Question:I've just finished a six-week program to rehab a mild injury to my right Achilles' tendon. I've gotten my full motion back but the calf muscle and ankle are so stiff. Is there any way to improve this?
Answer:Tendon stiffness after injury can be difficult to change. Even after a program of successful rehab, many people report continued tendon stiffness.
Studies on the effects of stretching on stiffness have mixed results. In some studies, there was no change in tendon stiffness after six weeks of stretching. Different types of stretching have been investigated. These include static, ballistic, passive, and eccentric. No study has been done to compare each type of stretching.
When looking at each type of stretching individually, ballistic stretching seems to be able to decrease Achilles' tendon stiffness the most. Ballistic stretching bounces into or out of a stretched position.
The stretched muscles act as a spring for motion. This type of bouncing is not usually advised. For example, it is not a good idea to bounce down repeatedly to touch your toes.
However a quick movement involving prestretching of the calf muscle and the attached Achilles' tendon may be an exception. This type of movement activates the stretch-shortening cycle of the muscle-tendon unit. With this type of exercise, proprioceptors (receptors to define when and how the muscle or joint is moving) help increase muscle recruitment over a short period of time.
Ask your rehab coach how to use these exercises to decrease stiffness without increasing muscle bulk and tension. A new form of exercise called plyometrics may help reduce your stiffness. Plyometrics is a type of exercise training designed to produce fast, powerful movements. With a little practice you will be able to incorporate this technique into your rehab program.Nele Nathalie Mahieu, PhD, et al. Effect of Eccentric Training on the Plantar Flexor Muscle-Tendon Tissue Properties. In Medicine & Science in Sports & Exercise. January 2008. Vol. 40. No. 1. Pp. 117-123.
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