Am a Physio.
Looks like im the first to chime in.
Like others have said it can make a difference exactly where the pain is. If it is right on the bone or further up?
Or how reactive it is to activity, can make a difference to your rehab.
If you want some specifics, below is general guide for my patients especially if it is insertional achilles issue.
Also if you are really sore start with the isometrics ie if you can not do 10 single leg calf raises with out pain stopping you.
Try isometric exercises to start with (shown to build strength while also decrease pain).
seated calf raises with weight on your knee is best.
If have access to the gym can use a bar in the smith machine.
Use a relatively heavy load eg 20kg+ plus the bar.
Lift and hold 30 sec, rest 2 mins repeat 3-5 times. The rest between reps is really important.
If your pain is 1-2/10 that's ok, if your pain is 4-5+/10 stop.
Progress by increasing time to 45 sec (eg over a week or 2).
Then increase the weight, using the pain scale as your guide.
Try and do 2 times per day.
DON'T stretch - especially initially in the rehab. Especially for insertional tendinopthies.
Best way to describe it is you don't want the tendon to be 'pulling away' from the attachment site, early on in the rehab. Give it a chance to heal.
That's also why you don't start with eccentric heel drops.
I see it a lot with my patients - wondering why they are not getting better with stretches and eccentric heel drops.
The most important thing to fix a tendon is build up strength. If you rest it's just getting weaker.
I say you need 'relative rest' for a few days at the start of the rehab, do the exercises, then slowly add low load activities eg swim and bike. Then progress to running.
Progression is isometric, then isotonic (eg calf raises 2-3x10 up and down on floor), then eccentric.
when you want to get back to running start with a jog/walk - start 1min jog : 1 min walk.
Progress run (jog) time using the same pain scale ie 1-2/10 = ok; 4-5+/10 stop.
If you are still getting pain 24 hours post run then you have done too much.
Hope that helps.
Looks like im the first to chime in.
Like others have said it can make a difference exactly where the pain is. If it is right on the bone or further up?
Or how reactive it is to activity, can make a difference to your rehab.
If you want some specifics, below is general guide for my patients especially if it is insertional achilles issue.
Also if you are really sore start with the isometrics ie if you can not do 10 single leg calf raises with out pain stopping you.
Try isometric exercises to start with (shown to build strength while also decrease pain).
seated calf raises with weight on your knee is best.
If have access to the gym can use a bar in the smith machine.
Use a relatively heavy load eg 20kg+ plus the bar.
Lift and hold 30 sec, rest 2 mins repeat 3-5 times. The rest between reps is really important.
If your pain is 1-2/10 that's ok, if your pain is 4-5+/10 stop.
Progress by increasing time to 45 sec (eg over a week or 2).
Then increase the weight, using the pain scale as your guide.
Try and do 2 times per day.
DON'T stretch - especially initially in the rehab. Especially for insertional tendinopthies.
Best way to describe it is you don't want the tendon to be 'pulling away' from the attachment site, early on in the rehab. Give it a chance to heal.
That's also why you don't start with eccentric heel drops.
I see it a lot with my patients - wondering why they are not getting better with stretches and eccentric heel drops.
The most important thing to fix a tendon is build up strength. If you rest it's just getting weaker.
I say you need 'relative rest' for a few days at the start of the rehab, do the exercises, then slowly add low load activities eg swim and bike. Then progress to running.
Progression is isometric, then isotonic (eg calf raises 2-3x10 up and down on floor), then eccentric.
when you want to get back to running start with a jog/walk - start 1min jog : 1 min walk.
Progress run (jog) time using the same pain scale ie 1-2/10 = ok; 4-5+/10 stop.
If you are still getting pain 24 hours post run then you have done too much.
Hope that helps.