The first time I felt my own Achilles complain was on a long descent in the Rhodope mountains, about thirty kilometres into a training day. A faint pinch behind the heel, the kind you can almost ignore. Two weeks later, putting my foot down out of bed in the morning felt like stepping on a knot of barbed wire. I had ignored exactly the warning I would have flagged in any of my athletes.
That was a long time ago, and since then I have rebuilt my own Achilles, walked my callanetics students through theirs, and helped trail runner friends crawl back from worse. The good news: Achilles tendonitis (more accurately, Achilles tendinopathy) responds beautifully to graded loading at home. You do not need a clinic, an ultrasound machine, or shockwave therapy for the vast majority of cases. You need patience, six well-chosen exercises, and the discipline to not skip ahead.
This is the protocol I give people. Six exercises, three phases, and a few simple tools that protect the tendon while you do the work.
What is actually happening inside an angry Achilles
Tendinopathy is not the same as tendonitis, even though most of us use the words interchangeably. Real inflammation ("itis") shows up in the very early, acute stage -- the first days to maybe a couple of weeks. After that, what you are dealing with is a degenerative change in the tendon's collagen structure. The fibres become disorganised, the tendon thickens, and the cells that build new collagen get sluggish. That is why rest alone does not fix it. Rest a degenerative tendon and you get a weaker, thinner, more vulnerable tendon. Load it correctly and it remodels.
There are two main locations:
- Mid-portion Achilles tendinopathy -- the painful spot is two to six centimetres above the heel bone. This is the classic runner version and the one that responds best to eccentric loading.
- Insertional Achilles tendinopathy -- pain right where the tendon attaches to the heel. This one is grumpier about deep stretching and dorsiflexion, so the protocol is modified (you do the drops on a flat floor, not over a step edge, at least initially).
If you wake up stiff, warm up after a few steps, feel a pinch at the start of a run that eases as you warm but returns worse the next morning -- that pattern is textbook tendinopathy. If your tendon is hot to touch, visibly swollen, you heard a pop, or you cannot rise on tiptoe at all, stop reading my exercises and see someone in person. That is a different problem.
The three phases and why order matters
The biggest mistake I see -- in both my callanetics students and trail-running friends -- is people skipping to heel drops the day they feel pain. The tendon is irritable. Eccentric loading on a hot tendon makes it angrier. You earn the heel drops by passing through the calm-down phase first.
- Phase 1 (acute, first 3-7 days): isometric holds. Quiet the pain, maintain neural drive to the calf.
- Phase 2 (subacute, weeks 1-6): seated and double-leg loading. Wake up the tendon under controlled tension.
- Phase 3 (remodelling, weeks 4-12+): single-leg eccentric and heavy slow resistance. This is where the tendon actually rebuilds.
You progress when pain on a 0-10 scale stays at or below 3 during the exercise, and morning stiffness is not worse 24 hours later. That 24-hour check is the single most useful rule in tendon rehab. Write it on a sticky note.
The 6 exercises
1. Isometric wall pushes (acute phase)
Stand facing a wall, hands on the wall, one foot back with the heel down. Push the ball of the back foot into the floor as if trying to drive your forefoot through the tile -- without actually moving. Hold for 45 seconds. Rest 60 seconds. Five reps, twice a day.
These isometrics calm the pain receptors around the tendon and let you keep loading without aggravation. Do not push so hard that pain spikes above 3/10. You should feel the calf working, not the tendon screaming.
2. Seated heel raises
Sit on a chair, feet flat, knees at 90 degrees. Place a weight on your thighs (a backpack with books works fine -- start around 5 kg). Raise both heels slowly (3 seconds up), hold the top for 2 seconds, lower slowly (3 seconds down). 3 sets of 15.
This loads the tendon at a low intensity because most of your body weight is supported by the chair. It is the bridge between "doing nothing" and standing heel work. Underrated, often skipped, very useful.
3. Double-leg standing heel raises with eccentric emphasis
Stand on a flat floor, fingertips on a wall for balance. Rise onto both toes (2 seconds), then transfer your weight to the affected side and lower slowly (3-4 seconds) on that leg alone. The lift uses both legs, the lower uses one. 3 sets of 15.
This is the on-ramp to the Alfredson protocol. The eccentric -- the lowering phase -- is where the tendon gets the loading stimulus it needs to remodel.
4. Single-leg eccentric heel drops (the Alfredson protocol)
The famous one. Stand on a step with the ball of the affected foot on the edge, heel hanging off. Use the good leg to push up to tiptoe, then transfer all your weight to the affected leg and slowly lower the heel below the level of the step (4 seconds down). Use the good leg to come back up.
3 sets of 15, twice a day, every day. Do them with the knee straight (loads the gastrocnemius), then repeat with the knee slightly bent (next exercise).
Yes, every day. Yes, even if it is mildly sore -- as long as pain stays at or below 5/10 during and is not worse the next morning. Once 3x15 feels easy, add load with a backpack. This is the protocol that has the best evidence base for mid-portion tendinopathy, and it works if you respect the dose.
For insertional tendinopathy: do the drops on a flat floor, not over an edge. Going below neutral compresses the tendon at the heel bone and flares insertional pain.
5. Soleus-specific bent-knee heel raises
Same as the heel drops but with the knee bent to roughly 20-30 degrees. The bent knee shortens the gastrocnemius and shifts the load onto the soleus -- the deeper calf muscle that crosses only the ankle.
Why this matters: the soleus contributes huge force during running, especially at the push-off and during hill descents. Mid-portion Achilles tendinopathy in runners is almost always also a soleus problem. Skip this and you leave half the calf undertrained.
3 sets of 15, daily, both eccentric and concentric.
6. Banded ankle work and the return-to-running test
Loop a resistance band around the forefoot, anchor it, and work through plantarflexion (pointing the foot), inversion, and eversion. 2 sets of 20 each direction. This builds the smaller stabilisers around the ankle that take pressure off the Achilles when you run on uneven ground.
Return-to-running test: before you go back to actual running, you should be able to do 25 single-leg calf raises on the affected side without pain, hop in place on that leg for 30 seconds, and pass the "morning after" check from a 20-minute walk. If any of those fail, you are not ready. Walking, cycling, and pool running are fine in the meantime.
How HYKLE products fit into Achilles rehab
The exercises do the rebuilding. But there is a whole supporting layer around them -- managing swelling after sessions, protecting the tendon during your return-to-running block, keeping the foot in a position that does not aggravate the Achilles all day at work. This is where my husband Deso and I have built the HYKLE line to do real work, not just to look good.
For post-session calf swelling and circulation, my first recommendation is HYKLE Compression Socks. Graduated 20-30 mmHg compression flushes venous return up the leg after eccentric heel drops -- and eccentric work, more than almost any other loading pattern, leaves the calf swollen and stiff the next day. Slip these on after your session and wear them for two to three hours. Several of my callanetics students who run on the side have told me their next-morning stiffness dropped noticeably once they made this a habit.
If your swelling sits lower -- right around the ankle and tendon itself -- the HYKLE Ankle Compression Socks target that area specifically. They are a beautiful option for the return-to-running phase, when you want compression around the tendon during your run without going full knee-high.
For people whose hands struggle with regular compression -- I see this constantly with older runners and post-surgical patients -- the HYKLE Compression Stockings with Zipper solve a problem most rehab guides ignore. If you cannot get the sock on, you do not wear it. The zipper changes that calculation.
Footwear matters more than people realise. When the Achilles is acutely irritated, a slightly elevated heel (10-12 mm drop) reduces tension on the tendon. But once you are in the remodelling phase -- and especially once you are building back to running -- you want to gradually reintroduce a flatter shoe so the calf and tendon learn to load through the full range again. HYKLE Barefoot Shoes are what I use in this transition phase, but only once you are past the acute stage. Going zero-drop on a hot Achilles is a fast way to a flare-up. Going zero-drop on a tendon that is two months into structured loading is part of the long-term solution.
For the cold months -- and this matters in northern Europe where I do most of my training -- the HYKLE OptiWarm Barefoot Shoes let you keep the wide toe box and flexible sole through winter walks, which keeps the calf and Achilles working through small ranges instead of going stiff in rigid boots.
And around the house: I have my husband, who tweaked his Achilles two years ago helping me move firewood, wearing HYKLE Slippers instead of going barefoot on tile. Cold tile floors and an irritable tendon are a bad combination.
If you also have plantar fascia involvement (the two often travel together), have a look at my piece on plantar fasciitis insoles vs custom orthotics -- the HYKLE Impact Pro insole is what I put in everyday shoes when the heel and the arch are both complaining.
Practical implementation: a sample week
Here is what a real week looks like in phase 3 (the remodelling phase) for one of my trail-running friends:
- Monday morning: Isometric wall pushes as warm-up, then 3x15 single-leg eccentric heel drops (straight knee + bent knee). Compression socks on for two hours after. 30-minute easy walk.
- Tuesday: Banded ankle work, seated heel raises with load. Cycling 40 minutes. No running.
- Wednesday: Heel drops again, both versions. Pool running or elliptical for cardio.
- Thursday: Lighter day -- banded work only. Walk.
- Friday: Full heel drop session with added backpack weight (slow progression, add 2-3 kg every two weeks).
- Saturday: Return-to-running test session. If passing, a 10-minute jog/walk with 1-minute jog, 2-minute walk intervals.
- Sunday: Off, or gentle hike in flexible shoes.
The non-negotiables: heel drops every single day or every other day in this phase, the morning-after check, and not adding speed work until you have at least four weeks of pain-free easy running behind you.
Hills and speed are the last things to return. The first run back is not the time to test how the tendon feels going up a steep climb. Add hills, then add tempo, then add intervals -- in that order, separated by two to three weeks each.
For runners who are also rebuilding from related issues, my foot and ankle strengthening routine and the peroneal tendinopathy protocol overlap heavily with this one. Tendons in the lower leg rarely fail in isolation.
The honest timeline
Mid-portion Achilles tendinopathy typically takes 12 weeks of consistent loading to feel substantially better, and closer to 6 months to fully remodel. Insertional cases often need longer. People who skip the protocol and just rest take six to twelve months and often re-injure. People who load aggressively without the calm-down phase first flare repeatedly and lose months.
The boring, patient path is the fast path.
Closing
If your Achilles has been whispering -- or shouting -- for weeks now, start tomorrow morning with the isometric wall pushes. Five sets of 45 seconds. That is it. Tomorrow night, do them again. By the end of week one, you will have something honest to evaluate: is the pain calming, or is it escalating? That tells you whether to progress or hold steady.
The HYKLE products around this protocol -- the compression socks for recovery, the ankle support for the return phase, the flexible footwear for everyday -- are the supporting cast. The lead role is yours. Six exercises, three phases, and the willingness to do the boring work for twelve weeks. That is what gets you back on the trail.
If you have questions about which sock weight or shoe makes sense for your phase, the HYKLE support team answers every email -- support@hykle.com -- and everything we sell has a 90-day test and return guarantee, even after use, so you can see how the products work alongside your rehab.