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Achilles tendon: returning to sport step by step

Pain and stiffness in the tendon at the back of the ankle, often stronger on waking or at the start of the effort.

Back of the ankle (tendon)

Why it happens

Rapid increase in volume, hills, speed sessions, sudden change of shoes, under-prepared calves.

Coming back in four stages

  1. 1

    Walking on flat ground for 20 to 30 minutes, or light cycling, if your healthcare professional agrees.

  2. 2

    Calf strengthening prescribed or approved by your physiotherapist: it is often the basis of tendon rehabilitation.

  3. 3

    Alternating walking and slow running, on flat ground, without hills or accelerations.

  4. 4

    Easy continuous running, then gradual reintroduction of hills and speed, only one new thing at a time.

Move on to the next stage after 2 sessions in a row with discomfort of 2 out of 10 or less and no pain the next day. Each stage usually lasts 1 to 2 weeks, depending on your healthcare professional’s advice. For the Achilles tendon, next-morning stiffness matters more than discomfort during the session: if it increases, stay at this stage.

Movements to postpone

  • accélérations et sprints from stage 4
  • côtes et descentes from stage 4
  • sauts from stage 4

Strengthening exercises

  • Isometric calf hold

    from stage 1 of the plan

    Standing, rise onto your toes and hold 30 to 45 seconds, with a hand on a wall if needed. 3 repetitions, no bouncing.

    To start: 3 holds of 30 seconds, 1 minute rest, once a day.

    Variations, mistakes and progression
    Easier
    Rise only halfway, both hands on the wall.
    Harder
    On one foot, then 45 seconds per hold.
    Common mistakes
    • Letting the ankle roll outwards (weight on the little toe).
    • Holding your breath.
    Moving on
    When 3 holds of 45 seconds on both feet stay at 2 out of 10 at most, on the day and the next morning.
  • 12

    Heel raises

    from stage 2 of the plan

    Standing, rise on both feet and lower slowly over 3 seconds. Keep the knee straight, then bent to work the other part of the calf.

    To start: 3 sets of 12, 3 seconds down, every other day.

    Variations, mistakes and progression
    Easier
    Seated on a chair, a light weight on your knees.
    Harder
    Heels over the edge of a step, to go lower.
    Common mistakes
    • Bouncing at the bottom instead of controlling the way down.
    • Rising higher on one side than the other.
    Moving on
    When 3 × 15 is easy with no discomfort the next day: move on to single-leg raises.
  • 12

    Single-leg heel raises

    from stage 3 of the plan

    Same movement on one foot, lowering over 3 seconds, a light hand on a wall if needed. Add a loaded backpack very gradually.

    To start: 3 sets of 8 to 10 per leg, 3 seconds down, every other day.

    Variations, mistakes and progression
    Easier
    Rise on both feet and lower on one.
    Harder
    On a step with the heel over the edge, then with a loaded backpack.
    Common mistakes
    • Leaning too much on the wall.
    • Bending the knee to cheat on height.
    Moving on
    When you can do 20 to 25 raises in a row on the injured leg, roughly as many as on the other.
  • 12

    Low step-up

    from stage 4 of the plan

    Step up onto a 10 to 20 cm step with the affected leg, come down slowly, pelvis steady.

    To start: 3 sets of 10 per leg, slow on the way down, every other day.

    Variations, mistakes and progression
    Easier
    10 cm step, one hand on the rail.
    Harder
    Higher step (20 to 30 cm), then with weights in your hands.
    Common mistakes
    • Pushing off with the leg on the floor.
    • Knee drifting inwards.
    Moving on
    When 3 × 12 on a 20 cm step is clean and causes no discomfort the next day.

The doses are starting points. Stay at 2 out of 10 discomfort at most, during and the next day; otherwise switch to the easier version or go back to the previous exercise.

When to stop and see a professional

Sudden pain, a snap felt or inability to rise onto your toes: medical emergency, a rupture is possible.

Rehab’s advice

Slower return: avoid hills and accelerations at first. If the tendon is stiff or painful on waking, repeat the stage.

What the Rehab plan does for this injury

The plan starts at 30% of your previous training volume and builds up to 80%, with a consolidation week every three weeks. If your discomfort reaches 5 out of 10, it stops and refers you to your doctor or physiotherapist.

In which sport?

General information, currently being reviewed by healthcare professionals. It replaces neither a diagnosis nor the advice of your doctor or physiotherapist.