Achilles Tendon Exercises — What Works, What Doesn't, and Why It Matters

TL;DR: The right Achilles tendon exercises depend entirely on where you are in your rehab. Isometrics first, slow isotonic loading second, heavy single-leg work third, elastic and plyometric last. Most people skip the first two stages — and that's why they relapse. Exercise selection matters less than exercise order.

If you've searched "Achilles tendon exercises" hoping for a list of things to do, this article will give you that. But it will also tell you something more useful: why the order you do them in matters more than the exercises themselves.

Most Achilles rehab stalls not because people are doing the wrong exercises — but because they're doing the right exercises at the wrong stage. Understanding the logic behind the progression changes how you approach every session.

Why Rest Alone Doesn't Fix an Achilles Tendon

When Achilles pain flares up, the instinct is to rest. And rest does help — it allows the reactive phase to settle, reduces pain sensitivity, and gives the tendon a break from whatever provoked it.

But rest doesn't restore load capacity. It never has.

Tendons remodel in response to mechanical load. The collagen fibres that give a tendon its strength and stiffness are laid down and organised in response to the specific demands placed on them. Without that stimulus, the tendon doesn't rebuild — it just becomes less capable of tolerating the loads you'll eventually ask it to handle again.

This is why people who rest their Achilles for six weeks, feel better, return to running, and are back to square one within a fortnight. The pain settled. The capacity didn't improve. The tendon was never prepared for what came next.

The goal of Achilles tendon exercise isn't pain relief — that's a side effect. The goal is progressive restoration of load capacity.

The 4 Stages of Achilles Tendon Exercise

Not all Achilles exercises work the same way. They sit in four distinct categories, each with a different mechanism and a different role in the rehab process. The order is not optional.

Stage 1 — Isometric Loading

What it is: Sustained holds against resistance with no joint movement. The muscle contracts, the tendon is loaded, but nothing moves.

What it does: Isometric contractions have a well-documented pain-modulating effect on reactive tendons. They reduce cortical inhibition — essentially, the brain's tendency to switch off the calf when the tendon is painful — and begin restoring the tendon's tolerance to load without the compressive or shearing forces that dynamic movement introduces.

When to use it: Early rehab. Reactive tendon. High pain levels. Any time the tendon is flaring and dynamic loading isn't tolerated.

Key exercises:

• Bilateral calf raise hold — straight knee (gastrocnemius emphasis)

• Bilateral calf raise hold — bent knee (soleus emphasis)

• Wall sit calf raise hold with added load

How to load it: 30–45 second holds at moderate to high effort. Pain during the hold should be no more than 4/10. Any discomfort should ease during or shortly after the set — not persist or worsen.

Stage 2 — Slow Isotonic Loading

What it is: Controlled dynamic movement through range — both the raising and lowering phases performed slowly, with deliberate time under tension.

What it does: This is where tendon remodelling begins in earnest. The mechanical stimulus from slow, loaded movement signals the cells within the tendon — tenocytes — to produce and organise collagen. Speed of movement matters here: a fast, bouncy calf raise produces a very different stimulus to a slow, controlled one. Three seconds up, three seconds down is a minimum. Slower is often better.

When to use it: Once isometric loading is well tolerated and pain is settling. The tendon is still being treated as reactive — no ballistic movement, no fast loading.

Key exercises:

• Eccentric heel drops off a step — straight knee

• Eccentric heel drops off a step — bent knee

• Slow concentric/eccentric bilateral calf raises with load

• Seated calf raises (soleus loading in isolation)

The Alfredson protocol — eccentric heel drops performed twice daily — became the gold standard for Achilles rehab based on a 1998 study that produced impressive results. It remains relevant, but it's frequently misapplied: performed too fast, with too little load, or without progressing beyond bodyweight. If you've tried heel drops and they didn't work, the protocol probably wasn't wrong — the execution was.

Stage 3 — Heavy Slow Resistance

What it is: Single-leg loading with progressive external resistance. The focus shifts from managing a reactive tendon to building genuine unilateral Achilles capacity.

What it does: This stage builds the structural foundation the tendon needs to tolerate running, jumping, and change of direction. Single-leg calf strength is the most important physical quality for Achilles tendon health — and it's the most commonly undertrained. Most people move to running before they've built adequate unilateral capacity. That gap is where relapses happen.

When to use it: Once bilateral and slow isotonic work is well tolerated, pain is consistently low, and you can perform single-leg work with confidence and control.

Key exercises:

• Single-leg calf raises on a step with progressive load (dumbbell, barbell, weighted vest)

• Single-leg seated calf raises with load

• Single-leg isometric holds at increasing percentages of bodyweight

Progression checkpoint: Before moving to Stage 4, you should be able to perform a single-leg isometric heel raise hold at 1.5× your bodyweight for 30 seconds — pain-free, no significant next-day flare. If you can't, you're not ready for elastic loading.

Stage 4 — Elastic and Plyometric Loading

What it is: Fast, spring-like movements that load and unload the tendon rapidly — the elastic energy storage capacity that running and jumping demand.

What it does: The Achilles tendon stores and releases elastic energy like a spring during running. This capacity is distinct from strength — a tendon can be strong under slow loading and still struggle with fast, repetitive elastic demands. This stage specifically trains that quality.

When to use it: Only after Stage 3 checkpoints are met. This is not a stage to rush into. The forces involved are significantly higher than slow resistance work, and a tendon that hasn't been adequately prepared will let you know quickly.

Key exercises:

• Double-leg mini hops (low height, high frequency)

• Single-leg mini hops

• Skipping

• Short acceleration runs

• Bounding

This stage is covered in detail in the Achilles Elastic Capacity™ program — the direct follow-on from the Load Restoration system.

The Exercise Most People Get Wrong

Eccentric heel drops are the most prescribed and most misapplied exercise in Achilles rehab.

The errors are consistent:

Too fast. An eccentric heel drop performed in one second produces a different tendon stimulus to one performed in three or four seconds. The slow phase is what drives the remodelling signal. If you're rushing through reps, you're not doing the exercise — you're doing a fatiguing version of it that misses the point.

Too light. Bodyweight eccentric heel drops are a starting point, not a destination. As capacity improves, load needs to increase. A backpack with weight, a dumbbell held in one hand, or a loaded barbell across the back are all appropriate progressions. If you've been doing the same bodyweight heel drops for eight weeks and wondering why nothing is changing, insufficient progressive load is almost certainly why.

Too painful. Some discomfort during eccentric loading is acceptable and expected. Sharp, escalating pain is not. The 4/10 rule applies here too — if you're consistently working above that, you're loading beyond what the tendon is currently prepared for.

Not progressed. The Alfredson protocol specifies a fixed number of sets and reps performed twice daily. What it doesn't specify well is when and how to progress beyond it. Staying at the same load for too long is one of the most common reasons eccentric-only programs stall.

What Not to Do

A few things worth naming clearly:

Stretching into pain — particularly for insertional Achilles tendinopathy, aggressive stretching into dorsiflexion compresses the tendon at its attachment and can significantly worsen the presentation. Stretching is not a treatment for Achilles tendinopathy.

Foam rolling directly on the tendon — the tendon is not a muscle. It doesn't respond to compression in the same way. Direct pressure on an irritable tendon achieves nothing useful and can increase reactivity.

Running through it hoping it warms up — the classic "it loosens up after five minutes" pattern is a sign the tendon is managing a load it isn't prepared for. Repeatedly asking a reactive tendon to cope with running before it has the capacity to do so is how a manageable problem becomes a chronic one.

Doing the same exercises indefinitely without progression — tendons adapt to load. When load stops increasing, adaptation stops. Stagnation in a program is a sign the stimulus has plateaued, not that you've arrived.

Insertional vs. Mid-Portion — Does It Change the Exercise Selection?

Yes, in specific ways.

Mid-portion Achilles tendinopathy (pain 2–6cm above the heel) responds well to the full progression above, including eccentric work through range.

Insertional Achilles tendinopathy (pain at the heel bone attachment) requires modification, particularly in Stage 2. End-range dorsiflexion — the position at the bottom of a heel drop off a step — loads the tendon with a compressive force at the insertion that can aggravate insertional pathology significantly. Eccentric work for insertional presentations is typically performed on a flat surface rather than off a step, at least until the tendon is less reactive.

If you're not sure which presentation you have, or your pain is in both locations, have it assessed before loading.

How Long Does This Take?

Honest answer: longer than most people want it to.

Meaningful collagen remodelling takes approximately 12 weeks of consistent, progressive loading. That's not 12 weeks until you're pain-free — it's 12 weeks until the tendon's structural capacity has genuinely improved. Pain often settles earlier than that, which is why people stop the program and relapse.

The timeline isn't negotiable. Tendons are slow-adapting structures. The work done in weeks 8 to 12 is as important as the work done in weeks 1 to 4, even when it feels less dramatic.

Where to Start

If you're currently dealing with Achilles pain and not sure where you sit in this progression, start with Stage 1. Bilateral isometric holds are safe, well-tolerated, and appropriate for almost any presentation. They'll tell you quickly how reactive the tendon is and give you a baseline to work from.

If you're past the reactive stage and ready for a structured 12-week loading program — one that takes you through Stages 1, 2, and 3 with clear progression checkpoints at each phase — the Achilles Load Restoration™ system is built exactly for that.

View the Achilles Load Restoration™ program →

And if you're adding Zone 2 cardio alongside your loading program — which is worth doing — use the heart rate zone calculator to find your personalised Zone 2 range.

Greg Dea is a Sports Physiotherapist and Strength & Conditioning Coach based on the Mornington Peninsula, Melbourne. He works with athletes across rehabilitation, return to sport, and performance.