1. Eccentric heel drop description
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a. Stand with the heel of the affected foot beyond the edge of the step or platform with the foot plantar flexed. Slowly lower the heel, bringing the foot into dorsiflexion.
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b. Perform the exercise both with the knee straight (gastrocnemius) and with the knee bent 45 degrees (soleus).
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c. Avoid concentric exercise by raising the foot back to the plantar flexed starting position using the unaffected foot, and hands if a railing is available.
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2. Number of exercises
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a. Perform 3 sets of 15 repetitions with straight knees, then 3 sets of 15 repetitions with bent knees.
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b. Perform this cycle twice daily (180 drops/day).
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c. Continue the program 7 days per week for 12 to 24 weeks.
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3. Exercise progression
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a. The exercises must be uncomfortable; when heel drops are no longer painful add weight by using a backpack, dumbbells, or a weight machine.
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