Cross friction massage for Achilles Tendonitis. Achilles tendonitis or Achilles tendinopathy / tendinosis (degeneration of the tendon) can often occur after an injury or because of overuse. This is such a common problem for runners and is often due to poor foot mechanics, weak foot muscles and weakness of glute muscles. This is one technique to break down scar tissue or adhesion which often form with chronic irritation of the achilles tendon. You still need to address the factors causing this problem so it doesn’t reoccur. But for helping the tissue heal, this is a great techniques.
This is Manu Kalia, physical therapist and Ayurveda herbalist. So I’m going to show you a cross friction massage technique for those of you who have Achilles tendon issues. So if there is an injury or a partial tear, sometimes you end up forming scar tissue or adhesions that form along the injured area, and sometimes also tendinosis which ends up turning into tendinopathies and other problems in that Achilles tendon. So if there is thickening or adhesions or tender points and things get painful and irritated, or it’s scarred down with some minor tears or those things, you’re going to work at breaking down the scar tissue and improve the circulation in that local area.So usually I do a technique, it’s a two-person technique and I’ll usually do it on a patient of mine, but I’m going to show you how you can do it yourself. And so there are a few different ways to do it, and so I’m going to show you one way to self-mobilize that tendon yourself.
So, first of all, Achilles-tendonitis-type issues, for that we’ll look at…here’s your Achilles tendon. This is the area we’re targeting right here. So your gastroc, your calf, turns into Achilles tendon which goes and inserts or attaches right at your calcaneus, which is your heel bone, so right at this point. So now, what are some of the sites or areas where you can have problems? So you can have issues essentially anywhere along that tendon, and more commonly you’re going to find problems around this area, less in the upper part through here or on the upper part of the tendon, more commonly right in here. Now, you can have problems on the medial side, which is the inside part of the tendon; you have them on the lateral side. It doesn’t have to be on exactly one spot. You can have it more posterior or even the back of the tendon. You can also have it anteriorly sometimes, in the front of the tendon, and that’s where people end up missing it sometimes and they can’t get to it because they can’t get to it, they can’t mobilize it or break down the scar tissue. And lastly, you can also have it at the insertion point right here where it attaches. A lot of times you’ll find people who end up getting bone spurs or thickening right at that point because it’s been constantly getting irritated through that area.
So when you think about doing scar tissue mobilization and breaking down those adhesions, you want to look at finding those tender spots. So let’s say this is the painful area. And sometimes it can be a little bit difficult locating the exact spot. You might find that you’re on the right area, you’re working on it, and you say, “Well, but I don’t feel that there anymore. Oh, but I feel it in another spot.” So you might have more than one spot. You might have to work through the range of that tendon to get things moving again.
So what I like to do is, let’s say I find this particular spot, so I’m going to grab on either side of the tendon and I’m going to work at it in different directions. So I might go up and down first. So remember, I have a little bit of pressure applied through here and I’m going back and forth. Now, if I had more of the issues let’s say on the inside than outside, more posteriorly, more on the back, I might even do a little bit of dorsiflexion, which is bringing my foot up. So you can see how that tightens up that tendon there just a little bit, and now I can work at…this is more exposed from the back, so I can get to that tender spot, I put a little pressure on that and I move back and forth, up and down. And I can go side to side also, put a little pressure. I can move side to side.
So it’s not pleasant, obviously—it’s tender—especially if you’re working on a thick spot. So it’s not comfortable, but over time it gets easier as the area gets softened up, you break down the adhesions and it’s much easier to move. So I look for it and I work on it, work on it, work on it. Spend about five to 10 minutes if you can. Ten is the max. And you can do that two to three times a week. You want to work on it almost every other day.
Now, you might find that, “Okay, well, I can get to this spot, but how do I get to that anterior part right here, which is usually hidden?” For that, what you want to do is you want to relax the foot more. So I do some plantar flexion, bringing that foot down. Now, you can see it puts a little more slack, so it allows me to get behind that. So I’m trying to get basically behind that or in the front of that tendon.
So let’s say if we’re more on the medial side, we use my finger and I can stabilize with the other finger and I can get in here and I can do stuff this way too. I’m on the front side of that tendon. I’m working on it doing cross friction work. Or I can grab with my thumb and then I can get in the front and I go up and down, and then I can go back and forth also to break down the adhesions.
And if it’s down through here, same principle, I can use my thumb and I can go across and I can look for tender spots and I can work through there, or I can go up and down. So you’re basically applying pressure and you’re moving back and forth, firm pressure. This doesn’t do any good if I just do this. It doesn’t really help it at all. I’m just moving the skin.
So as I said, find those tender spots and get in there and work on those, and it’s going to be a bit tender but over time it gets easier and easier. And make sure you compare it, left versus right side, and see if you’re having issues, whether both sides are as tender. It might not be that you have ongoing issues necessarily, but it might be just that the tissues are just really tight and they’re just not moving.
If you have any questions, make sure you leave a comment.