Daily Mobility Exercises by Dr. Kelly Starrett Forums Foot/Ankle Achilles Tendon- Eccentric Heal Drops


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    • #71603
      AvatarDavid Ryan

      Looking for advice here. About 2 years ago I decided to get back into running after a long break from running. After a couple runs, I started to have pain in my achilles tendon. I did too much too soon. I gave it some time to heal and I planned to get back into running. It seems to heal. I started running again and the pain immediately returned. I went to the doctor and he was not much help. The doctor told me I had achilles tendonitis and gave me some simple stretches to do. They stretches didn’t help much. Some days I feel discomfort in my achilles just walking around. I came across something called Hakan Alfredson’s Heel Drop Protocol, which stated to perform eccentric heel drops on stairs, 3 sets of 15 twice a day and eccentric heel drops with the knee bent, 3 sets of 15 twice a day. I started doing it. The article said to do this for 12 weeks. At first, like stated in the article, the achilles was very sore, but after a week it wasn’t so sore. After about 4 weeks my achilles actually didn’t bother me as much. I still haven’t run on it but things were definitely looking up. At the 4 weeks mark that’s when my ankle, side of my heel and part of my foot where the shin meets the foot began to hurt. I went to the doctor, told him what was happening. Again not much help. The doctor just gave me some shoe insoles. So I stopped doing the heel drops, now my achilles still hurts and so do the other areas that started hurting while doing the heel lifts. Seemed that I could have started to run again if I continued to do the heel lifts until the other parts of my foot didn’t start to hurt. Haven’t run in 2 years now. Btw both of my Achilles’ tendons bother me, my right more than my left.
      Any advice?

    • #76391
      AvatarKeith Broussard

      I would suggest two books. Ready to run by Kelly and your whole body barefoot by Katie Bowman. Both are quick reads.

      The foot and ankle are much more intricate than a single mobilization can cover. Don’t forget to mobilize and strengthen the tissues of the actual foot and get all of the compartments of the shin i.e. the front both sides of the tibia.

      What may have happened in your case as you work out some of the tension on the posterior chain didn’t address the anterior. The muscles that control dorsiflexion remain tight and had nothing to balance them out so they pull stuff out of whack without the balancing tension. That’s crazy oversimplified there’s a lot more going on there but you get the idea.

      Look into banded distractions and smashing of the foot ankle and entire lower leg complex. Voodoo flossing is another good idea.

      Also see Roop and Jami series on the foot and ankle.






    • #76392
      AvatarPatrick Thomas

      GarageGymsHeros makes some great points.

      Have you changed the type of shoe you are running in?
      Going to a flatter sole shoe or making changes in running technique have an impact too.
      Rebuilding Your Feet With Brian MacKenzie
      Rebuilding The Feet, Part 2
      Rebuilding the feet, part 3 

      Pro Episode # 44: The Last 25% of Your Ankle Restriction (Snatches and Pistols here we come!)

      A couple for the achillies
      Pro Episode # 57 – Managing Achilles “Tendonitis”
      Episode 25: Heel Cords of a Cheetah, Achilles Well Being

      Episode 319: Protect Those Heel Cords Man!
      Episode 167: Unglue That Heel Cord
      Start with some running drills and looking at run technique before just going out and running.
      Build things back in with proper technique makes a difference.

    • #76394
      AvatarDavid Ryan

      What’s you opinion on doing the eccentric heel drops? I have heard this has worked for many people. If I perform the heel drops and mobilizations in the calf/ankle/foot area as well hopefully that might prevent other part of my ankle/foot to bother me. Or should I drop the heel drops completely?

    • #76395
      AvatarKeith Broussard

      In general I’m sure that they are fine. The question is not whether or not they’re okay but are they the answer to your problem? It’s hard to tell. These issues generally have any combination of three issues 1)tissue extensibility, are the tissues long enough ( which the heel drops work on the posterior tissues). 2) joint mechanics are the components properly positioned in the capsule. 3) motor control ( are you moving well?)

      The thinking is that the straight leg focuses on the gastrocnemius and the bent knee version is for the soleous. Both are extremely reasonable to stretch and work on unless they happen to have full ROM and you’re impinging in the front of the ankle which could be the issue.

      Can you put your feet together and squat all the way down? If so it may not be a flexibility issue you’re dealing with.

      As an experiment I’d try to add some distraction work to the ankle before the heel drops. is the pain better same or worse? And does a feet together squat get better same or worse?

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