Achilles & Ankle (P)Rehab Program
The Achilles and Ankle (P)Rehab program was designed based on common ankle issues Dr. Mitch sees in practice. These include achilles tendon injuries and ankle inversion sprains. When rehabilitating these injuries and any ankle issue for that matter, it is important to start by training the fundamental function of the joints, then progress to more advanced linear loading.
The joints are important because without good functioning joints, nothing else will work well! A healthy joint will have good efferent and afferent neurological flow. ‘Efferent’ meaning signals from your brain down to your joints to involuntarily control body movement, and ‘afferent’ meaning signals from you joints to your brain telling your brain about the current state/position of your joints (ie. kinaesthetic awareness, or proprioception).
The ankle is complex because there are several joints that make up the ankle and function in harmony with the many joints of the rear foot and mid foot. However, training ankle rotation will help target all of the joints involved in ankle movement. In this program, we train ankle inversion because of the prevalence of inversion ankle sprains. In these cases, developing connective tissue strength on the outside of the ankles, like we do in our ankle inversion class, is vital.
After 2 weeks of improving fundamental joint function with rotational training, we introduce linear training – ankle dorsiflexion. This will focus on training the Achilles tendon and the deep posterior leg muscles at length. In Achilles tendon issues like old partial tears or tendinopathy, there is ‘scar tissue’ build up. Scar tissue is just normal tissue your body naturally makes to try to repair itself, but it patches up the injured tissue in a disorganized way.
The problem with these scar tissue patches is that they don’t distribute force well. In Achilles tendinopathy or a tendon with an old tear, the functioning and load bearing capacity of the entire Achilles tendon and the muscles of the posterior leg (ie. the calf muscles) are compromised. Progressively stretching and loading the Achilles tendon over time can improve the architecture of the scar tissue, improving the strength and resilience of Achilles tendon.
Outside of the ankle-specific training, additional classes will include hip and knee training. When training a specific injury, a comprehensive multi-region approach is best because in real life, a single joint rarely functions on its own. The hip and knee training will help you build better hips and knees that directly compliment the ankle training. We will again start with rotational training, then progress to training larger tissues of the lower limbs, including the hamstrings. The hamstrings form an indirection connection with the Achilles tendon, making them both very important for the transmission of larger forces, like in running and jumping.
In addition to the program, the CARs morning routine will be completed every day. Movement is vital for joint health, so make sure every joint gets a little movement love every day. As well, Ankle CARs will be completed for 10 repetitions each direction, 3 times per day. The ankle CARs should be done nice and easy to help with recovery and to optimize adaptations from your training sessions.
After you complete the 4-week program, re-assess yourself and determine if you need to run through the program again. These programs have been designed to be able to be repeated in succession as training cycles. The split between rotational training in week 1 and 2, and linear training in week 3 and 4 allows for training multiple capacities without reaching plateaus. These programs are completed in 2-3 cycles.