Rehab experts, help!

I have had bilateral Achilles tendinosis for over 10 years. I always managed it by keeping my calf strength up. Recently I had laid off training for an extended period of time and my Achilles tendons now hurt even when I just walk around the block. Whenever I do any calf exercises, even with extremely light weights, the tendons hurt the next day. Also, I will experience a ‘itchy’ or prickling sensation in my soleus and gastrocs the day after. They don’t hurt during exercise. I realize that there will be pain during any rehab program, but how much and what type is acceptable without setting back progress? Also, why are eccentric contractions often recommended over both concentric/eccentric? I have had ART performed on them and it helped but it seems that I really need to re-strengthen my calfs. I would greatly appreciate input from those of you versed in PT.

Make sure the ART wasn’t just done on the calf region. I’ve had many runners who had the same complaint with involvement in the origin of the hamstrings, dorsal ligaments, hip flexors, rectus femoris, and thoracolumbar region. Alomost any muscle involved with your gait can be contributing.

Your statement about having tendonosis for 10 years should be clue. Have you ever been examined as to why you have a recurrent problem? It seems to be a little to simple to relate your complaint to just “weakness” in your gastroc/soleus. Could be a flexibility or mechanical issue somewhere else. Just curious…how many ART treatments have you had? Have you tried reducing the stretch component of your calf exercises?

First off, I would like to thank you guys for your time. I went through about two dozen seessions with an ART practioner. I am no expert in anatomy, but he seemed pretty thorough in working many areas of the lower and upper body. I do limit the stretch component of most calf exercises and that helps. I just mentioned the strength aspect because there seems to be an inverse relationship between the amount of weight I can lift (in good form with slow tempo) and reduction in symptoms (pain, crepitus). I certainly would not expect an entire program or anything like that but do you guys have any very basic guidelines on rehabilitating this area? I have successfully performed ‘self’ rehab on my rotator cuff an other areas in the past but this is proving much more difficult especially in this early period when the tendon is most vulnerable to reinjury. I definitely appreciate your time and advice.