Exercises For Achilles Tendonitis/Tendinopathy - What, When, How Often?

In this video, Maryke discusses how exercise benefits your Achilles tendon when you have Achilles tendonitis, what exercises you should be doing, how you can adapt them to suit your needs, and how to know when you're ready to get back to sport.

👉Other relevant videos:

📚Chapters:
00:00:00 Introduction
00:01:12 How exercises help treat Achilles tendonitis
00:03:31 Exercises should be individualised
00:04:41 What strength exercises to do
00:05:25 How to adapt your exercises
00:17:40 How to add and increase weights
00:27:02 When can you go back to sport?
00:29:24 Maintenance exercises to prevent recurring Achilles pain
00:31:56 How we can help

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References:
Van Der Vlist, A. C., et al. (2021). "Which treatment is most effective for patients with Achilles tendinopathy? A living systematic review with network meta-analysis of 29 randomised controlled trials." British Journal of Sports Medicine 55(5): 249-256.
Gravare Silbernagel K, Vicenzino BT, Rathleff MS, et al. Isometric exercise for acute pain relief: is it relevant in tendinopathy management? British Journal of Sports Medicine 2019;53:1330-1331.
Rio, E., Kidgell, D., Purdam, C., Gaida, J., Moseley, G.L., Pearce, A.J. and Cook, J., 2015. Isometric exercise induces analgesia and reduces inhibition in patellar tendinopathy. Br J Sports Med, 49(19), pp.1277-1283.
O’Neill, S., Radia, J., Bird, K., Rathleff, M.S., Bandholm, T., Jorgensen, M. and Thorborg, K., 2019. Acute sensory and motor response to 45-S heavy isometric holds for the plantar flexors in patients with Achilles tendinopathy. Knee Surgery, Sports Traumatology, Arthroscopy, 27(9), pp.2765-2773.
Beyer, R., Kongsgaard, M., Hougs Kjær, B., Øhlenschlæger, T., Kjær, M. and Magnusson, S.P., 2015. Heavy slow resistance versus eccentric training as treatment for Achilles tendinopathy: a randomized controlled trial. The American Journal of Sports Medicine, 43(7), pp.1704-1711.
Cook, J.L. and Purdam, C.R., 2009. Is tendon pathology a continuum? A pathology model to explain the clinical presentation of load-induced tendinopathy. British Journal of Sports Medicine, 43(6), pp.409-416.
Silbernagel, K.G., Thomeé, R., Eriksson, B.I. and Karlsson, J., 2007. Continued sports activity, using a pain-monitoring model, during rehabilitation in patients with Achilles tendinopathy: a randomized controlled study. The American Journal of Sports Medicine, 35(6), pp.897-906.
Clifford, C., et al. (2020). "Effectiveness of isometric exercise in the management of tendinopathy: a systematic review and meta-analysis of randomised trials." BMJ Open Sport & Exercise Medicine 6(1): e000760.
O’Neill, Seth, Paul J. Watson, and Simon Barry. "Why are eccentric exercises effective for Achilles tendinopathy?" International Journal of Sports Physical Therapy, 10.4 (2015): 552.
Baxter JR, Corrigan P, Hullfish TJ, O'Rourke P, Silbernagel KG. Exercise Progression to Incrementally Load the Achilles Tendon. Med Sci Sports Exerc. 2021 Jan;53(1):124-130. doi: 10.1249/MSS.0000000000002459. PMID: 32658037.
Cook, J. L., et al. (2018). Insertional and mid-substance Achilles tendinopathies: eccentric training is not for everyone–updated evidence of non-surgical management. Journal of Manual & Manipulative Therapy 26(3): 119-122.
Martin, R. L., et al. (2018). "Achilles pain, stiffness, and muscle power deficits: midportion Achilles tendinopathy revision 2018: clinical practice guidelines linked to the International Classification of Functioning, Disability and Health From the Orthopaedic Section of the American Physical Therapy Association." Journal of Orthopaedic & Sports Physical Therapy 48(5): A1-A38.

[TreatMyAchilles]

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[georgialilley]

Such a helpful video! I had three physio sessions with a highly recommend physio in my area, and all they did was rub deep heat on my foot for 15mins each time 🤦‍♀️ I’ve learned so much more from your videos than from any practitioner I’ve actually paid good money to get help from. Thank you!

[jarotsuharyaji]

I suffer from pains on the back of my heel in some 'random' morning or after some sleeps. It hurts when walking and especially when standing with heel lifted. It takes one or several says to disappear itself. Stranglely I notice that most of the time it heals or at least feels much better after I play table tennis. When searching for explanations on the internet, I came across your videos and now everything makes sense! I am just now following the very first few exercises here and the pain has significantly reduced. Thank you!

[pf]

Your level of description is awesome; it gives me the understanding to enable me to make adjustments to your recommendations based on my own body.

[olagustafsson]

This is by far the best and most nuanced guide I have stumbled across. My Achilles rehab is now on track again. The goal is to once again conquer the Ironman distance. Not this year and probably not even next year but 2026 🙂

[TinaFabulous]

This information has been so very helpful. I just spent a month in a soft cast do to my severe tendonitis. I am 50 years old and I am a dance instructor. I did well without the boot for a week and ended up having to do a lot of walking and set myself back. I'm very scared that I'm never going to be without pain and will always be walking weird, not being able to go back to dancing.
Going to watch the menopause video next!

[csujoy]

This is really helpful. I have suffered with multiple Achilles tendonitis over the last couple of years when I started running. I only did calf raises but when I stopped doing it, I was back with the pain...Now I want to sign up for a more structured rehab and need guidance like this. I am ready to give 6 months to this and control my addiction to run long distances as this rehab should help me to be a better runner in the long run

[ClaireNeff]

You were big help in my Achilles tx. I agree with everything you say.

[earthquakemagoon]

So many videos on this subject! Barely any go into depth on what to do. This video is awesome!! Covers all the 'in depth' information that is needed. Best video out there!! I wish you were located here in Arizona then I would come to do therapy there! Thank you Maryke!! Skal!

[cbanl]

Your videos are exceptional! I'm so happy I came across these. I had flat foot reconstruction surgery a few years ago which included an Achilles lengthening. My right foot feels great but my left Achilles has been sore ever since 17 months after my surgery. I recently found out I have mild tendenosis. I'm going to talk to my podiatrist this week to understand what needs to happen moving forward, I'm just concerned about living with pain permanently. Unfortunately there isnt as much information on YouTube about tendonosis as there is about tendonitis. Im going to use your tips and hopefully my Achilles will make a turn around.

[kittykittyhere]

Extraordinary series, thank you so much! Too often we don't get any explanations from docs who are too busy. Or we lose valuable time waiting for an appointment with them while our Achilles tendonitis tends to get worse during that time because we are in fear of doing something wrong if try to do any exercises on our own (personal experience, second time in ten years). At least gentle isometric can give us a degree of personal involvement in our own rehab while we are waiting for professional advice. I cannot say Thank You enough times.

[jennyjones]

Absolutely incredible explanation, Maryke. Thank you so much for all this incredible and sound advice. I feel like you've answered so many questions of mine in such a clear and methodical way. There is hope after all!

[TheWIZELY]

Extremely informative this is EXACTLY what my physio is doing with me. I am coming up for a year in rehab and just starting to slowly build up the running miles. The biggest thing I have noticed is Achilles tendonitis rehab takes time, patients and persistence!

[andrewturnbull]

An excellent and informative video, as suffering from both Achilles and plantar facia pain I have come to realise how weak my calves and ankles/feet are, even though I do a lot of cycling it just doesn't load them the same. So recently when I started do lots more walking / jogging these issues flared up as without doubt I didn't have the capacity within them to take these extra new loads. So now 5 steps backwards and following the advice laid out here to strengthen those calves and tendons and have the patience and commitment that is outlined to see this through, no quick fix here especially as I am a 68 year old male and the body just doesn't heal / recover like it used to.

[oceanclau]

This woman is amazingly gifted at explaining things! Extremely helpful. Many thanks!

[lkc]

This is the real deal. Thorough, practical, and accurate. Thanks Maryke, Kevin and TMY

[mattg]

Wow, just what I was looking for. Thankyou 🙌 and such a well put together and paced video 👏👏

[AlexJones-bmcn]

This is an unbelievable video, as are the others of yours I’ve just watched. Thank you so much!

[Erin-ywxd]

This video is what my doctor should have ordered! After not being helped very much by a variety of doctors in my HMO, I stumbled across your video. You gave me hope and a way forward toward returning to my gentle hiking activities. Yosemite, here I come in a few months! 🏞 Thanks so much for the super excellent video!

[diBundy]

Thank you so much, this has been incredibly informative and helpful