Achilles tendon ยท Home exercise plan

Midportion Achilles Tendinopathy Exercises

Progressive tendon loading is first-line care for midportion Achilles tendinopathy. This plan uses straight-knee and bent-knee calf work, gradual resistance, and morning stiffness as a load signal.

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Clinically reviewed August 28, 2026

Written and clinically reviewed by Jeremy Swisher, MD

Board-certified primary care sports medicine physician. Reviewed August 28, 2026.

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Jeremy Swisher, MD

Evidence-informed home exercise program

Midportion Achilles Tendinopathy Home Exercise Program

Name: __________________________________

Affected side: ______________

Start date: __________________

Review date: _________________

Clinician or PT: ______________________________

Before you start

This starter program is intended for adults who have already been evaluated and told midportion Achilles tendinopathy is the likely diagnosis. It is not for postoperative recovery, a suspected rupture, or insertional pain without modification.

This program may fit

Gradual-onset, load-related pain about 2 to 6 centimeters above the heel attachment, often with morning stiffness and sometimes with localized thickening.

Get assessed first

Pain directly at the heel attachment, a sudden injury, substantial swelling, inability to perform a heel raise, recent surgery, uncertainty about rupture, or a known inflammatory, endocrine, or metabolic disorder. Stop tendon-loading exercise and contact the prescribing clinician immediately for new Achilles pain, swelling, or weakness during fluoroquinolone treatment. FDA-approved fluoroquinolone medication guides direct patients to stop the medicine at the first tendon symptoms and obtain prompt medical guidance. If symptoms begin after the course has ended, seek prompt assessment. Age over 60, systemic corticosteroid treatment, or a kidney, heart, or lung transplant increases concern.

Stop signs

Call 911 for chest pain, trouble breathing, fainting, or another medical emergency. Seek same-day urgent assessment for new one-sided calf warmth or swelling, or for a sudden pop, bruising, a palpable gap, inability to push off or perform a heel raise, acute major swelling, or other signs of tendon rupture.

Check the next morning

Some tendon discomfort during loading can be acceptable when mechanics remain controlled and next-morning pain or stiffness does not increase. Complete rest is usually unnecessary.

Fit and safety

Confirm this is the right diagnosis.

This starter program is intended for adults who have already been evaluated and told midportion Achilles tendinopathy is the likely diagnosis. It is not for postoperative recovery, a suspected rupture, or insertional pain without modification.

This program may fit

Gradual-onset, load-related pain about 2 to 6 centimeters above the heel attachment, often with morning stiffness and sometimes with localized thickening.

Get assessed first

Pain directly at the heel attachment, a sudden injury, substantial swelling, inability to perform a heel raise, recent surgery, uncertainty about rupture, or a known inflammatory, endocrine, or metabolic disorder. Stop tendon-loading exercise and contact the prescribing clinician immediately for new Achilles pain, swelling, or weakness during fluoroquinolone treatment. FDA-approved fluoroquinolone medication guides direct patients to stop the medicine at the first tendon symptoms and obtain prompt medical guidance. If symptoms begin after the course has ended, seek prompt assessment. Age over 60, systemic corticosteroid treatment, or a kidney, heart, or lung transplant increases concern.

Do not self-start with these warning signs

Call 911 for chest pain, trouble breathing, fainting, or another medical emergency. Seek same-day urgent assessment for new one-sided calf warmth or swelling, or for a sudden pop, bruising, a palpable gap, inability to push off or perform a heel raise, acute major swelling, or other signs of tendon rupture.

This is a diagnosis-specific home program, not a substitute for an examination. A clinician may change the exercise, dose, range, or timeline based on your history.

Your home program

Use two calf angles and one clear progression.

Perform the straight-knee and bent-knee loading exercises on the same day. Use the isometric hold as an entry option on more painful days, not as mandatory extra volume. When you reach the single-leg heel-raise progression, use it in place of the slow straight-knee heel raise rather than as extra volume. Keep all work on a flat floor for this midportion starter plan.

Frequency
Loading at least 3 days per week
Equipment
Wall or counter, chair, optional backpack or dumbbell
First checkpoint
Commit to at least 12 weeks
Primary goal
Stronger push-off, walking, stairs, running, and jumping
  1. Exercise 1

    Optional calf-raise isometric hold

    On more painful days

    Dose4 holds of 20 to 30 seconds

    Rise onto both forefeet on a flat floor and hold at a comfortable height while using a counter for balance. Keep pressure even across the forefoot.

    Make it easier

    Hold lower or shift more weight to the less painful side.

    Progress it

    Shift more weight toward the involved side.

    My starting dose or notes

  2. Exercise 2

    Slow straight-knee heel raise

    At least 3 days per week

    Dose3 sets of 8 to 15 repetitions

    With knees straight and support nearby, rise for two to three seconds and lower for two to three seconds. Start with both legs.

    Make it easier

    Use more hand support or a smaller range.

    Progress it

    Progress to one leg, then add a backpack or dumbbell.

    My starting dose or notes

  3. Exercise 3

    Slow bent-knee heel raise

    At least 3 days per week

    Dose3 sets of 8 to 15 repetitions

    Keep a small, steady bend in both knees while lifting and lowering the heels slowly. Keep the knees over the middle toes.

    Make it easier

    Use a wall sit position with a smaller heel lift.

    Progress it

    Shift toward one leg or add external load.

    My starting dose or notes

  4. Exercise 4

    Single-leg heel raise progression

    3 days per week when ready

    Dose3 sets of 6 to 12 repetitions

    Use this in place of the slow straight-knee heel raise when ready. Rise and lower on one leg with a slow tempo, stable ankle, and similar heel height across repetitions.

    Make it easier

    Use the other foot lightly for assistance.

    Progress it

    Add load while preserving height and control.

    My starting dose or notes

  5. Exercise 5

    Initial two-leg pogo readiness

    2 to 3 days per week when ready

    Dose2 sets of 10 to 15 contacts

    Use small two-leg springing contacts as an entry check for the athlete progression. Keep the rhythm quiet and controlled. Add this only after walking, stairs, and repeated single-leg heel raises are tolerated.

    Make it easier

    Use brisk marching or quick heel raises without leaving the floor.

    Progress it

    Move to the athlete return-to-sport program for single-leg plyometrics, running, repeated jumping, and court exposure.

    My starting dose or notes

Optional video companion

See the movement principles in context.

The written program above remains the prescription. This independent third-party video adds a visual explanation of the condition and common exercise options.

E3 Rehab video

Achilles Tendinopathy / Tendinitis / Tendinosis | Heel Pain Rehab (Education, Myths, Exercises)

Third-party educational resource

YouTube content does not load until you choose this button.

A visual overview of Achilles tendinopathy, load monitoring, calf strengthening, and staged return to faster activity.

Watch on YouTube (opens in a new tab)

Use with this program

Use this video for education and technique, not as a second exercise program. Follow the exercises, dose, progression, and symptom rules on this page. Video examples are options, not additions. Links or promotions inside the video are provided by E3 Rehab and are not part of this program. The video discusses both midportion and insertional Achilles tendinopathy. This page is specifically for midportion pain. Keep early loading on a flat floor, and do not add step-deficit raises or hopping before slow strength and daily activity are stable.

Symptom response

Let the next day guide the dose.

Some tendon discomfort during loading can be acceptable when mechanics remain controlled and next-morning pain or stiffness does not increase. Complete rest is usually unnecessary.

Continue

Green light

Tolerable discomfort, good heel-raise control, and morning pain or stiffness that is unchanged or improving.

Adjust

Yellow light

Next-morning pain or stiffness increases, the heel-raise height falls, or running and strengthening together create a cumulative flare. Reduce load or total contacts.

Stop

Red light

Stop. Call 911 for chest pain, trouble breathing, fainting, or another medical emergency. Seek same-day urgent assessment for new one-sided calf swelling, a sudden pop, new bruising, a palpable gap, or inability to push off.

Change one variable at a time

When symptoms are too reactive, first reduce range, resistance, repetitions, or frequency. When the current dose feels controlled for several sessions, progress only one of those variables.

Progression

Build capacity in stages.

  1. Stage 1: establish a tolerable load

    Use two-leg slow raises and optional isometric holds. Continue general activity within pain tolerance rather than resting completely.

  2. Stage 2: increase tendon strength

    Progress from two legs to one leg, then add external load. Choose a resistance that makes the final repetitions challenging while controlled.

  3. Stage 3: establish initial impact readiness

    Add fast calf work and a small dose of two-leg pogo contacts after slow strength and daily activities are stable. Use the separate athlete progression for running volume, single-leg plyometrics, repeated jumping, speed, and court exposure.

Signs you are ready for the next stage

  • You have completed the progressive loading stage needed for the activity you plan to resume.
  • Pain stays at 5 out of 10 or less during activity and returns to baseline by the next morning.
  • Pain and stiffness are not increasing from week to week.
  • Walking, stairs, and repeated heel raises are controlled without a sustained flare.
  • These markers guide progression but do not independently clear high-demand or competitive sport.

When to schedule an evaluation

Schedule a visit if the pain is at the heel attachment, the diagnosis is uncertain, symptoms are worsening, a rupture is possible, or a consistent twelve-week loading trial does not improve function.

Call UCLA Orthopedics at 310-319-1234

Use this tracker through the first checkpoint above. Mark up to three key sessions each week, check weekdays for frequent work, and note symptoms, resistance, duration, or activity gains. Continue through a longer condition-specific trial when useful.

WeekKey sessionsDaily or most-day workNotes
123
1MTWTFSS
2MTWTFSS
3MTWTFSS
4MTWTFSS
5MTWTFSS
6MTWTFSS

Questions? Call UCLA Orthopedics at 310-319-1234.

Full guide and references: https://jeremyswishermd.com/achilles-tendinopathy-exercises/

Clinical review: August 28, 2026. Independent professional site; not an official UCLA Health website. UCLA Health manages appointments and clinical communication.

Optional video: An E3 Rehab technique companion is available in the full online guide listed above.

General education only, not individualized medical advice. For a medical emergency, call 911.

Common questions

Questions about this program

Should I stretch the tendon over the edge of a step?

Not automatically. This midportion starter plan uses a flat floor. Heel drops below a step can aggravate insertional Achilles pain and should be matched to the diagnosis.

Do I need eccentric heel drops specifically?

No. Eccentric, concentric, heavy slow resistance, and combined loading can all work. The important principle is progressive tendon loading at a challenging, tolerated intensity.

Must I stop running completely?

Usually not. Continue activity within pain tolerance when the next-morning response is stable. Reduce running volume or intensity if it repeatedly drives a flare.

How long does recovery take?

Commit to at least a twelve-week loading trial. Recovery commonly takes three to six months, and return to higher-demand sport may take longer.

Evidence

Guidelines, reviews, and clinical studies

This plan translates current clinical guidance into a practical home program. The cited sources support the treatment principles, but they do not establish one universal exercise recipe for every patient.

Evidence and recommendations can change. Last clinical review: August 28, 2026.

Related care

Athlete progressionReturn to running, jumping, and basketball Open guide Return to sportSports injury evaluation Open guide Different heel patternPlantar heel pain exercises Open guide

Need a diagnosis or progression plan?

Start with a focused sports medicine evaluation.

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