Achilles Tendinopathy Rehab for Runners
What Is Achilles Tendinopathy?
The Achilles tendon, a band of durable tissue that joins two muscles in the calf to the heel, has spring-like properties that allow people to produce force off the floor (Maghsoodi, n.d.). Although a single overload event can trigger tendinopathy, it most often develops gradually from repeated stress and overuse (Vos et al., 2021).
Common Causes in Runners
Achilles tendinopathy is especially common in athletes whose tendons absorb repeated stress. In runners, it’s often driven by:
Tight calf muscles
Poor ankle range of motion
Excessive pronation
Sudden increases in training mileage or intensity
Lots of hill work
(Davis, n.d.; Runner’s World Editors, 2021)
Signs & Symptoms
Pain in the tendon (mild to severe)
Redness or a burning sensation
Decreased ankle mobility
Build-up of scar tissue
(Runner’s World Editors, 2021)
Four Phases of Rehab Exercises
Studies now show that tendons heal best under controlled load rather than complete rest (Maghsoodi, n.d.). Follow this four-phase progression, performing 5 sets of each exercise, 45 seconds per set, resting 2 minutes between sets, and increasing your running mileage by one mile every 1–2 weeks as tolerated:
Phase 1: Supine Calf Isometric With Band
In sitting, loop a band or towel around your heel. Push the heel forward against the band to create tension—no pain.
Phase 2: Single Leg Heel Raise Isometric Hold
Stand near a wall. Raise both heels, then shift weight onto the sore side and lift the other foot. If painful, keep both heels up together.
Phase 3: Single Leg Heel Raise Weight Shift
With knees straight, rise onto your heels and slowly sway side to side, loading each Achilles in turn.
Phase 4: Single leg/Double leg Pogos
Facing a wall, bounce up and down. Start with both feet and small hops, then progress to single-leg pogos as your tendon tolerates.
How Physical Therapy Can Help:
Physical therapy combines targeted soft-tissue techniques, joint mobilizations, and progressive loading exercises tailored to your running goals. Your therapist will set both short- and long-term rehab milestones, blending mobility work, strength training, balance drills, and education so you avoid under- or over-loading your tendon.
Ready to Get Back to Running?
If you or anyone you know has Achilles tendinopathy and wants to return to running pain-free, reach out to us at Athletic Edge PT—San Diego’s premier sports-performance physical therapy clinic.
Written by Jun Bae, current student of Natasha Hastings
