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I'm in physical therapy for tight calves and achilles tendinopathy that is believed to have been caused by a tight psoas. I've been doing the psoas exercises for two weeks and while my hips are more flexible, I haven't seen any change in my calves. I cut out all cardio from my routine, even walking, to avoid using my calves, and it's driving me absolutely mad. Has anyone had this problem and resolved it successfully, and if so, how long did it take? Thanks.

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  • If your hip flexibility has noticeably increased but your ankle problem still persists, that strongly suggests to me that a tight psoas was not actually the cause of your problem. I would suggesting getting a second opinion from a different physical therapist, NOT mentioning to them anything about what the first PT told you, and seeing if they give you the same diagnosis.
    – David Scarlett
    Commented Sep 29, 2021 at 4:19

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Was this the diagnosis given by your physical therapist?

There’s always 2 “sides” of muscles you need to consider when resolving muscular imbalance. Muscle A will be tight, while the antagonist muscle will be weak. For example, biceps and triceps. If your biceps are tight, your triceps will be elongated (stretched out), and most likely weak.

Hence, to resolve this, you need to stretch/foam roll the tight muscle, and strengthen the antagonist muscle to restore “balance”.

For your case, taking a more global perspective, I’m more inclined to believe your issues are caused by a lack of strength in your glutes into hip extension.

During gait, if your glutes are not working, the calves got to work extra hard to propel you forward. I will strongly advise against stopping your cardio and trying to avoid using your calves as that will further exacerbate your issues. Tendon likes load, and you need to progressively load your Achilles’ tendon again. There is no hard and fast rule for this. You need to find your own sweet spot. Example:

  • Step 1: Try walking for 1km. Some pain during the start is normal. Ask yourself as you walk more: does my pain increase? Remain the same? Decrease? As long as it did not increase, you are good to go
  • Step 2: In the next 48 hours, did your pain increase? If so, rest, reduce your load. In this example, walk 500m and repeat step 2. If there’s no increase in pain, you can maintain this, or increase it by 5-10%. In this case, walk 1.05-1.1km, and repeat step 2.

I’ll definitely do exercises targeting your glute max. Examples: Split squats, squats, single leg deadlifts, isolated hip extension exercises if your muscle has been very “dormant”. Check with your physical therapist if you’re seeing one

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