Achilles Tendinopathy: Why Stretching Isn’t the Answer and What Actually Works
The Achilles tendon is a very strong tendon in your body, connecting your calf muscles to your heel bone. It’s also a very common site of injury in active people — especially runners. If you’ve been dealing with persistent heel pain, you may have what’s called Achilles tendinopathy.
Many people assume that stretching is the best treatment, but research shows that’s usually not the case. Instead, the key lies in understanding how the tendon changes with injury and how to retrain it properly.
Why Stretching Often Fails
Traditional advice for tendon pain is to “just stretch it out.” But the Achilles tendon isn’t like a tight muscle — it actually behaves more like a spring.
In chronic tendinopathy, the Achilles loses stiffness — meaning it doesn’t store and release energy efficiently anymore.
Stretching does not address this loss of stiffness.
Instead of stretching, the goal should be restoring stiffness and strength through the right kind of loading.
Acute Achilles Tendinopathy
When pain is new and sharp, the tendon is in an acute reactive phase. Here’s what works best:
Unload the tendon temporarily: strategies like heel lifts or activity modification reduce stress.
Relative rest: avoid high-load activities (like sprinting or hills) while pain is severe.
Progressive reloading: once symptoms calm, you can start a progressive loading program.
Think of this stage as calming down an irritated tendon before teaching it how to handle stress again.
Chronic Achilles Tendinopathy
When pain lingers for months or even years, the tendon needs a different approach. Here, the goal is to rebuild stiffness and strength.
Heavy, slow resistance training is the gold standard.
Slow calf raises (3–5 seconds up and down) strengthen the tendon and improve stiffness.
Tendons adapt best to slow, controlled reps rather than quick movements.
Runners: uphill running increases Achilles strain. Start with flat surfaces or slight declines until the tendon adapts.
Loading is not only safe but essential for recovery in chronic tendinopathy.
Mid-portion vs. Insertional Achilles Tendinopathy
Not all Achilles pain is the same — and treatment strategies need to reflect that.
Mid-portion tendinopathy (pain 2–6 cm above the heel):
Responds very well to heavy, slow calf loading.
Exercises like heel raises on a step are effective.
Insertional tendinopathy (pain right at the heel bone):
Sensitive to compressive forces at the tendon’s attachment point.
Avoid exercises or stretches that push into deep dorsiflexion (heel dropping below a step, aggressive calf stretches).
Instead, keep the heel slightly elevated during strengthening to avoid compressing the tendon against the heel bone.
The Bottom Line
Stretching might feel good temporarily, but it doesn’t solve Achilles tendinopathy.
In the acute phase, unload and rest, then carefully reintroduce loading.
In the chronic phase, tendons thrive on heavy, slow strength training.
Modify running by avoiding uphills early on, and adjust exercises depending on whether your pain is in the mid-portion or insertional Achilles.
With the right strategy, the Achilles can regain its spring-like stiffness — and you can get back to running, training, and moving without pain.