Heel-drop (eccentric) and heavy slow calf exercises are the backbone of Achilles tendon rehab. Moderate pain during exercise (up to about 5 out of 10) is acceptable if it settles by the next morning.
The classic heel-drop programme
| Exercise | How | Dose |
|---|---|---|
| Straight-knee heel drop | Stand on a step, rise on both feet, lower slowly on the sore leg | 3 x 15, twice a day |
| Bent-knee heel drop | Same, with the knee slightly bent | 3 x 15, twice a day |
Continue for 12 weeks. Add a backpack with weight as it gets easier.
Tendon pain for more than 3 months? Get the free guide and a doctor review of your scan.
Alternatives
- Heavy slow resistance: seated and standing calf raises with weight, 3 to 4 sets, every other day
- Isometric holds for painful days
For insertional pain (where the tendon meets the heel), do the drops on flat ground, not off a step.
Pain monitoring
Rate pain 0 to 10 during exercise. Up to 5 is acceptable if it settles by the next morning. If the next morning is worse, reduce sets or weight.
Progression
| Weeks | Focus |
|---|---|
| 1 to 2 | Isometric holds, double-leg calf raises |
| 3 to 6 | Single-leg heel drops, add weight |
| 7 to 10 | Heavy slow resistance, seated calf raises |
| 11 to 12 | Hopping, skipping, return to running |
Tendon pain for more than 3 months? Get the free guide and a doctor review of your scan.
When exercise is not enough
If pain has not improved after 3 months of consistent loading, ask for a free scan review to see whether stem cell treatment could help.
