Achilles tendinopathy exercises: a stage-by-stage home program

Published October 14, 2026 · Updated November 1, 2026 · Protocol Archive Editorial

Protocol Archive → Conditions → Achilles tendinopathy

Achilles tendinopathy exercises: a stage-by-stage home program

Talk to your doctor first. General education, not medical advice.This content is general education, not medical advice, diagnosis or treatment. Get approval from your physician or another qualified healthcare provider before starting any exercise program, especially if you have a medical condition, a recent injury or surgery, are pregnant, or take medication. Stop and seek medical advice if an exercise causes pain, dizziness, chest discomfort or shortness of breath. You choose to exercise at your own risk. Read the full medical disclaimer.

Last checked: October 2026 · Protocol Archive Editorial · General information, not medical advice

The Achilles tendon joins the calf muscles to the heel bone. Achilles tendinopathy causes pain, stiffness and sometimes swelling in the tendon, often worst with the first steps in the morning or after rest. It is linked to sudden increases in activity, training errors such as a lot of hill running, extra body weight, and weak or tight calves.

There are two main types. Mid-portion tendinopathy causes pain about 2–6 cm (roughly 1–2 inches) above the heel bone. Insertional tendinopathy causes pain at the back of the heel, where the tendon attaches to the bone. The exercises are similar, but insertional programs usually avoid lowering the heel below the level of a step.

Complete rest is usually not helpful and can make the tendon less able to cope when you restart. Progressive strengthening of the calf is the main treatment, and the tendon adapts slowly over months.

Get it checked first. Have heel or tendon pain checked by a clinician to confirm the diagnosis and the type (mid-portion or insertional), because this changes which exercises suit you. If you felt a sudden snap or pop, get urgent care before doing any exercise.
On this page

  1. Stage 1: Calm the tendon
  2. Stage 2: Build calf strength
  3. Stage 3: Return to activity
  4. Videos
  5. What to expect
  6. When to get help
While pain limits walking or daily activities

Stage 1: Calm the tendon

Load the tendon gently without flaring it, and keep the ankle moving.

  1. Toe Stand Strength Exercise

    Use this as a static hold (isometric) at first, not repeated raises.

    Typical dose: Rise part way onto your toes and hold 30–45 seconds, 4–5 reps, 1–2 times a day, holding a chair1

  2. Ankle Pumps

    Keep within a comfortable range.

    Typical dose: Point the foot up and down 10 times, 3–4 times a day4

  3. Stand on One Foot Balance Exercise

    Builds ankle control while the tendon settles.

    Typical dose: Up to 30 seconds: hold a chair, then let go, then try eyes closed4

  • A mild increase in pain during or after exercise is generally acceptable if it settles within 24 hours. One NHS leaflet treats pain below 4 out of 10 as fine, and 5–6 out of 10 as acceptable if it settles within a few hours. If pain is higher or lasts longer, ease back rather than stopping completely.1,3
  • Limit activities that clearly aggravate the tendon, such as long walks or runs, for around six weeks, but keep active within comfortable limits.6
  • Supportive shoes, and a small heel lift for insertional pain, may help. Avoid very flat shoes and walking barefoot.2,3,8
Once stage 1 is no longer challenging (often after a few weeks)

Stage 2: Build calf strength

Strengthen the calf and tendon with slow, controlled raises and lowering.

  1. Eccentric Heel Drops (Achilles)

    Mid-portion pain: lower the heel below the step. Insertional pain: do not drop below the step; instead do slow raises and lowers on flat ground.

    Typical dose: 10–15 reps, 3 sets, once a day; slow on the way down1

  2. Foam Pad Balance Exercise

    Adds an ankle control challenge as strength improves.

    Typical dose: Stand on one leg on a cushion or uneven surface for up to 30 seconds; start on the good leg4

  • Progress from two-leg to single-leg heel raises, moving slowly (about 3 seconds up and 3 seconds down).1,6
  • Some programs add bent-knee calf raises to work the deeper calf muscle (soleus).3,6
  • Stretching can irritate the tendon, especially near the heel. Strengthening matters more.1,5
When strength work is comfortable and pain is settled

Stage 3: Return to activity

Build walking tolerance, then reintroduce running and sport gradually.

  1. Endurance Exercise: Walking

    Then return to jogging with a short, slow run, increasing distance before speed.

    Typical dose: Build walking time gradually, aiming to walk several miles comfortably before you jog4,6

  • Keep up your strengthening exercises for at least 3 to 4 months, even after pain improves.6
  • Hopping and jumping are added later, once single-leg heel raises are comfortable.4,6

Want this as a checklist? Turn these exercises into a printable home program with videos and daily check-offs. Adjust the list and doses with your clinician.

Make it a home program

Printable handout (PDF, 2 pages). Every exercise on this page with a usual starting amount, boxes for your clinician to write your plan, a pain guide and a 6-week tracker.

Download PDF A4 size Large printEn español: PDF · A4

Watch the exercises

Every exercise above links to its own page with a video and step-by-step instructions. Here are two to start with.

Play video
Toe Stand Strength Exercise. Full steps, cues and safety notes: Toe Stand Strength Exercise page.
Play video
Eccentric Heel Drops (Achilles). Full steps, cues and safety notes: Eccentric Heel Drops (Achilles) page.

What to expect

These are what published guidance usually says. Your own recovery may be faster or slower.

Question What sources say
When to move up a level When the current level is easy and pain stays the same or better the next morning.4,8
First improvements Most people notice some improvement within 8–12 weeks of starting exercise and adjusting activity.1
Full recovery Most improve within about 6 months, but recovery can take up to 12 months, especially if pain has lasted a long time.2,3
If you are not improving If symptoms have not improved after 6–12 weeks, ask about a referral to a physical therapist.2,3
Flare-ups Most flare-ups settle within 6 weeks. Get advice if a flare-up is not settling after a couple of weeks.2,3

What to avoid or change for now

  • Lowering the heel below a step if your pain is at the back of the heel bone (insertional).
  • Complete rest, which makes the tendon less able to cope when you restart.
  • Sudden increases in walking, running, hills or speed work.
  • Walking barefoot or in very flat, unsupportive shoes.
  • Stretching hard into the tendon early on.

When to get help

  • A sudden pop or snap at the back of the ankle, with sudden sharp pain, may be an Achilles rupture. Go to the emergency department right away and do not exercise on it.1,2,8
  • You suddenly cannot stand on tiptoe on that leg, or walking becomes difficult after an injury. Go to the emergency department.1,8
  • You cannot put weight through the foot or ankle. Get urgent care the same day.3
  • Unexplained calf swelling, redness, heat, or a hard, painful calf, which can be a blood clot. Get medical help right away, and call 911 if you are also short of breath or have chest pain.1,3,7
  • Constant night pain that stops you resting or sleeping. See your doctor promptly.3
  • Fever, night sweats, feeling unwell, or unexplained weight loss along with the pain. See your doctor promptly.3

For a medical emergency, call 911 (US and Canada), 999 (UK), 000 (Australia) or 112.

Next steps

Related guides: Shin splints, Peroneal tendinopathy, or see all conditions.

Need a physical therapist? How to find one in the US or UK, including direct access and checking registration.

More exercises: browse the free exercise library, every one with a video.

Frequently asked questions

What is the difference between mid-portion and insertional Achilles tendinopathy?

Mid-portion pain is about 2–6 cm above the heel bone, while insertional pain is where the tendon attaches to the heel. Insertional programs usually avoid lowering the heel below a step.

Are heel drops good for Achilles tendinopathy?

Slow heel-lowering exercises are a core treatment for mid-portion tendinopathy. For insertional pain, keep the heel at or above the level of the step.

Should I stretch my Achilles tendon?

NHS physiotherapy leaflets say stretching can irritate the tendon, especially near the heel, and that strengthening is more important. Gentle stretching may help stiffness later on.

Is it OK to exercise with Achilles pain?

A mild increase in pain that settles within 24 hours is generally acceptable; one NHS leaflet uses below about 4 out of 10 as a guide. If pain is higher or lasts longer, reduce the amount next time.

How long does Achilles tendinopathy take to heal?

Many people improve within about 6 months, but it can take up to a year. Keep up your exercises for at least 3 to 4 months.

Sources

  1. Leicestershire Partnership NHS Trust: Achilles tendinopathy (CHSMSK22)
  2. NHS Lanarkshire: Achilles tendinopathy
  3. East Lancashire Hospitals NHS Trust: Achilles tendinopathy
  4. King’s College Hospital NHS Foundation Trust: Achilles tendinopathy (patient leaflet)
  5. Berkshire Healthcare NHS Foundation Trust: Achilles tendinopathy (physiotherapy leaflet)
  6. Royal United Hospitals Bath NHS Foundation Trust: Advice and exercises: mid-portion Achilles tendinopathy (PHY055)
  7. NHS: DVT (deep vein thrombosis)
  8. Wrightington, Wigan and Leigh NHS Foundation Trust: Achilles tendinopathy (physiotherapy leaflet)

Last checked October 2026. Found something out of date? Email hello@protocolarchive.com.

This guide summarizes published hospital, health-service and professional-body advice listed under Sources. It is general information, not medical advice, and does not replace an assessment by your own clinician, whose plan may differ for good reasons. Stop an exercise and get advice if it causes sharp or worsening pain. Protocol Archive is independent and is not affiliated with the NHS, AAOS or any hospital or video publisher named on this page.

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