Resistance training is a form of exercise or physical activity that increases muscle fitness by working an individual muscle or a group of muscles against some external resistance. This results in increased endurance and stamina.
Resistance training also helps build muscle power and keeps them toned.
The simplest form of resistance training is moving your body against gravity while doing a push-up, plank, and pull-up.
According to the first principle of resistance training – specificity, the kind of exercises that you include in your resistance training must help you reach your fitness goal.
For example, for some people, losing their belly fat and toning the muscle may be the goal, whereas for another, increasing muscle strength and endurance may be the fitness goal. The kind of resistance training exercises will differ for both and will become very specific as they progress in their training. Also, specific exercises are more effective than just doing a few generic resistance exercises.
The next principle of resistance training is progressive overload. This means getting out of your comfort zone and pushing your body to do more. During resistance training, your body will adapt and become more efficient while you reach your fitness goals.
According to this principle, your muscles grow only when they are subjected to more stress than they are used to. In order to overcome progressive resistance during resistance training, your muscles get training to become stronger and larger. One need not increase progressive overload in a linear fashion.
This is one principle that all resistance trainees must remember– if you stop your resistance training for a few months to a year, all the gains you made ‘during’ your training will be lost, and you will be back to square one. Just like muscles get trained during resistance training, one can lose their muscle mass by not subjecting muscles to stress.
This is an essential concept of resistance training, which states that all of us are different in the way we respond to muscle training. This is based upon our age, gender, genetics, and nutrition. While some people build muscles quickly, others take a while to get there with the same kind of workout schedule.
When you are just beginning your resistance training, you may experience a quick increase in strength. This stage is followed by plateauing of the strength, i.e., you might not find an increase in your strength beyond this point. The next stage is an increase in muscle strength and size. However, this requires a lot more effort.
The initial increase in one’s strength during resistance training is due to a phenomenon called neural adaptation, wherein the nerves that supply the muscles tend to change their behavior based on muscle requirement. The nerve cells send signals frequently, and a lot of muscle units get deployed to fire when a muscle group contracts. This indicates the plateauing stage of maximum strength. However, even though you have reached your maximum strength and plateaued, the continued training helps to increase your muscle size. Continuing your resistance training post this plateau stage will get you past it.
Muscles, like any other body tissue, require periods of rest between workouts. Lack of adequate rest to your muscles affects their strength and growth. Ideally, after training a specific group of muscles, you need to rest them for at least 48-hours. This allows your muscles to relax and grow before your next workout session.
Resistance training has many benefits as per research, and these include:
- Improved physical performance in athletes
- Improved ability to control body movements
- Increased stamina and sustenance during a sport
- Increased walking speed
- Toning of muscles
- Improved muscle strength
- Reduction in belly fat
- Improved brain function
- Prevention of lifestyle diseases such as diabetes, hypertension, and cardiovascular diseases
- Improved mobility and balance
- Better posture
- Reduced chances of falls, therefore, reduces the risk of injuries
- Helps relieve insomnia
- Enhanced efficiency in sports and in performing daily tasks
- Improved brain function
How your muscles grow, how much strength they can reach, and how resistance training affects them have a strong genetic component. There are several genes that have been found to affect muscle development, growth, and their response to resistance training.
Commonly associated genes include MSTN, CCL2, CCR2, LEPR, FTO, and SH2B1. Let’s understand more about their effects.
The MSTN gene is a protein-coding gene that encodes the growth factor, myostatin. It regulates the size of muscles beginning in early embryonic development and continuing throughout life.
Two polymorphisms in the MSTN gene, A55T and K153R, have been shown to cause strength-training induced muscle hypertrophy among Chinese men.
The A55T variant is also called rs1805085. The GA and AA genotypes are associated with enhanced strength training-induced muscle building.
The K153R variant is also called rs1805086. The AG genotype is associated with enhanced strength training-induced muscle building as compared to the AA genotype.
The LEPR gene or the Leptin Receptor gene is responsible for regulating body weight. This receptor is activated by the hormone leptin, which is released by the fat cells in the body.
rs1137101
rs1137101 is an SNP in the LEPR gene. In response to resistance training, adults with the G allele gained greater arm muscle volume and subcutaneous fat volume than adults with the AA genotype.
There is no age limit for when one can begin resistance training. However, the rate of muscle growth and development is greatest from 10-20-years of age. After reaching growth maturity, muscle growth and strength increase do not happen quickly.
Gender affects the quantity of muscles. Men inherently have more muscle mass than women, and the growth of muscles in men is favored by testosterone. The larger the muscle, the stronger a person is.
There are primarily two types of muscle fibers that come into play when it comes to training – slow-twitch and fast-twitch. The slow-twitch fibers are used for aerobic activities as they produce small forces for a long period of time. This makes them ideal for endurance-based activities. Fast-twitch fibers, on the other hand, produce strong forces for short periods, making them great for anaerobic activities and ideal for Olympic sports like weight lifting.
Though there is no gender difference in the distribution of slow and fast-twitch fibers, some people are inherently born with a higher percentage of one of the fiber types. While most marathon runners have higher slow-twitch fibers, football players may have higher fast-twitch fibers. During resistance training, fast-twitch fibers experience a greater increase in muscle size and strength and show faster results.
The length of your limbs is an important factor that determines if you can lift heavyweights. People with short limbs can lift heavier weights due to favorable lever mechanisms in their arms and legs. However, those with longer muscles have a larger scope of increasing their muscle size and strength as compared to people with shorter muscle lengths.
Did you know that muscle strength is directly affected by where its tendon is inserted on the bone? The farther your tendon insertion from the joint, the greater your mechanical advantage. So, people who have forearm tendon attachments away from the elbow joint tend to lift more weight than those who have them close to the joint.
In order to train your muscles well, you must ensure you are practicing good lifting techniques. The right techniques will bring about effective results.
Apart from all the factors mentioned above, your muscle’s response to strength training depends upon the type of training program you are undergoing.
For an effective resistance training plan, a good diet and nutrition plan along with healthy lifestyle habits is crucial.
Count your calories: During your resistance training, you need to limit your calories. Using online calorie counters is a good way to keep track of your caloric intake.
Measure your food: It is common practice for athletes and sportsmen to measure the food they eat. Measuring food can seem tedious at first but is very useful in keeping track of what you are eating and how many calories you consume in a day. You can use a small scale with measuring cups and spoons for this exercise.
Eating sufficient amounts of macronutrients: While training, you must get sufficient amounts of proteins, carbohydrates, and fats as these help in muscle growth and development and keep your body cells healthy. During resistance training, protein intake is particularly important because your muscles are made up of proteins.
Also, remember to consume sufficient calories each day as these fuel your workouts. Having an energy deficit prior to your workouts can make building muscle and endurance difficult. Always chart out a plan for foods during your resistance training, prior to it and after it. Having a large banana and 1 cup of cottage cheese or two whole wheat bread slices with egg whites, etc., make for great pre-workout meals.
Strict meal timings: Just as your workout timings are important, timing your meals and sticking to them consistently each day is important too.
Limit your drinking: Alcohol is bad for your health and even worse if you are resistance training for an event. Alcohol is very high in calories, and your body tends to burn this alcohol as fuel before burning other fuel types. Also, it can disrupt your next day’s schedule and interfere with your training schedule.
Avoid wrong foods: Eat only what does your body good. This means you must stay away from the bad foods that include sugary-foods, processed foods, etc.
Keep yourself hydrated.
Get a good night’s sleep and rest every day as this helps your body cells and tissues recover.
< https://www.emedicinehealth.com/strengthtraining/articleem.htm>
https://cathe.com/4-principles-of-resistance-training-and-how-some-people-get-them-wrong/
< https://www.afpafitness.com/research-articles/factors-affecting-muscular-strength>
https://excellenceinfitness.com/blog/nutrition-for-fitness-training-the-facts-you-need-to-know
< https://pubmed.ncbi.nlm.nih.gov/24479661/>
< https://link.springer.com/article/10.1007/s00421-016-3411-1>
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3500611/
< https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7081265/>
< https://pubmed.ncbi.nlm.nih.gov/17235396/>
Proper blood circulation is vital for a person’s health. Circulation of blood delivers oxygen and nutrients to all the parts of the body and removes carbon dioxide and other toxins.
The circulatory system, also called the cardiovascular system, consists of the heart and blood vessels.
With the increase in physical activity, your muscles need more blood supply and oxygen. This increase in blood flow is essential to boost your workout and prevent muscle soreness. Better circulation can also strengthen the heart and cardiovascular system and prevent cardiovascular diseases.
Regular exercise and physical activity are needed to boost circulation, which is essential for health and physical fitness. Exercise strengthens the circulatory system and makes it more flexible and expansive.
Following a consistent training plan has several benefits concerning the circulatory system. It helps strengthen the heart and blood vessels, improves the efficiency of gas exchange, and boosts overall circulation.
Genes related to blood circulation are candidates for gene doping. They can increase the endurance and aerobic performance of athletes. Gene doping is banned by the World Anti-Doping Agency (WADA). There are other natural ways to improve blood circulation.
The signs and symptoms of reduced blood flow include
- Numbness
- Throbbing or stinging pain
- Tingling
- Swelling
- Cramping
Vascular endothelial growth factor (VEGFA) is a glycoprotein that helps form new blood vessels. This gene is expressed in various cells and plays an important role in vascular development, lymph genesis, tumorigenesis, and development. The gene activates signaling pathways during lack of oxygen to cells or tissues and promotes angiogenesis to supply adequate amounts of oxygen to cells or tissue. An increase in oxygen supply plays a vital role in an athlete’s performance and increasing endurance.
The hypoxia-inducible factor (HIF) family of proteins regulates the activity of genes in low-oxygen environments. The HIF1A gene encodes proteins involved in the process of hypoxia, angiogenesis, and erythropoiesis(red blood cell formation) activation or regulation of glucose metabolism. This greatly helps in athlete’s endurance and aerobic dependence.
rs11549465
The rs11549465 C >T polymorphism is present in exon 12 of the HIF1A gene. The T allele is associated with increased transcriptional activity of the gene and hence increases the hypoxic resistance of cells (high glucose metabolism, high angiogenesis), offering better endurance to athletes.
Exercising
Exercise is one of the best ways to improve blood circulation and strengthen the circulatory system. Walking, jogging, knee bends, yoga, stretching are very basic exercises that can boost circulation. Follow a training plan suited to your body and be consistent. Cardio or aerobic exercises can improve circulation and your breathing capacity.
Diet
- Include food sources that contain omega-3 fatty acids like salmon, mackerel, kale.
- Eat foods rich in iron. These include red meat or spinach. Iron is needed for hemoglobin, which is the oxygen carrier.
- Drink lots of water. This helps flush out toxins from the blood.
- Include a rich source of antioxidants like tea, onion, pomegranate.
- A rich source of vitamin E and B vitamins helps improve circulation.
Smoking
Smoking is bad for your circulatory system. Nicotine is found to tighten blood vessels and restrict blood flow.
Massage
A good massage helps you relax and de-stress. It also improves blood circulation and promotes circulation in congested areas.
Maintain a healthy weight to reduce your risk of health conditions and promote proper circulation.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4551211/
https://www.medicalnewstoday.com/articles/320793#_noHeaderPrefixedContent
Power is the amount of energy produced per unit of time. Muscle power is the kind of force your muscles exert at high speeds in a given period of time. Any activity that requires speed and high force will need more muscle power.
People with high muscle power are stronger, agile, and can handle intensive physical activities better.
Muscle power is a very important feature of functional performance for Olympic trainers. Trainers, athletes, and sportsmen and women, all constantly work hard in improving their muscle power to better their performance.
Activities like sprinting, weight lifting, high and long jumping, punching, and fast kicking all require high muscle power.
For common people, muscle power could be a factor that determines their longevity.
A study analyzed the relationship between muscle power (upright row movement) and mortality in 3878 adults between the years 2001 and 2016. The study concluded that those who have low Mean Muscle Power (MMP) during daily movements had chances of early mortality
The terms muscle power, strength, and endurance are often interchangeably used. There are subtle differences between these, and you need to use them right.
While some people have higher muscle power genetically, others can improve their muscle power with the right food and training.
The ACTN3 gene is called the ‘Speed Gene’ and is a highly discussed gene in athletes and Olympic trainers. This gene helps make the alpha-actinin-3 protein that helps in quick contractions of the fast-twitch muscle fibers.
A particular polymorphism of this gene is found in elite power athletes and sprinters who need more muscle power to function.
rs1815739
The AGT gene helps make a protein called angiotensinogen and converts angiotensinogen I to angiotensinogen II. This protein controls blood pressure levels in the body and balances the levels of salt and fluids.
rs699
A study analyzed the effects of AGT gene polymorphisms in muscle power in 63 power athletes, 100 world-class athletes, and 119 non-athletes.
The study concluded that the C allele of the SNP rs699 of this gene increases angiotensinogen II levels in the body and aids more muscle growth after power training.
The DMD gene helps make a protein called dystrophin. This protein is important in muscle movement and helps in strengthening muscle fibers and aiding in contraction and relaxation of muscles.
rs939787
A 2016 Genome-Wide Association Study (GWAS) analyzed the relationship between DMD polymorphisms and muscle power.
The study concluded that the T allele of the SNP rs939787 of this gene was excessively present in power athletes when compared to endurance athletes. This allele was hence associated with power and performance.
The ability to improve muscle power and strength is high in younger trainers. As a person ages, the ability of the muscles to grow and strengthen reduces.
Men have more muscle tissues than women because of the presence of the male hormone testosterone. Larger muscles aid better muscle power, and this is true for both normal individuals and Olympic trainers.
Olympic trainers with longer muscle fibers find it easy to exert more muscle power than those with shorter muscle fibers. People with longer muscle fibers develop more power, muscle size, and strength with the right training.
Your muscles get stronger and more powerful when you use them right. People who go through power training extensively find their muscle power, strength, and endurance improving with time.
Diet, without a doubt, is a very important factor that determines muscle power. When your muscles are well-developed, they get the ability to perform better. A good diet improves muscle power, muscle strength, and muscle endurance, while a bad diet can cause muscle loss and decrease muscle power.
A 2016 study concluded that a diet rich in foods like red meat, butter, potatoes, and oily gravies could bring down muscle performance. This is especially true for older individuals.
One of the best ways to improve muscle power is to take up power training. Power training is similar to resistance training but done faster.
These are some of the effective power training exercises you can try out to improve muscle power.
Lifting heavyweights may be good for muscle strengthening. However, if you want to improve muscle power, you should concentrate on lifting mid-range weights repeatedly. A higher number of repetitive exercises done quickly helps make the muscles powerful.
Choosing the right nutrition will help improve muscle power quickly while training. Some of the vital nutrients for power training are:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3245773/
https://www.researchgate.net/publication/223128738_Training_for_Muscular_Power
https://www.jospt.org/doi/pdf/10.2519/jospt.1983.5.1.7
https://www.sciencedirect.com/topics/medicine-and-dentistry/muscle-strength
https://medlineplus.gov/genetics/gene/dmd/
Erythropoietin, also known as EPO, is a hormone produced by the kidneys and liver. It is essential for the production of red blood cells (RBCs) that carry oxygen.
The kidney cells responsible for producing erythropoietin are sensitive to oxygen levels. They synthesize and release more erythropoietin when they detect low oxygen levels in the body. About 10% of erythropoietin is produced by the liver.
The main function of this hormone is promoting the development of red blood cells by the bone marrow.
Training leads to an increased oxygen demand from the muscles, which is met by oxygen transport through red blood cells. Blood supply needs to be increased, and more RBCs need to be produced to meet the oxygen demand of the muscles.
Optimal levels of erythropoietin in the blood can increase oxygen transport and energy levels. Differences in erythropoietin levels are based on several factors, including nutrition, underlying conditions, and genetics.
EPO is available as a drug in the market. It can enhance an athlete’s performance by facilitating increased oxygen supply to the muscle cells. This gives the athlete an unfair advantage over others. Artificially increasing EPO levels can increase the number of red blood cells and ultimately enhance the aerobic capacity and endurance performance of the athlete. This is called blood doping and is banned in most professional sports since the early 1990s.
Nutritional factors and underlying conditions can affect the amount of erythropoietin in the blood. The amount of this hormone is also partially influenced by genetics. Variations in the EPO gene dictate the production and levels of erythropoietin in blood.
EPO as a drug is normally used to treat severe anemia because the body produces lower amounts of this hormone in anemic conditions. EPO drugs are also used in the treatment of End-Stage Renal Disease, cancer, and HIV.
The normal range for EPO in the body is 4 to 26 milliunits per liter (mU/mL) of blood.
Variations in the EPO gene, the gene that encodes this hormone, can lead to differences in the levels of erythropoietin produced by the body.
rs1617640 and Erythropoiesis
The rs1617640 is a T→G polymorphism present in the erythropoietin (EPO) gene. It has been associated with decreased EPO expression, suggesting it could negatively affect endurance performance. Studies have shown that the TT and TG genotypes are associated with increased erythrocyte, hematocrit, mean corpuscular hemoglobin, and mean corpuscular hemoglobin concentration values resulting in aerobic advantage for athletes.
Health conditions: Chronic kidney disease(CKD) can lead to a decrease in erythropoietin levels and lead to anemia.
Chronic low oxygen levels, anemia, or rare tumors can result in excess erythropoietin.
Higher levels of EPO are usually due to chronic low oxygen levels or when EPO is produced by rare tumors. This leads to a high red blood cell count, which is called polycythemia. Polycythaemia usually has no symptoms but can lead to weakness, fatigue, headache, itching, joint pain, and dizziness. High EPO levels will thicken the blood and can lead to clotting, heart attack, and stroke.
If an athlete takes repeated doses of EPO to increase performance, it can stimulate the development of antibodies against EPO, and this can lead to an attack on EPO produced in the body also. This leads to a decrease in red blood cells and results in anemia.
Low levels of EPO are usually caused by chronic kidney disease, and this results in anemia. Levels of RBC can also be reduced due to a number of other conditions, including hypoxia due to exercise and high altitudes. Synthetically made erythropoietin is given as a supplement to treat this. It is also used for patients with some rare types of cancer.
The first test used to detect EPO was introduced at the 2000 Summer Olympic Games in Sydney. This is a combination of a blood and urine test to confirm the possible use of EPO.
In 2003, urine tests alone were accepted to detect the use of recombinant EPO.
The methods used to detect EPO are constantly being modified and improved to increase sensitivity. This is being done in order to detect the newer versions of EPO and EPO biosimilars that are used in doping.
Athlete Biological Passport is a unique, personalized, and electronic record of an athlete’s biological values taken over time from multiple blood samples.
The main aim of this is to construct a profile and determine the natural levels of hormones and other chemicals in the athlete’s body. This information will help avoid the false positives that occur in doping tests due to naturally higher levels of EPO.
Lower levels of erythropoietin may be a result of your genetic predisposition to decreased EPO gene expression and RBC count.
Include food such as beef, spinach, kale, prunes, raisins, legumes, nuts, milk, cheese, carrots, red peppers, watermelon, grapefruit, and cantaloupe in your diet. These food types can help increase RBC production.
If the RBC count and erythropoietin levels are low even after supplementing through diet, consult a physician to find the underlying cause.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3579209/
https://pubmed.ncbi.nlm.nih.gov/24504226/
https://www.sciencedaily.com/releases/2012/12/121205200059.htm
https://www.hormone.org/your-health-and-hormones/glands-and-hormones-a-to-z/hormones/erythropoietin
https://www.medicinenet.com/erythropoietin/article.htm
https://www.wada-ama.org/en/questions-answers/epo-detection
Cardiac output refers to the amount of blood pumped out per ventricle each minute. It is measured in liters per minute. It is calculated as the product of heart rate and stroke volume. Heart rate is the number of times the heart beats in a minute, and stroke volume is the volume of blood pumped out by the ventricle during one contraction.
The cardiac output of a healthy person during rest is around 5-6 L/minute of blood. It may rise to 3 to 4 times more than normal when the intensity of physical exercise increases, and as a result, the oxygen requirement by your muscles increases. It rises to more than 35 L/min in trained athletes during exercise.
An optimal cardiac output is needed for a continuous supply of oxygen and nutrients to all the organs.
During exercise, as you exert yourself, your muscles need more oxygen. The demand for blood supply increases. Your heart beats faster to pump more oxygen-rich blood to the muscles. When this happens, more volume of blood is pumped out from the heart. An increase in heart rate and stroke volume leads to an increase in cardiac output during exercise.
When you exercise, more blood is pumped into your muscles. As your body temperature increases, more blood is pumped into the skin also. This happens because of increased cardiac output and redistribution of blood flow.
Optimal cardiac output maintains blood pressure at a desirable level to supply sufficient amounts of oxygen-rich blood to all the vital organs in the body.
As the intensity of exercise increases, the cardiac output also increases till you reach a point of exhaustion.
The ADRB2 gene encodes for the beta-adrenergic receptor protein. It binds to epinephrine and mediates physiologic responses that include relaxation of smooth muscle, heart muscle contraction.
Several SNPs in this gene are associated with cardiovascular regulation during rest and exercise and with the progression of cardiovascular diseases.
*rs1042713 *
rs1042713 is an SNP in the ADRB2 gene. People carrying the GG genotype are found to have an increased value of cardiac output during rest and exercise compared to the other two genotypes.
https://www.ncbi.nlm.nih.gov/books/NBK470455/
https://www.webmd.com/heart/heart-cardiac-output
https://pubmed.ncbi.nlm.nih.gov/23438238/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3076691/
The largest and strongest tendon in the body is the Achilles tendon. Also called the Calcaneal tendon, it is a band of fibrous tissue that connects the heel bone (calcaneum) to the calf muscles. The Achilles tendon helps in the movement called plantar flexion, which is the bending of your foot downwards at the ankle. This happens when the calf muscles flex. The Achilles tendon pulls on the heel and allows us to stand on our toes when jumping, walking, or running.
The Achilles tendon is prone to injury because of the high tensions placed on it and limited blood supply. Problems in this tendon affect the back of the lower leg. This might also affect your ability to walk properly.
Repeated microtrauma or tiny injuries to the Achilles tendon can lead to a condition called Achilles Tendinopathy. Over time, when the tendon does not heal completely after injury, the damage builds up and leads to this condition.
The tiny injuries can be due to overuse of the Achilles tendon, training on very hard surfaces, not wearing appropriate footwear for training, following poor training techniques, and making sudden changes in the training schedule. If not taken care of, it can lead to a sudden injury or severe rupture of the Achilles tendon.
This condition can affect both athletes and non-athletes. People who take part in sports that involve running or jumping, like football, tennis, badminton, and dancing, are at a higher risk if they don’t train properly.
Several studies have documented the influence of genetics on this condition. Variations in genes like MMP3, TNC, TIMP2 can increase your risk of this condition.
This gene encodes a protein belonging to the matrix metalloproteinase(MMP) family. Proteins of this family are involved in the breakdown of the extracellular matrix, which is present in the space between cells in various processes as well as disease conditions.
rs679620
rs679620 is an SNP found in the MMP3 gene. The GG genotype is found to be associated with Achilles Tendinopathy. Athletes with the G allele are found to have an increased risk of chronic Achilles tendinopathy.
This gene encodes a protein called tissue inhibitor of metalloproteinases 2. These proteins inhibit the activity of metalloproteinases and also prevent the proliferation of certain cells.
rs4789932
rs4789932 is an SNP found in the TIMP2 gene. Athletes with C allele are found to have an increased risk of chronic Achilles tendinopathy.
Gender: Achilles tendinopathy is more common in men probably because of stiffer tendons.
Health conditions: People with certain types of arthritis are more prone to Achilles tendinopathy. It is also common in people with high blood pressure, high cholesterol, or diabetes.
Medication: Fluoroquinolones are a class of antibiotics used against certain bacterial infections and are most commonly used to treat Urinary Tract Infections. People taking these medications are found to have a higher risk of developing Achilles tendinopathy.
Age: This condition is more common in people above 30 years of age.
Your doctor or physiotherapist can usually diagnose this condition through physical examination. They might prescribe certain tests to rule about underlying health conditions that may be the cause. If the diagnosis is not clear with a physical examination, an ultrasound or MRI is taken.
Rest: A break from physical activity and sports that strain the Achilles tendon is recommended. You can start again once the pain becomes better. Talk to your doctor to devise a plan.
Pain-killers: Your doctor may prescribe certain pain-killers like paracetamol or ibuprofen to relieve the pain temporarily.
Ice treatment: Ice-packs are useful to reduce pain and minimize swelling.
Exercises: Certain exercises can help stretch and strengthen the Achilles tendon. A physiotherapist can help you devise a suitable exercise plan.
Orthotics: A change in footwear or specialized footwear may be recommended by a specialist to relieve pain.
Specialized treatment: Various treatments are being researched to find the best way to treat this condition. These treatments include shock-wave therapy, which uses special sound waves, and autologous blood injection, which is the injection of your blood in the area around the Achilles tendon. The use of this treatment and side-effects should be discussed with your doctor before going ahead.
Surgery: In very severe cases, if all other treatment options fail, surgery is recommended.
https://www.webmd.com/fitness-exercise/picture-of-the-achilles-tendon#1
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1079614/
https://www.physio-pedia.com/Achilles_Tendinopathy#cite_note-1
https://pubmed.ncbi.nlm.nih.gov/19042922/
