Achilles Tendinopathy: Why It Happens and How to Exercise Through It
By Madison Bennett
BSc Sport & Exercise & MSc Physiotherapy
The Achilles tendon is the thick band of tissue at the back of your lower leg, connecting your calf muscles, the gastrocnemius and soleus, to your heel bone.
It plays a key role in walking, running, and jumping by transmitting force from the calf into the foot.
When the tendon is exposed to more load than it can tolerate, whether that’s a sudden increase in training, a change in activity, or simply not enough recovery, it can become stiff, painful, and sensitive, especially during or after movement. This is what we refer to as Achilles tendinopathy.
So, how do we manage it? The key is loading, but doing so progressively, in a way that allows the tendon to adapt and recover effectively. Rather than complete rest, we want to guide the tendon through a staged increase in demand.
Instructions
Step 1
Isometric Strength: Begin with calf raise holds. Work both straight-leg and bent-knee variations. Hold for 30–45 seconds. Rest between efforts. This phase helps to settle pain while gently reintroducing load to the tendon.
Step 2
Isotonic Strength: Next, move into controlled calf raises. Use both straight and bent knee positions. Start with bodyweight. Progress by adding load (e.g. dumbbells or a barbell). You can also incorporate eccentric-focused work, such as slowly lowering off a step to increase time under tension. Focus on: Control, full range of motion & building strength through the tendon.
Step 3
Introduce plyometrics: Once strength and tolerance improve, begin adding faster, more dynamic movements. Start simple, then progress as capacity increases: Pogos, Split stance jumps, Single-leg variations. Focus on quick, controlled ground contacts and maintaining stiffness through the ankle.
Workout Notes
Achilles tendinopathy isn’t just about pain, it’s about load capacity.
If you don’t progressively rebuild that capacity, the problem often lingers or returns.
- Too little load = no adaptation
- Too much load = flare-up
- The right progression = stronger, more resilient tendon
If you suspect you have Achilles tendinopathy, it’s important to get an individualised plan. Factors like training history, strength levels, and daily activity all influence how quickly and safely you should progress.
Exercise is one of the most effective tools we have, but it needs to be targeted, progressive, and specific to you.