mthomasondpt
Lil-Rokslider
I'm a PT and willing to chime in to back up what others have said. Not only have I treated patients with achilles tendinopathy, but I've successfully recovered from that as well. A good PT will be skilled enough to determine any mechanical limitations of the ankle/foot or poor movement patterns throughout your kinetic chain. This often requires manual treatment and exercise for the hip, knee, etc. So, its not always as simple as doing some exercises for your achilles. HOWEVER, we have pretty well-established clinical practice guidelines that recommend exercise as the main treatment because the problem in the end is the tendon is in poor health (assuming there are no tears as mentioned before) and the only way to really get it back to normal is to appropriately stress it through exercise so that it remodels back stronger and stronger over time. Exercise can be effective in different forms (i.e. eccentric, heavy-load, slow speed, progressive, isometric, etc.). In my experience, heaviest loads that are tolerable done in a slower manner (3-4 seconds up, 3-4 seconds down) are a great starting place. If that is too much for you to start, then long-held isometrics are good. Guidelines indicate that frequency of training may not matter too much, but don't overdo it early on. Progress the loads (resistance, # of reps, # of sets) as your achilles can tolerate. Eventually you want progress to where you do more dynamic exercises, meaning speed of movement, but you'll need to drop resistance back down and then slowly progress that back up as your tendon tolerates it. Good luck to anyone dealing with this. I feel for you because it really sucks and can be a bitch to deal with. However, there is a way back to normal function. If you can get to a good PT, do it.
