  I really don’t want to strain the achilles, so that means I need my calf back … let the hard work begin :)

Here is a list of some of the URLs:

  • http://revdesportiva.pt/files/form_cont/Eccentric_Training_for_the_Treatment_of_tendinopathies.pdf
  • http://www.ncbi.nlm.nih.gov/pubmed/12942235
  • http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2658965/
  • http://runnersconnect.net/running-injury-prevention/achilles-tendonitis-and-insertional-achilles-tendinopathy-in-runners/
  • http://www.fitnessunderoath.com/a-painful-way-to-put-1-5-inches-on-your-calves-in-8-weeks/
  • http://primehealthsolutions.org/how-to-get-big-calves-fast-arnolds-top-tips/

14 Responses to “Research on strengthening the achilles tendon and calves”

  1. Thanks for the info, Beanie… though I had to research YouTube what an “eccentric” is - I thought I was an eccentric, but I guess I’m wrong, LOL.
    According to the video, this exercise would requires an Achilles tendon that can lift your heel off the ground, so I won’t be trying it for a while.

    The video I saw? https://www.youtube.com/watch?v=15qfIXq46z0

    Thanks again!…………… Manny

  2. LOL Manny, I can just see the eccentric doing eccentrics :)

    Here’s a better video but it only shows the straight leg version (you only need to see one rep, I don’t know why the video is so long!).
    https://www.youtube.com/watch?v=M6EKuuZ7C2E

    If you scroll down this article it shows some photos of a guy doing both straight and bent leg versions.
    http://runnersconnect.net/running-injury-prevention/achilles-tendonitis-and-insertional-achilles-tendinopathy-in-runners/

    You can see she lifts up with her “good” leg and then lowers with the bad. What I do is stand at a staircase and then step up onto the second step and put my toes back down on the first step (so no use of the calf to get up on tiptoes) and then let all the weight go into that back foot as I lower. Then step up again onto the 2nd and toes down on the 1st and repeat. That way you only do eccentric lowers on both legs, no concentric calf raises at all.

    Don’t try this until your PT says you can though. When I started at 12 weeks I did it on the floor and I had to hold onto a table to support my body weight because my injured leg didn’t have enough strength to lower slowly, it would have just collapsed like a limp noodle!

  3. Thanks, Beanie! The video is excellent and I didn’t feel it was long at all, since I was in shock just imagining myself trying to do it, having my “limp noodle” calf collapes on me as you mentioned at the end of your post… LOL

    You are certainly educating me as to how to improve my body!
    Thanks again!………… Manny

  4. Thanks Beanie,

    I am going to start these on my good leg…my achilles is sore from over compensation. Might as well do what I can to prevent damage on the good one.

  5. Beanie…
    Thank you so much for collecting all of this information. I’m sure it took you quite a bit of time and I appreciate you sharing it with us.
    Your recovery is definitely an inspiration, not only on your progress, but your knowledge you continue to share along the way.
    I can’t wait to see the pics of your bulging calves…!!!

    thanks again,

  6. Thank you so much for this! I had no idea what eccentric exercises are but after watching the videos, I realize that’s what my PT has had me doing. You are right- it’s SO boring but I can really tell how much stronger I’m getting rather than this point last time. I will definitely get on a more aggressive program once my PT gives me the go-ahead. Thank you for all of your research and sharing!

  7. thanks for the research, I looked it up and it did indeed say that these can help Achilles tendonosis, that is really important and what my MRI showed before surgery. I’m going to start them on my good foot as well, the last thing my OS said to me was, “don’t forget about the other foot”, I don’t want to see him again anytime soon, lol

  8. beanie,

    thank you for putting all of these up and sharing your progress.

    i am torn between joy and sadness at the recovery prospects, one of my proudest body parts are my legs (i’ve always worked them hard, very decent calfs in particular), the sadness is that i’m going to loose some of them to the rupture and the recovery.

    for what is worth, i’ve been told by the surgeon that the ‘loss’ of power and strength is almost non existent for a surgical procedure and around 10% for a non-op (my case). so i’m confident that you will get back to pre-injury levels without trouble.

    in my younger years i obsessed over building up the calves, being a basketball player/rower. it took about 2 years to get them to the desired state (that is two years of dedicated training) and one thing that i did at the time was to use the step machine as a warm up routine (irrespective of what gym day it was) for about 15 minutes (can’t remember exactly it was over 15 years ago) with roughly 5 minute warm up, then build up to hardest resistance for the next 5-7 minutes and then reduce to normal resistance as a cool-down for the next 5minutes.

    as i progressed this routine eventually was done with only the top of the foot on the steps (similar to the exercises in the links you sent, almost just on the toes). i remember going for up-hill walks and runs only on my tip toes all the way up, something i continued till a few years ago to keep the calves alive.

    you may laugh, but i also used to put weight on a tightly secured backpack (rice/beans/pulses/sugar bags were good for this) and do all the calf exercises at home whenever it wasn’t a gym day.

    the burning sensation is quite a buzz, but again, i’d be weary pushing too much after the ATR….

    good luck with the recovery and do come back later on this year to wow us again!

  9. Pozaicer thanks for sharing your calf routine. I hadn’t thought of the step machine, but it’s an excellent idea and I am going to add it in to my gym routine. Your results say the same thing as Arnie did - there’s not getting around it, building back the calf is going to take a long time and a lot of work! I understand why people stop bothering about it, but I am determined to get it back. I feel like I’ll be putting my achilles under too much stress if I don’t work at the calf, especially if I start running flat out 5 & 10kms again. I’m definitely not laughing at you with the backpack - I meet and greet my entire apartment block every morning as I stand on the stairs with my backpack loaded with weights doing my calf exercises. I’m pretty sure they all think I’m nuts, especially the new people who never saw me hobbling about in the boot :) All the best with your recovery, I’ll be checking in to see how you go.

  10. hi beanie,

    glad i’m no the only nutter with loaded backpacks in the world, that is the biggest relief of the first day of the week :D

    moving down to three wedges today, 3 weeks to go for PT (all being well)

    it was indeed difficult to build them, but the great thing is that once ‘here’ they never go as long as you keep working them occasionally (unless you do an ATR, but this i’ll verify in 2 months :D). we are all different of course, but i found that within a year i had some incredibly strong calfs and by the second one the definition appeared (i like a toned and lean look though, so don’t be thinking of Arnie’s standards here!)

    anyhow, i managed to call myself Carlos in another post, so you are actually speaking to the same guy there and here.

    suerte

  11. Seriously beanie…!!!
    You entered the crossfit games after 6 months of recovery.??!!!
    Amazing is an understatement when it comes to describing your determination to your recovery. You’re truly astonishing.
    I can’t wait to hear about your experience in the Games. Have you competed in one before…??? Good luck, warrior…!!

  12. These are great exercises. I bet they can improve calf + tendon strength tremendously. I will try them.

  13. Hey Bryan, I must have a screw loose hey? But seriously, it’s the Open which is the first phase of the Games and it’s for everybody. You’re probably thinking of the actual Games which is the top of the crop, and those people are amazing and so strong and fit that it’s mind blowing … that’s not me! Last year about 270,000 people signed up. I’m probably going to come 270,000th this year - but it doesn’t matter, at least I’ll be giving it a go and I’m hoping I can manage to put up a score for each of the 5 workouts - that will be a great victory for me :)

  14. I am into my 4th week doing the Eccentric heel drops with 45 lbs in my backpack. I want to keep this up for 12 weeks. I wish progress was faster though as it is very easy to get discouraged. Need to keep pressing on

Leave a Reply

*
To prove you're a person (not a spam script), type the security word shown in the picture.
Anti-Spam Image

Powered by WP Hashcash