functional exercise: heel raises

yoga book / functional exercises / heel raise

Feedback: We’d love to hear what you think about this description, give us feedback at:
postmeister@yogabuch.de
Last updated: 27 Sep 2024
Name: Heel Raise
Level: A

Classification

Classic: Functional exercise
physiological: Strengthening the gastrocnemius and soleus through plantar flexion of the ankle

Contraindication

Freshly operated tears of the Achilles tendon do not tolerate powerful plantar flexion or wide dorsiflexion.

Effects

Preparation

Follow-up

derived asanas:

similar asanas:

Diagnostics (No.)

Varianten

on stairs

Instructions

  1. Depending on the variation, place the balls of one or both feet on a block
  2. Raise your heels to the maximum and lower them to the same height as the balls of your feet or to the floor, depending on the variation.
  3. Repeat as long as controlled execution is possible.
  4. It is possible to vary the following parameters, the specifics of which are listed below as variants, but can be combined with each other:
    • complete lowering of the heel or only to the level of the ball of the foot

Details

  1. This exercise performs a powerful plantar flexion in the OSG, strengthening both the soleus and the gastrocnemius.
  2. If the stand is unstable, it can be supported with one hand on an object or on the wall.
  3. This posture is used for both strengthening and rehabilitation in the case of injuries to the triceps surae, such as strain (Munich Consensus Statement 2b) or muscle fibre tears (Munich Consensus Statement 3a or 3b). See the notes there or the corresponding rehab protocols. In particular, in the case of a strain, partial weight-bearing may only be introduced after a few days, after a muscle fibre tear much later, depending on the severity.
    This exercise can also be useful for achillodynia. This disorder is usually a degenerative process induced by overuse, i.e. excessive strain in view of the given load capacity, which is best remedied by means of sustained strength training. In rehabilitative training, a discomfort of NRS 3 to a maximum of NRS 5 is permitted if the discomfort has subsided after training and by the next day, and tends to decrease rather than increase over the exercise sessions. The duration of rehabilitation should not be underestimated. During this time, maintenance stimuli of the disorder such as impact-like loads should be largely or completely avoided.
  4. In the case of a relatively recent strain, holding the foot in the lower end position may be significantly less painful than actively lifting the heel. It should be noted that the intensity of pain in this injury should not exceed NRS 3 or 4 throughout, if possible.
  5. When the heels are raised high, the triceps surae work in rather short sacomere lengths, when they are lowered low, in rather long ones. This must be differentiated by muscle: since the gastrocnemius is also a knee flexor, its sacomere length is at its greatest sacomere length when sufficiently elevated under the ball of the foot like a block, the soleus will not reach the greatest possible sarcomere length because the gastrocnemius already sets a limit for the dorsiflexion of the ankle. If the heel is lifted high, the sarcomere length of the soleus is minimised, but not that of the gastrocnemius, as the knee joint would have to be flexed for this. It therefore always works in longer sarcomere lengths, which is favourable for strengthening. In terms of rehabilitation, the larger sarcomere lengths can be rather difficult at the beginning, which is why a variation with lowering the heel only to the level of the ball of the foot is described.
    A load shift between the two muscles gastrocnemius and soleus is not possible, unlike with stretching (see soleus stretch on the block and gastrocnemius stretch on the block), they always lift the body weight together. It may be possible to use the time factor to influence which muscle is used more, as the type 1 fibre content of the soleus is higher, meaning that it is more of a holding muscle than a fast-moving muscle. However, if this exercise is used for rehabilitation, the execution time must not be too short if the aim is to address the fast-moving gastrocnemius, so that damaged structures are not overloaded on the one hand and sufficient strengthening stimuli are provided on the other.
  6. As the muscles being addressed are the very powerful triceps surae, which contribute significantly to a person’s propulsion when running and sprinting and should also be able to handle the body weight with a certain degree of ease, the use of external weights such as dumbbells may be necessary. When performing the one-legged heel raise, the dumbbell can be held in the same hand as the side or in the opposite hand. The contralateral hand has the advantage of providing additional strength in the trunk and also in the abductors of the support leg. If this is necessary or desired, this is the method of choice. However, if the strength of the abductors or the trunk is borderline, or if there are injuries, you should switch to holding on the same side.
  7. This exercise is typically performed with the knee joint extended. If it is flexed a little, a significantly greater up to the greatest sarcomere length is achieved for the soleus when the heel is lowered. If this is affected by a disorder, this may be desirable. If the knee joint is flexed sufficiently far, the soleus can be brought to the greatest possible sarcomere length as is possible without flexion of the knee joint for the gastrocnemius with the knee joint extended.
  8. When held in the lower end position, this exercise corresponds to the soleus stretch on the block and gastrocnemius stretch on the block, depending on whether the knee joint is flexed or extended.
  9. Depending on how this exercise is performed, the pelvis can be moved slightly forwards in relation to the heel, which usually makes it necessary to lean on an object. This shifts the working range of both muscles of the triceps surae towards greater sarcomere length.
  10. In some cases, a slightly sharp sensation in the anterior ankle joint occurs in addition to or instead of the sensation of strain or stretching of the soleus or a sensation in the Achilles tendon, which may be due to OSG-impingement, as is more common in footballers, for example.

one-legged

Instructions

  1. As described in the instructions for the basic exercise, perform the exercise on one leg.

Details

  1. The one-legged version is much more intense than the two-legged version. If there is an irritation in the calf muscles, such as a strain, or if there is significant damage to the Achilles tendon, you must proceed with appropriate caution. The two-legged version may then be indicated first. If there is a strain, full stretching can be tolerated during a longer healing phase, but further increased tension in the affected muscles, i.e. the soleus or the gastrocnemius, as occurs when the heel is lifted, can quickly lead to a multiplication of the intensity and possibly to a NRS 10. In this case, the weight can be carefully shifted between the two feet to test the resilience of the affected muscle and also to intensify the stretching effect if it is insufficient in normal two-legged execution. Full resilience of the affected muscle in maximum stretching through complete weight shifting and full resilience of the affected muscle even when lifting the heel from maximum stretching is a necessary, but not yet a sufficient prerequisite for resuming running training or sports with a running component at the end of rehabilitation. Apart from the expected good scalable or provocable feedback from the two proprioceptors Golgi tendon organ for the applied tendon force and muscle spindle for the sarcomere length, no other sensation may occur.
  2. Die einbeinige Ausführung zeigt meist sehr klar, daß der Trizeps surae nicht nur Plantarflexor ist, sondern bei dieser Bewegung auch ein supinatorisches Moment im Subtalargelenk erzeugt. Üblicherweise zeigt sich das ohne Krafteinsatz des Trizeps surae in einem unten nach medial kippenden Calcaneus. Liegt ein Knickfuß vor, so wird diese Valgus-Position des Calcaneus unter größerem Krafteinsatz des Trizeps surae aufgehoben, was sich der Single Heel Rise Test zunutze macht.
  3. Bei schwachen Abduktoren, vor allem kleinen Gluteen kann die Hüfte des nicht abgestützten Beins gegenüber der anderen absinken. Dann sollte auch auf ein Trendelenburg-Zeichen und Duchenne-Zeichen geachtet werden, um das Ausmaß der Schwäche einzuschätzen. Dann kann diese Übung auch als Training der Abduktoren eingesetzt werden, wenn darauf geachtet wird, daß die Hüfte des nicht abgestützten Beins so gut als möglich auf gleicher Höhe bleibt wie die des Standbeins.Um diese Übung effektiver zu machen, kann eine Kurzhantel in der kontralateralen Hand gehalten werden.

double-legged

Instructions

  1. Perform the exercise on both legs, i.e. raise both heels opposite the supported balls of the feet at the same time and lower them simultaneously.

Details

  1. A straightening of the calcaneus with knee foot should also be seen here, even if the required force input of a single triceps surae is just under half as great with a two-legged version.

Complete lowering of the heels

Instructions

  1. For the lower end position, lower the heels as far as possible, i.e. until the gastrocnemius reports a stretch sensation of up to NRS 8.

Details

  1. This may be contraindicated for various disorders of the triceps surae such as strain (Munich Consensus Statement 2b) or for muscle fibre tears (Munich Consensus Statement 3a or 3b). In this case, lower the heels only as far as the rehab protocol allows.
  2. If the elevation of the balls of the feet is not sufficient, the heels will touch the ground without achieving a significant stretch sensation. Then use a higher elevation.

Limited lowering of the heels

Instructions

  1. Only lower your heels to the level of the balls of your feet when performing the exercise.

Details

  1. This version may be indicated for various disorders of the Achilles tendon or the triceps surae.

with dead weight

Instructions

  1. Perform the exercise as above in the basic position on one leg or both legs without additional weight.

Details

  1. The strength that can be achieved with your own weight should be rather low in a double-legged version, but may be more suitable in a single-legged version depending on your constitution. For the rehabilitation of muscle injuries or achillodynia, the intensity that can be achieved with one or both legs may be sufficient and appropriate. If further strengthening is required, an additional weight must be used, preferably a dumbbell(s) held in one or both hands (if there is no need to support yourself), see below.

with additional weight

Instructions

  1. Perform the exercise with one or both legs as described above. Hold a weight like a dumbbell in one hand.

Details

  1. Hold a weight like a dumbbell in one hand. As explained above in the details of the basic position, the contralateral grip has the advantage over the ipsilateral grip of strengthening the core muscles and abductors.