Achilles tendon pain can be frustrating—especially when it’s affecting your ability to train, play, or just get around comfortably. Whether you’re in the middle of your sport season or taking time off to recover, understanding how to manage your tendon health is key.
Here’s a practical guide to managing Achilles tendon pain based on what stage you’re in: In-Season (when you’re still active in sport) or Rehabilitation (when you’ve stepped back to recover). Let’s break it down.
First- make sure you have the right diagnosis! Achilles tendon pain can be managed and rehabilitated, BUT we need to make sure we know what it is you’re dealing with! For example, a peritendonitis is treated slightly differently to a tendinopathy.
The following guide is for information purposes ONLY. This may not apply to your specific situation, so please seek advice from a qualified health professional before starting a rehabilitation plan.
In-Season: Keep the Gains, Don’t Push the Pain
During your sport season, the goal is to manage symptoms, not make big changes. Your tendon is already under load from training and competition, so adding more stress can cause flare-ups. Here's what to focus on:
✅ What to Do:
Stick to Isometric and Isotonic Strength Exercises: Think slow, controlled calf raises—especially single-leg.
High load for tendons = activities with spring (e.g. hopping, jumping, running).
Don’t Change Too Much: New shoes or different surfaces can surprise your tendon. Keep things consistent if possible.
Keep Tendon Load Steady: Spread out high-load days (e.g. Tues/Thurs/Sat) so your tendon gets rest between.
Look at the Whole Week: Include gym warm-ups (like skipping or box jumps) in your load tracking—those count! Reduce un-necessary load
Monitor Morning Pain/Stiffness: Low and stable pain is okay. Flare-ups mean you may need to tweak your routine.
❌ What to Avoid:
Stretching (yes, really—it can irritate your tendon)
Injections
Completely deloading—this reduces your tendon’s strength
Ignoring pain the next day—it’s your body’s feedback tool
💡 Pro Tip: If a hop hurts, try an isometric calf hold. If the pain decreases after the hold, it's a good warm-up tool before games!
Off-Season or Rehab Phase: Rebuild the Right Way
If you're in recovery mode—whether it’s the off-season or you've had to take a break—this is the time to get stronger, address weaknesses, and set your tendon up for success.
Step-by-Step Rehab Plan:
Stage 1: Isometric Strength (Holds)
Start with isometric calf raises—great if you’re sore, nervous about pain, or just starting back.
Holds should be heavy (as tolerated), done for 45 seconds at a time.
These help reduce pain and begin rebuilding strength without flare-ups.
Stage 2: Isotonic Strength (Slow Movement)
Begin slow calf raises
Do both standing (gastrocs) and seated (soleus) variations.
Aim for 4 sets of 6–8 reps every other day.
Add sled pushes or stair walking —just keep it controlled and pain-free.
Stage 3: Energy Storage Prep
Progress to skipping, small jumps, and sport-specific drills.
You need to pass the strength test: 35+ single-leg calf raises on each side to move to the next stage
Continue listening to your pain/stiffness the next morning.
Stage 4: High-Load, High-Speed Return to Sport
Single-leg hops, zig-zag runs, cutting drills—all while watching for morning symptoms.
Surface and footwear should match what you’ll use in your sport.
🧠 Reminder: Your tendon doesn’t mind heavy, slow loads—it’s speed that’s tricky. Build up slowly.
Other Essentials for Tendon Health
Footwear: Avoid overly stiff shoes. Heel lifts may be required but external is better!
No Stretching: It can cause more harm than good.
Address Foot Strength: Train your feet too—flat toes, aligned properly, support your calf strength.
Manage Peritendonitis Carefully: This condition around the tendon often needs less load and more targeted intervention
The 24-Hour Rule: Your Tendon Talks—Listen to It
The most important thing you can learn is this: what you feel the morning after matters most. Tendon pain that’s low and stable is okay. If it spikes, look at what changed (e.g. added jumping, a new warm-up drill, or more volume) and adjust. You can progress through the stages if your morning stiffness remains low and stable.
🎯 Recovery is not about zero pain—it’s about controlled, consistent progress.
Final Thought: Strength is Your Superpower
Don't fall into the trap of doing nothing when your tendon hurts. The key is to adjust the load, not eliminate it. Your tendon needs strength to heal—and with the right plan, you can stay active while managing or overcoming Achilles pain.
Your Physiotherapist can help tailor your recovery or in season management plan!
Written by: Shannyn McGrice, Physiotherapist
Please note these blog posts are for information purposes ONLY. This may not apply to your specific situation, so please seek advice from a qualified health professional before starting a rehabilitation plan.