Calf strengthening
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emphasis of this program is that you must work just into pain. This is one of the few occasions
when “no pain, no gain” is true!
Develop a supervised eccentric strengthening programme as part of you rehabilitation. The
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reps.
The exercises are done, after adequate warm-up and stretching, twice daily, attempting 3 sets of 15
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followed by a raise to the start position on the other leg. This is done with straight leg and then
bent leg to work both calf muscles.
Stand on the edge of a step and aim for a slow lowering of the heel on the symptomatic leg,
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symptomatic leg until you can do single leg heel drops and raises. Once performed pain free,
weights are added to get back into pain again.
Start with lowering and raising on both legs and slowly increase the amount of weight through the
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After exercise treat the tendon with ice.
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This is not a quick fix and requires a minimum of a six-month programme of increasing load.
Muscle and joint flexibility
When can I get back to refereeing?
Your return to sport will depend on your symptoms. You can maintain fitness with activities that don’t
make the tendon painful such as cycling, rowing, swimming etc. while you begin the stretching and
strengthening programmes.
Once you have control of the acute symptoms and can tolerate the eccentric strengthening exercises,
you can try activities such as running. The aim is not to cause pain during the activity. A bit of post
exercise stiffness and discomfort that settles with ice is acceptable. The time for which you can jog
before pain begins is a good indicator of improvement and recovery. When you can jog for about 30-40
minutes without pain, you can begin to increase the speed and work towards sprinting and sudden
changes of direction. Even as you return to sport you should continue the stretching, strengthening and
icing treatments
How long will it take?
From studies of this problem about 50-75% of runners who followed the programmes returned to sport
in 12 weeks
And if all else fails?
If, in spite of following the programmes for at least 6 months after correction of any underlying
problems, you remain symptomatic you may require surgery. This operation is not without problems
and it may take 6-9 months afterwards to get back to sport.
Achilles problems are usually associated with lower leg muscle tightness. Most referees do not follow
flexibility programmes, other than during warm-up or cool-down. To be effective a stretching regime
must, after an appropriate warm-up work, cover all the major muscle groups, aiming for “hold” of 20-
30 seconds repeated 2-3 times each session. Get advice on safe stretches, which cover all the muscle
groups.
You may have stiff ankle or foot joints which need mobilisation. Sports massage may help muscle and
joint stiffness and tightness.
Running gait.
If you develop Achilles problems you should see a sports podiatrist for assessment and advice on any
biomechanical problems which are contributing to you symptoms. You may need orthotics or insoles
for your shoes and boots to correct any problems.
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