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Hi ! Thanks for those advices!! So how can I monitor if the reabilitation it's going better....? I could to each activity a vote and see if it's getting better? Cheers!!

Thank you for this. Months ago a car pinned my ankle under a tire as I was exiting the rear passenger side. They had to back up to release my foot. It was very swollen & badly bruised. MRI & xray showed nothing broken or nerve damage, just inflammation. I walked for months on it until it became unbearable. Podiatrist thought it was plantar fasciitis & gave cortisol shot. Worked great for 3 weeks then pain in the back of my ankle came with a vengeance and I am limping & can barely walk by the end of the day. Just started going to PT for the achilles but it is so frustrating since I haven’t walked for exercise in over 3 weeks and pain hasn’t reduced at all. I’ve been biking but now it’s getting too cold. I must stay active for my physical & mental well/being. You mentioned that it is highly unlikely a rupture could occur. Should I resume walking (3-4 miles daily) as long as I can stand the pain and limp through it? Could I cause more damage? Thank you

I have midsection and insertional on both heels. Insertional tendonothfor 8 years after breaking my left ankle and spraining my right ankle at the same time. Lumps appeared on the midsection area last year and the area was extremely sore to touch. This caused me to stop dancing all of this year to prevent flaring them up and give them a chance to recover whilst attempting to do rehab exercises. I am having difficulty with the raises due to arthritis in my big toe joints being aggravated. I persevere with the pain while doing the exercises although I only need to do a few and it causes my toes to not bend up or down and then I have to walk by lifting my feet up and placing down, not rolling through heel to toe for days afterwards and this puts me off doing the exercises. I have arthritis causing pain in my hips and knees and some other issues with my pelvis and groin with barely any strength in my glutes as well. So I am really only up to doing the heel raises on both legs. I am only 56 and have lost my ability to squat, lunge, jump, hop and now dance. Refraining from dancing has allowed my lumps to reduce and I am able to touch there now but even a short walk flares them up and causes overnight pain. Would you please advise me where I should start? Do seated heel holds and raises help strengthen the Achilles enough? I would greatly appreciate your feedback as I would dearly love to return to dancing and become active once again.

This video is great

How do you know if a tendon has elongated clinically? Is it just poor ability to produce force down the line or heel height?

Thank you Dr. Peter, I'm one-week post achilles rupture, having just made the decision to rehab conservatively via no surgery. I'll definitely jump over to follow as I'm very keen to learn more, thank you.

I signed up for a sponsored walk of 300 miles over October. I was doing really well... however, I overdid it last week, walked 6 miles fast having not given myself enough time to rest from the previous fast walk. I believe I have insertional tendonopathy. I have 33 miles left to do this week. I've found that putting heel raisers inside my shoes helpful. It's definitely caused by me pushing off my toes. Is that likely to be rectified with calf strength exercises in the long run? Or do I need to look at getting a foot specialist to investigate? I'm doing a 50k ultra in March...

Thank you for the information. I have a question, my Achilles tendons on both feet bulge out and are swollen. The swelling has spread to my ankle bones also. Do I need to take any special measures to address this before I try the exercises? I've had this problem in both feet for about 8 years now. I do wear supportive shoes with an elevated heel. It helps me with getting through a work day, but unfortunately I can attest that it's not actually healing my tendons by just doing this and giving it time!

Would love more videos on non-operative Achilles rupture mx

Such a great video to use as patient education resource. Thank you.

Thanks for this, definitely the best one I found on the subject so far. It describes all symptoms perfectly. Information overload is indeed a big problem, the downside of the ease of access to information is that you have to filter it somehow. With loads of conflicting ideas on a matter it's easy to just give up and do nothing.

Interesting video! See a real mixed bag of people healing long, short and somewhere in the middle. Increased DF noticed on assessment at day 45 with some despite following a well known boot protocol. As I understand it (please correct me if I'm wrong) an USS may show approximation in full equinus position but given the spiral nature of ruptures it's hard to know for sure? Perhaps this is a bigger factor in terms of healing length rather than the rehab? A lack of DF in the ones that have healed short creates an equally challenging functional issue for many.

Have you seen new 2022 meta analysis on tendon loading "Mechanical, Material and Morphological Adaptations of Healthy Lower Limb Tendons to Mechanical Loading"? >70% loading versus <70% no major differences in tendon response. Based off this is 70%+ 1RM still required to rehab tendinopathy? Under normal conditions ( no intentional slowing of reps) 70% of 1RM is a 12 rep max but loads are much lighter in HSR so that would be well under 10 reps is it necessary to train that heavy to rehab?

Thanks for sharing this important information

Amazing lecture Peter. One question - when discussing the mechanisms of improvement in pain, how can we be sure about the direction of the relationship between pain catastrophising/kinesiophobia and pain? Was a mediation analysis used?

Such an important topic discussed here. It's too bad it is not widely understood! Thanks for the amazing lecture professor.

OUTSTANDING. Thank you, Dr. Malliaras.

Thank you for the informative video. I got diagnosed today with bilateral insertional achilles tendinopathy today so I'll be waiting to hear from physio to start the rehab programme. Wanted to start with the exercises you discussed in the mean time but I can't even do the toe stands, it's too painful!

Such a great video to pass onto patients to help them during their experience of this condition. This will certainly help my clinical practice - thank you!

Hi Peter, great video! Don’t you recommend seated calf raises now instead of standing calf raises? I think I heard you say that on a previous course I did with you. Cheers

Thank you so much for sharing those valuable Informations. I really appreciate it. But I have one question: Is this a Fallout Boy Figure next to the Screen? :D