Christopher Ellis explains the difference between acute Achilles tendonitis and chronic tendinosis, and why isometric exercises like pressing your foot against a wall work better early on. These contractions load the tendon without movement, letting you start rehab safely.
All right, now let's get into the rehab component. So I kind of see it on a spectrum. On one side you've got tendonitis, on the other side you've got tendinosis. So you just have to meet the tissue where it is. So on the acute phase tendonitis, you have to be a little more conservative. And that's where I'll usually start off with isometrics. So what is an isometric? It's when the muscle is under tension, but you don't see any movements. So picture a plank, right? Your core, your shoulders, they're all engaged, but they're not changing in length. So let's keep— we'll stick with the Achilles reference or analogy. So if I was to take my foot and press down on a gas pedal, that's what the calf and Achilles do. Achilles is just a tendon of the calf or gastroc. So it's that plantar flexion movement. So if you put your foot against a wall and just pushed into the wall and your tension, the calf is now generating tension along with Achilles. And if I'm watching you, I don't see any movement. Your foot's not moving. That's an isometric.
