Zeren PT & Performance

Runners presenting with Achilles tendinopathy (AT) can be all over the map in terms of their irritability & tolerance to exercise.

Sometimes, they only get pushback w/ hills, brisk running, or when “shoeing down.”

In other cases, the tendon is a hot mess, and walking more than a hundred yards is a chore, or one adopts a hitch in their giddyup. I speak from experience 😉

As much as the goal may be to work 🏃🏼‍♂️🏃🏽‍♀️ up to exercises involving high contraction intensity (> 90% of a max voluntary effort), not to mention plyometric work, we often need a few in-between steps. Imagine that?! 🧐

Enter SHOULDER EXTENSIONS COMBINED W/ SINGLE LEG CALF ISOMETRICS

These are a staple in my programming for runners presenting w/ a more sensitized or reactive AT to get some meaningful load through the region.

The primary reasons to consider this exercise as part of a progressive loading program for 🏃🏼‍♂️🏃🏽‍♀️ w/ AT are as follows:

NO PLACE TO HIDE | Isolated single-joint tasks seem important for tendon rehab because, in this case, there is no place for the CMC & Achilles tendon to hide.

UPRIGHT TORSO | Common denominator among the best runners in the world.

FATIGUE RESISTANCE | Builds fatigue resistance in the posterior shoulder musculature, rotator cuff, and spinal extensors—excellent, esp for triathletes considering the overhead demands of swimming.

"DO IT!" | You gotta do this exercise to appreciate how it promotes moving purely vertically, which is important because people often shortchange the exercise by leaning forward.

Reminders:
🔹Don't treat isometrics as a right of passage; their value is missed if only viewed for pain amelioration.
🔹Aim to keep the foot straight so the big toe is pointed towards high noon, except for hip versions.
🔹The non-balancing leg shouldn't be doing s**t aside from augmenting your balance so you can focus on loading the stance leg.
🔹Draw the arms parallel to your torso w/ elbows straight, wrists neutral, & palms facing forward.

While the dosage will be dictated by the context, goals, & desired adaptations, I often find myself using 10s holds on 10-15s rest. Beyond that, it's up to you to plug and play.