Stretching and strengthening exercises for the Achilles tendon

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The Achilles tendon runs down the back of the lower part of the leg. It connects the heel bone to the calf muscle and helps raise the heel off the ground while a person is walking. Doctors might also call it the heel cord.

Common injuries to the Achilles tendon include:

• Achilles tendon rupture: Jumping, falling, running, or tripping can sometimes tear the tendon. Following a sudden sharp pain or “pop” in the back of the leg, symptoms may include swelling in the area between the heel and the calf and difficulty walking and standing on tiptoe. Anyone who suspects that they have an Achilles tendon rupture should speak to a doctor because they will usually need medical treatment.
• Achilles tendinitis: Overuse or injury can inflame or irritate the tendon. Symptoms include swelling, pain, and stiffness in the back of the leg in the morning. The pain will usually get worse with activity.

Both conditions can be painful. Rehabilitating exercise programs can help people during the recovery period.

The American Academy of Orthopaedic Surgeons and the National Health Service (NHS) recommend the following Achilles tendon stretches and exercises as part of the recovery process. As well as loosening the Achilles tendon, they can help reduce the stress on it by lengthening the attached muscles.

Experts recommend that people first carry out the stretches under the supervision of a physical therapist.

Tiptoes

People can perform this exercise by following the steps below:

1. Stand on both feet with the legs straight.
2. Use the uninjured leg to rise onto the tiptoes.
3. Keeping both feet on the floor, transfer the weight across to the affected leg and lower down, using the good leg to help if necessary.
4. Repeat. Aim for 3 sets of 15 repetitions, twice a day.

If the exercise becomes too easy, a person can make it more difficult by bending the knees. Once they have mastered this, they can try performing the exercise on one leg at a time.

Bilateral heel drop

The set of movements for this exercise is as follows:

1. Stand on the edge of a stable raised platform, such as the bottom step of a staircase.
2. Carefully adjust the position of the feet so that just the front half of each foot is on the step. It should be possible to move the heels up and down without them hitting the floor.
3. Carefully rise onto the tiptoes then lower both heels as far as possible.
4. Repeat 20 times.

Single heel drop

The single heel drop is similar to the bilateral heel drop, but it places all of the person’s weight onto one leg. A person should only attempt this exercise when they are comfortable doing the bilateral heel drop and begin finding it easy.

People should be very careful and move slowly while carrying out Achilles stretches.

The exercises may feel uncomfortable, but they should get easier as time goes on. They should not hurt, so anyone who experiences pain while stretching should stop and speak to a physical therapist.

Once someone has mastered the stretches, they can try doing them while holding small weights or using a weighted rucksack. This added weight will help strengthen the tendon and calf muscles.

Initially, anyone with an Achilles injury should rest the leg and use an ice pack to help ease the swelling. The best way to get back into exercising afterward is to wait until it is not painful and to take things slowly.

While rehabilitation may vary among individuals, the first 2 months usually focus on preventing rerupture. During the third month, people typically work on improving calf muscle strength. Over the next 3 months, rehabilitation attempts to help a person return to sports.

In addition to stretches, rehabilitation may include lighter exercises, such as walking, jogging, cycling, or swimming.

According to the American Orthopaedic Foot & Ankle Society, people can usually start light jogging within 3–6 months of an Achilles rupture. However, they note that it can take longer, sometimes 6–9 months, to get back to sports that involve pivoting or jumping. Some people find that it takes more than a year to get back to full strength.

In a 2016 case report, it took 14 months for a female basketball coach to recover fully from an Achilles tendon rupture without surgery.

By stretching the calf muscle, people can reduce stress on the Achilles tendon. According to the NHS, the following calf muscle stretches and exercises for calf problems may help strengthen the calves:

The wall push

To perform a wall push, people should follow the steps below:

1. Face a wall, standing about an arm’s length away from it.
2. Put both hands on the wall at shoulder height.
3. Take a large step backward with the right foot. Keep the back straight.
4. Press the hands into the wall and both heels into the floor.
5. Feel the stretch in the right calf.
6. Hold for 30 seconds.
7. Bring the right foot back in toward the body, switch sides, and repeat.

Standing calf stretch

This stretch involves the following movements:

1. Stand facing a wall and place the foot of one leg against it with the toes pointing up and the heel on the floor. The higher the toes are on the wall, the deeper the stretch.
2. Keep the other leg behind the body with the toes facing forward and the foot flat on the ground.
3. Lean forward, keeping both heels on the floor.
4. Hold for 30 seconds. Repeat 3 times.

Resistance band calf exercise

To perform this exercise:

1. Sit on the floor or on a bed, and extend the legs straight out in front.
2. Wrap a resistance band or bit of fabric around the ball of one of the feet.
3. Keeping the knee straight, pull the toes up toward the nose until there is a stretch.
4. Hold for 30 seconds. Repeat 5 times on each leg.

The Achilles tendon is in the back of the lower leg, and it connects the calf muscle to the heel bone. Achilles tendon ruptures and Achilles tendinitis are common and often painful.

Stretching the tendon can help people recover from Achilles tendon damage by loosening the heel cord and increasing mobility. Experts warn people to be careful when stretching the tendon. Strengthening the calves can also help people who have suffered an Achilles tendon injury.

Anyone who thinks that they may have ruptured the Achilles tendon or finds that the pain does not get better over time should speak to a doctor.