achilles pain: compression, tendon length, hyperflexibility

I get Achilles tendon pain when I do side to side squats if I allow my foot to extend too much while the sole stays on the ground. To prevent this pain, I have been staying high during this exercise, as it limits the extension of my foot when the sole of my foot is on the ground, but on the other hand that prevents me from getting the benefits of the stretch in my hamstrings and hamstring tendons. I will occasionally get pain when I am walking downhill which causes the same combination of foot extension and pressure. I am wondering:

- If I should instead let the sole of my foot raise off the ground, while keeping my heel on the ground, in order to go deeper with the squat,

- Whether this problem might generally be caused by too much length in the Achilles tendon itself -- I seem to have quite a bit more flexibility in my Achilles than I have in general, making it seem as though I might be causing the tendon to compress on itself when my foot is in extension, so I am wondering if I might be better off not stretching my achilles as increasing its length would exacerbate this problem. 

Thanks for any feedback.

Hi Mike,local hypermmobility is something pretty common in people. Basically in this situation i suggest to avoid painful range of motion. Did you have previous injury?

I don't recall a previous injury. Maybe I'm forgetting something? Is there a way to test whether hypermobility might be the issue?

Mike, can you post video? I don’t understand what you mean by "if I allow my foot to extend too much” or "when my foot is in extension.” In the side-2-side squat, are you referring to the leg that is straight (ankle plantar-flexion), or the leg that is supporting most of your weight (ankle dorsi-flexion)? 

You can use the Beighton Test to measure GJH (Generalized Joint Hypermobility). It’s a "yes/no” 5-questions scoring system where you assign 1 point for each question you answer with a “yes.” Supposedly, the higher the score, the higher the joint laxity and hypermobility. Someone can correct me, if I'm wrong. I don’t love this test because I don’t like generalizations and I prefer to look at the individual and how well all the moving parts work together. Not to mention it leaves out equally important joints (for example: shoulders, hips, ankles, feet and spine) where hypermobility can be present, or not! A person could score high in the test, yet have super tight hips, spine and ankles. 

If you’re on the upper end of the Beighton scale, it usually means that you have poor stability in those joints and it’s always wise to focus on building dynamic joint stability anyway. If you have above “normal" degree of laxity in your joints, it's not such a good idea to go bananas with static stretching (for those particular joints) because it can exacerbate the ligamentous laxity and hence creating more instability, which is not good in the long-run. For instance, I’ve learned (a little too late) that the more stable and strong I can get my shoulders to be, the less problems I have in stabilizing my hyper-mobile elbows. Thank you F1/H1.
 

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Thank you Eva.

What to say more,you need to check with an expert if your situation leads to joint instability , if you have local tissue adhesion and what range of motion you cannot explore. 

Meanwhile, work around the problem, trying to avoid painful range of motion.

Thanks Eva -- it is the straight leg that gets the pain -- the ankle plantar-flexion based on what you've said I think. In terms of the possibility of hypermobility, I have uploaded a photo doing kneeling Achilles (though just comparing that to the demo on the GB site, I'd say I'm not hypermobile).

With respect to my technique, I added a vid as suggested. I am quite high as going lower seems to hurt the Achilles. Would I be better of letting the foot lift on the extended leg, while keeping the heel on the ground in order to get my hips lower and reduce compression on the Achilles?

Thanks for any insight.

These are the first images and video I've posted -- used the .gif format for the video, but it was very slow, any suggestions on posting? Had a look on forum but didn't see instructions.

The .gif doesn't seem to have uploaded as a video (though it plays in .gif as a video in Quickplayer). 

I've uploaded to YouTube:

If there are any suggestions for direct video uploading please let me know.

Also, Alessandro, a photo of what I mean by letting my foot lift with the heel on the ground -- compromises the technique from the ankle perspective as my Achilles is sore, but gives me more stretch in the hamstring and tendons. Would this meet your suggestion of "working around" the injury? Or should I simply not squat as low?

Thanks

Hi Mike, 

Thank you for sharing your video. As Alessandro said, please avoid any painful range of motion.

It seems to me that while your ankle dorsi-flexion is admirable your hips are pretty tight! Which btw is not an uncommon combo. From the top of my head, I have at least 3 clients with similar mobility issues.

I would suggest to focus on increasing your overall hip/legs mobility first: adductors, hamstrings,  posterior hip capsule, etc. The Middle Split course would be a great for you.

One thing you could try before performing side-2-side squats is to warm-up with some hip, legs stretches (like Pigeon variations) and some ankle mobility (unloaded, open chain) by doing 5-10 slow ankle circles in both directions. You can do the ankle circles by standing on one leg while the other foot does the ankle circles without touching the floor --> to see if the hip stretches and ankle mobility will alleviate the ankle discomfort.

Thanks Eva -- I am doing the stretch series, so I do the middle split course weekly but I'm still pretty new. Hopefully the hips will open up in time. I will try warming up a bit more before as you suggest.

Cheers