The Best Achilles Tendinopathy Exercises

1. Stand facing the wall so you can use your palms to support yourself.
2. Place your healthy foot near the wall and your injured leg slightly behind at hip-width.
3. Bend both knees slightly until you feel a stretch in the lower portion of the calf of the injured leg.
   • Make sure to drive your heel into the ground.
4. Hold the stretch for 30 seconds with controlled and even breathing.
   • Hold for 15 seconds if too difficult.
5. Repeat 3 times (2-3 times daily in the morning and evening).
6. For a deeper stretch bend your knees more, and lean further into the stretch.

What to do if you cannot feel the stretch?

• Drive your hips backwards and engage your core.
• Make sure your feet are perpendicular to the wall and about a hip-width apart.

Toe-To-Wall Stretch

1. Place the ball of your injured foot against a wall and the healthy foot slightly behind it.
   • Your healthy foot should remain fully flat on the floor.
2. Keeping your front leg straight, lean forward into your toes until you feel a stretch in the calf of your injured foot.
3. Hold for 15 seconds and repeat 3 times (2-3 times daily in the morning and evening).
   • increase up to 1 minute.
4. For a deep stretch, lean further into the wall and try placing your toes higher up on the wall.

What to do if you cannot feel the stretch?

• Make sure your toes are firmly flat against the wall.
• Push your hips forward and engage your core, keeping your body upright.

Calf Step Stretch

1. Stand with the forefoot of both your feet on the edge of a step – use your hands to support yourself on a railing or chair.
   • Your heels should be hanging off the edge of the step.
2. Drop your heels downwards until you feel a stretch in the back of your heel and calf.
3. Hold the stretch for 15 seconds and repeat 3 times.
   • Between sets of 15 seconds, use your healthy foot to raise both heels upward.
4. Repeat 3 times (2-3 times a day in the morning and evening).
5. Hold for longer to feel a deeper stretch – up to 1 minute.

What to do if you cannot feel the stretch?

• Change the angle of your knees – a straighter leg will target your calf and bent knees will target your tendons.

Towel Stretch

1. Sit on the floor with your legs out in front of you.
2. Use a towel or a resistance band and loop it around your injured foot, gripping both ends with your hands.
3. Slowly pull your foot towards yourself until you feel a stretch in your heel.
4. Hold the stretch for 30 seconds with controlled and even breathing.
   • Hold for 15 seconds if too difficult.
5. Repeat 3 times (2-3 times a day in the morning and evening).
6. For a deeper stretch, try raising your leg up off the ground whilst keeping it straight.

What to do if you cannot feel the stretch?

• Make sure the tension is in your heel and not your back or your hips.
  • Engage your core and use your arms rather than your body to pull your feet towards yourself.
• Make sure the towel is looped around the upper part of your foot, closer to your toes.
• Ensure your feet are relaxed and aren’t flexing against the resistance of the towel.
• Try variations with the towel looped around one or both feet.
• You can lie flat on your back as this may be easier and can allow for greater movement with a resistance band.

Strengthening Exercises for the Calf

These exercises will strengthen your calf muscles and reduce strain on the Achilles Tendon. Start with the lower-intensity exercises and work your way down the list. Only do what is comfortable for you and consult your doctor for advice if you are unsure.

Seated Toe Raises

1. Sit in a chair with your back straight and your feet shoulder-width apart.
2. Slowly raise your toes as high as you can while keeping your heels planted on the ground.
3. Hold at the top of the movement for 2 seconds and bring your toes back down to the floor.
4. Repeat this movement 10-15 times.
5. Complete a total of 3-4 sets of these repetitions.
6. Perform this 2-3 times a day (in the morning and evening).

You may also try this exercise while standing or leaning with your back against a while to regulate the intensity of this exercise.

Seated Heel Raises

1. Sit in a chair with your back straight and your feet shoulder-width apart.
2. Slowly raise your heels while keeping your toes planted on the ground.
3. Hold at the top of the movement for 2 seconds and bring your heels and knees back down to the floor.
4. Repeat this movement 10-15 times.
5. Complete a total of 3-4 sets of these repetitions.
6. Perform this 2-3 times a day (in the morning and evening).

You can try adding weights by placing them on top of your knees or increasing the repetitions to regulate the intensity of this exercise.

Eccentric Exercises for the Calf

Eccentric exercises lengthen your muscle fibres during contraction. While these exercises may be more difficult to perform, they can reduce the thickness of your tendons and encourage tissue repair.

These are good targeted exercises for Insertional Achilles Tendonitis as well as mid-portion tendonitis.

Start with the first stage and work down the list based on your comfort and ability.

Stage 1

1. Stand flat on the floor with both feet – keeping both legs straight.
2. Raise both heels using your healthy leg keeping both feet touching the floor.
3. Slowly transfer the weight to your injured leg and lower yourself down slowly.
   • Use your healthy leg to aid your injured leg and your arms to steady yourself if required.
4. Repeat this movement 10-15 times.
5. Complete a total of 3-4 sets of these repetitions.
6. Perform this 2-3 times a day (in the morning and evening).

Variation: Try the same steps with a slight bend in both knees during the movement.

Progress to stage 2 when you no longer use your healthy leg for support and the repetitions become easier.

Stage 2

1. Stand flat on the floor with both feet– keeping both legs straight.
2. Raise both heels using your healthy leg keeping both feet touching the floor.
3. Slowly transfer the weight to your injured leg and lift your healthy leg off the ground.
4. Slowly lower yourself down using your injured leg.
5. Repeat this movement 10-15 times.
6. Complete a total of 3-4 sets of these repetitions.
7. Perform this 2-3 times a day (in the morning and evening).

Variation: Try the same steps with a slight bend in your knee when lowering yourself down with one leg.

Progress to Stage 3 when the exercises become easier.

Stage 3

1. Stand on both feet on a step with your heels hanging off the edge – keeping both legs straight.
2. Raise both heels using your healthy leg keeping both feet touching the step.
3. Slowly transfer the weight to your injured leg and lift your healthy leg off the ground.
4. Slowly lower yourself down using your injured leg.
5. Repeat this movement 10-15 times.
6. Complete a total of 3-4 sets of these repetitions.
7. Perform this 2-3 times a day (in the morning and evening).

Variation: Try the same steps with a slight bend in your knee when lowering yourself down with one leg.

You can also try this movement using your healthy leg to aid the injured one.

Exercises to Avoid with Achilles Tendonitis

In Achilles tendonitis, the tendon is weakened or damaged, and overworking the tendon can cause more damage. Intense and explosive movement will slow the healing process and sports should be avoided.

The exercises above aim to strengthen and increase the flexibility of the tendon gradually and safely. Don’t push yourself too hard and increase the intensity only when you are comfortable. Speak with your doctor if you have any questions regarding your recovery.

High Intensity Sports

Sports and intense exercise like can cause immense strain on your weakened tendon and slow the healing process or cause more damage. 

The unpredictability and impact of the movement in sports that require sudden and reactive movements like football, tennis, basketball etc. can cause unnecessary strain on your tendons. 

Additionally, demanding exercise for your calves will cause strain to your tendons after your muscles fatigue.

Try to take a short break from sports and activities while your Achilles tendon recovers from injury.

Sprinting

Running will demand a lot of stability and strength in your ankles whilst also subjecting your tendons to repetitive high-impact force. Explosive movements like sprints cause excessive strain and can damage your weakened tendons.

Lower the intensity of exercise by doing light jogging or walking, shorten the distances and lower your pace.

Incline Walking or Jogging

Inclines and hills will cause more strain on your tendons and create excessive tension. This will slow the healing process and cause unnecessary strain on your calves.

Try to avoid hills and stick to flat surfaces. You can also use more padded insoles and shoes with softer soles to cushion your feet as you jog or walk.

Plyometrics

Plyometrics and sports which require jumping like basketball and volleyball should be avoided while your Achilles tendon heals. 

Jumping and jump training require a lot of explosive force and strain on your calves and tendons, as well as causing intense impact forces when landing.

Plyometrics and jumping should be avoided because they can cause Achilles Tendon Rupture and lengthen the healing process or cause more pain.