Midportion Achilles Tendinopathy Exercises

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. 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. 01
   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. 02
   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. 03
   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. 04
   Exercise 4

   Single-leg heel raise progression

   3 days per week when ready

   Dose3 sets of 6 to 12 repetitions

   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. 05
   Exercise 5

   Later-stage pogo or hop

   2 to 3 days per week when ready

   Dose2 to 3 sets of 15 to 20 contacts

   Begin with small two-leg springing contacts. 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

   Progress toward single-leg or activity-specific hopping.

   My starting dose or notes

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.

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: restore spring and sport

   Add fast calf work, pogo contacts, hopping, and running volume only after slow strength and daily activities are stable.

Signs you are ready for the next stage

• Morning pain and stiffness are stable or improving.
• Repeated single-leg heel raises have good height and control.
• Walking and stairs do not produce a sustained flare.
• You can add load without losing the slow tempo.