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Medically Reviewed by
Dr. Peter Hanna, DPM
Board Certified Podiatrist
A dull ache above the heel after a run. Morning stiffness in the back of the ankle that eases once you get moving around the house. These early signs of Achilles tendonitis are common, especially among weekend athletes and anyone who’s recently ramped up their activity level.
Achilles tendonitis is inflammation of the tendon from overuse, and it’s a fundamentally different problem from an Achilles rupture, which is an actual tear in that same tendon. Confusing the two matters, because what helps one can be entirely wrong for the other. This guide focuses specifically on early-stage tendonitis, the stretches and exercises that generally help, and the warning signs that mean you’re dealing with something more serious.
Achilles tendonitis develops gradually. It’s the tendon’s response to repeated small stresses that outpace its ability to recover, similar to how other tendons and muscles get irritated with overuse. Symptoms build over days or weeks: stiffness, a dull ache, tenderness along the tendon, especially after activity or first thing in the morning.
An Achilles rupture is a different event entirely. It’s a partial or complete tear of the tendon, usually happening suddenly during a forceful push-off, a sudden pivot, or a jump. People who rupture their Achilles often describe a sharp pain accompanied by a popping or snapping sound, followed immediately by difficulty walking or an inability to push off with the injured leg.
The exercises in this blog post are intended for the gradual, overuse pattern of tendonitis. If your symptoms started suddenly, with a specific pop or snap and immediate loss of function, stop reading this as a self-care guide and seek medical evaluation instead. That presentation needs a different kind of care entirely.
Achilles tendonitis is typically an overuse injury. It shows up often in runners who’ve recently increased their mileage, intensity, or hill training faster than their tendon could adapt. It’s also common in people who play sports occasionally, like weekend tennis or basketball, without a consistent training base to support sudden bursts of activity.
Tight calf muscles increase strain on the tendon with every step, which is part of why stretching plays such a central role in both prevention and early management. A sudden change in footwear, especially switching to shoes with less heel support or a flatter sole, can also increase tendon load unexpectedly.
Age is a factor too, since the tendon naturally becomes less elastic and more prone to irritation over time, which is why tendonitis shows up more often in middle-aged recreational athletes than in younger competitive ones.
The most common early symptom is a mild ache or stiffness in the back of the leg, just above the heel, often most noticeable first thing in the morning or after a period of rest. Pain typically increases with activity, particularly running, jumping, or climbing stairs, and eases somewhat once the tendon warms up.
Tenderness to the touch along the tendon, sometimes with mild swelling or a thickened feel compared to the other leg, is another common sign. Some people also notice a mild creaking or crackling sensation when moving the ankle, particularly with activity.
None of these early symptoms typically involve a sudden onset or the inability to bear weight. If you’re able to walk, even with discomfort, and the pain built up gradually rather than appearing in an instant, you’re likely dealing with tendonitis rather than a rupture.
Stretching and specific strengthening exercises address two of the main contributors to Achilles tendonitis: tight calf muscles and a tendon that hasn’t adapted to current activity demands. Gentle stretching improves flexibility in the calf and ankle, which reduces the tension placed on the tendon with every step.
Strengthening, particularly a type called eccentric loading where the muscle lengthens under tension, has research support for helping the tendon remodel and tolerate load better over time. This is different from simply resting completely, which can leave the tendon deconditioned and more vulnerable once activity resumes.
The goal with early-stage tendonitis exercises isn’t to push through pain, but to gradually restore flexibility and strength within a comfortable range, giving the tendon a chance to adapt rather than continuing to be overwhelmed by the same stresses that caused the problem.
A standing calf stretch is a common starting point. Stand facing a wall with your hands against it, step one foot back with the knee straight and heel flat on the ground, and lean forward gently until you feel a stretch in the calf. Hold for 20 to 30 seconds and repeat two to three times per side.
A seated towel stretch works well for people whose pain makes standing stretches uncomfortable. Sit with your leg extended, loop a towel around the ball of your foot, and gently pull the towel toward you while keeping your knee straight, feeling a stretch along the back of the leg and into the Achilles.
Both stretches should feel like a mild pull, not sharp or shooting pain. If a stretch reproduces sharp pain rather than a gentle stretching sensation, ease off the range of motion or stop and let symptoms settle before trying again.
Eccentric heel drops are one of the most studied exercises for Achilles tendonitis. Standing with the balls of both feet on a step and heels hanging off the edge, rise up onto your toes using both legs, shift your weight onto the affected leg, then slowly lower that heel below the level of the step over several seconds.
This slow lowering phase is the important part, since it’s the eccentric, lengthening portion of the movement that appears to help the tendon adapt. A common approach is two to three sets of 10 to 15 repetitions, performed once symptoms have calmed down enough to tolerate the movement without sharp pain, and typically done once with the knee straight and once with the knee slightly bent to target different parts of the calf and tendon.
These exercises are generally introduced gradually and are best guided by a professional, especially if pain increases rather than settles with practice. What works well for one person’s tendon irritation may need to be modified for someone else depending on how far along their symptoms are, how active they were before symptoms started, and whether any other foot or ankle issues are part of the picture.
Warming up before stretching or exercising, even with a few minutes of easy walking, helps the tendon tolerate the movements better than starting cold. Progress gradually rather than jumping straight into full intensity, since the whole point of these exercises is controlled, tolerable loading rather than pushing through pain.
Mild discomfort during exercise that settles quickly afterward is generally considered acceptable, while sharp pain, pain that lingers for hours afterward, or pain that gets progressively worse day over day are signs to scale back and get evaluated rather than push forward on your own. Keeping a simple log of which activities and exercises trigger symptoms can make it much easier to spot patterns and adjust before a minor setback turns into a longer one.
Returning to running or sports should happen gradually as well, typically by rebuilding volume and intensity slowly over weeks rather than returning to a previous training load all at once.
A few signs mean this is no longer a simple, self-manageable case of tendonitis. Sudden, sharp pain accompanied by a popping or snapping sound is the hallmark of a possible rupture and needs prompt evaluation rather than stretching.
An inability to push off on the affected foot, stand on your toes, or bear weight normally after an acute injury also points toward a more significant tendon injury. A visible gap or divot along the tendon, noticeable swelling that develops rapidly, or pain that hasn’t improved at all after several weeks of appropriate rest and gentle exercise are all reasons to have the tendon properly evaluated rather than continuing on your own.
Footwear plays a bigger role in Achilles tendonitis recovery than many people expect. A shoe with a slightly raised heel, even a small heel-to-toe drop of 8 to 12 millimeters, reduces how far the tendon has to stretch with every step, which can ease strain while symptoms are settling.
Very flat shoes, minimalist trainers, and worn-out running shoes with collapsed heel cushioning tend to increase strain on the tendon and are worth avoiding until symptoms have improved. A temporary heel lift, a simple foam or gel insert placed in both shoes to keep the ankles level, is sometimes recommended as a short-term way to reduce tendon load during the early, more irritated phase.
Switching back to a completely flat shoe or going barefoot too early in the recovery process is one of the more common reasons mild tendonitis lingers longer than it needs to. Easing back into flatter footwear gradually, once symptoms have mostly resolved, tends to work better than an abrupt switch.
Complete rest for weeks at a time isn’t usually the best approach for Achilles tendonitis, since a tendon that isn’t loaded at all can become deconditioned and just as vulnerable once activity resumes. The more effective approach is usually relative rest, reducing or modifying the specific activities that aggravate the tendon while staying active in ways that don’t.
Low-impact cross-training, like swimming, cycling, or using an elliptical machine, lets you maintain cardiovascular fitness without the repetitive impact that running or jumping place on the Achilles tendon. This matters both physically and for staying consistent with a longer recovery process, since total inactivity for weeks at a time is hard for most active people to sustain.
The general pattern that tends to work is easing off high-impact activity, staying active through lower-impact alternatives, and gradually reintroducing the aggravating activity once stretching and strengthening exercises are well tolerated without pain.
Runners who increase mileage or intensity too quickly are among the most common groups affected. Weekend athletes who play sports like basketball or tennis without regular conditioning between sessions are also at elevated risk, since their tendons face sudden demands without a consistent training base.
Middle-aged adults returning to exercise after a period of inactivity, people with naturally tight calf muscles, and anyone who has recently changed footwear, especially to something with less heel cushioning, also see this condition more often. Certain medications, including a class of antibiotics called fluoroquinolones, have also been associated with an increased risk of tendon problems and are worth mentioning to your provider if you’re on one and developing new tendon pain.
If your symptoms haven’t meaningfully improved after a few weeks of gentle stretching and modified activity, or if you’re not confident your symptoms fit the gradual tendonitis pattern described here, it’s worth having your tendon evaluated directly. This is especially important if you have any uncertainty about whether you’re dealing with tendonitis or something more significant, like a partial tear.
Our team evaluates Achilles tendon problems regularly and can help confirm what you’re dealing with before you invest weeks in a self-care routine aimed at the wrong condition, and can guide you toward a more structured plan if home exercises alone aren’t enough. Learn more about our approach to Achilles tendon care in Miami.
Early Achilles tendonitis often responds well to gentle stretching, gradual strengthening, and smart pacing of activity. The key is recognizing the difference between this gradual overuse pattern and a sudden, sharp injury that points toward a rupture, since the two require very different responses and confusing them can genuinely delay the right care.
Mild cases often improve within a few weeks of consistent, gentle stretching and gradual strengthening, though more established cases can take several months to fully resolve, especially if activity isn’t modified along the way.
Many people can continue some activity with mild symptoms, but pushing through worsening pain typically delays recovery. Reducing mileage or intensity temporarily, alongside stretching and strengthening, tends to work better than continuing at full volume.
Tendonitis refers to the acute, inflammatory phase of irritation, while tendinosis describes a more chronic state where the tendon has developed degenerative changes without much active inflammation. Both benefit from load management and exercise, though chronic cases may take longer to respond.
Yes. Morning stiffness and discomfort that eases somewhat with movement is a common pattern, similar to how many overuse tendon injuries behave after a period of rest.
If stretching or exercise causes sharp pain rather than a mild stretch sensation, if pain worsens over days instead of improving, or if you notice a popping sound, sudden severe pain, or trouble bearing weight, stop and get evaluated rather than continuing on your own.
Dr. Peter Hanna is a board-certified podiatrist and reconstructive foot & ankle surgeon with over 15 years of experience. He serves as Director of Podiatry at South Florida Multispecialty Medical Group, specializing in complex reconstruction, minimally invasive surgery, and diabetic foot care.
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