Achilles Tendinopathy
Achilles tendinopathy / tendinitis
Understanding Achilles tendinopathy
The Achilles is the strong tendon — the "heel cord" — that connects your calf muscles to your heel bone. With overuse (running, walking, stairs, a jump in activity), it can get irritated, thickened, and sore. It''s a tendon problem, and the key thing to know is that tendons recover best with the right kind of gradual loading, not with rest alone. This program is built around exactly that.
The reassuring outlook
Achilles tendinopathy can be slow and stubborn, but the great majority settle with patient, progressive loading — especially the slow "eccentric" heel-drop exercises that rebuild the tendon. It often takes several weeks to turn the corner and a few months to fully settle, so steadiness matters more than speed. Most people get fully back to their activities.
Why rest alone isn''t the answer
Resting a sore tendon feels right, but tendons that aren''t loaded get weaker and don''t reliably heal. The evidence-based approach is the opposite: ease off the overload, then gradually load the tendon in a controlled way so it rebuilds stronger. Some mild ache during and after the exercises is normal and expected with tendon work.
What you might be feeling
Achilles tendinopathy typically brings pain and stiffness at the back of the heel or lower calf — classically worst with the first steps in the morning and with activity — sometimes with a tender, thickened spot in the tendon. It usually eases as the tendon strengthens. If anything new or unexpected comes up, or you''re unsure how you''re doing, your care team is the best place to check.
The key: progressive eccentric loading
The heart of recovery is calf and heel-raise strengthening, building into eccentric heel drops — slowly lowering the heel below a step — which is the proven way to rebuild this tendon. Load it patiently and consistently and the tendon gets stronger and quieter. Calf stretching and good footwear support the work.
How this program is built
It starts with calf stretching and heel raises, adds the eccentric heel-drop loading, and builds toward single-leg strength. Start manageable and progress gradually — a little more load each week. Expect some mild ache with the tendon work; sharp or sustained pain is the signal to ease back a notch.
Staying comfortable day to day
A small heel lift in the shoe can ease the tendon early, and supportive shoes help. Ease off the high-impact activity (running, jumping) that flares it while you build the tendon''s tolerance, then return gradually. Keep doing the loading — it''s the treatment.
When it flares
When it''s more bothersome: ease off the impact activity for a few days, drop back the loading a level, use a heel lift and ice, and a short anti-inflammatory course if appropriate for you. Then rebuild the loading. Flares are part of tendon recovery and don''t undo your progress.
Tracking how you''re doing
Your quick daily check-in gives you and your care team a shared view of how things are trending — a simple way to see progress and keep your care team in the loop. It is not a monitoring or warning system.
This guide is general education, not medical advice, and doesn't replace evaluation by a licensed provider. For urgent symptoms, contact your care team or call 911.