7 Best Achilles Tendon Stretches: Podiatrist Protocol (2026)

Tightness and pain in the Achilles tendon is one of the most common complaints I see in both athletes and sedentary patients. If you’ve been told to “just stretch it out,” you may have gotten incomplete advice. There’s real science behind which Achilles tendon stretches work, when to use them, and when stretching might actually make things worse.

Understanding the Achilles Tendon

The Achilles tendon is the largest and strongest tendon in the body, connecting the gastrocnemius and soleus muscles to the heel bone (calcaneus). It transmits the force of calf contraction to propel you forward with every step. Despite its strength, it’s one of the most injury-prone tendons because it absorbs massive loads — up to 8 times your body weight during running.

Achilles tendinopathy exists on a spectrum: from mild reactive tendinopathy (early-stage inflammation from sudden load increase) to degenerative tendinopathy (chronic changes to the tendon structure) to partial or complete rupture. The type of tendinopathy you have determines which stretches are appropriate.

The Best Achilles Tendon Stretches

1. Standing Calf Stretch (Gastrocnemius)

This is the foundational Achilles stretch. Stand facing a wall, place both hands on the wall at shoulder height. Step one foot back about 2-3 feet with the heel flat on the ground and the knee straight. Lean forward until you feel a stretch in the upper calf. Hold 30 seconds, repeat 3 times each side.

This stretch primarily targets the gastrocnemius, the larger calf muscle that crosses the knee joint. The knee must be straight to get the full gastrocnemius stretch — if you bend the knee, you shift the load to the soleus.

2. Bent-Knee Calf Stretch (Soleus)

Same position as above, but bend the back knee slightly while keeping the heel down. This shifts the stretch deeper into the soleus muscle, which connects directly to the Achilles below the gastrocnemius. Hold 30 seconds, 3 times each side. The soleus is often neglected but contributes significantly to Achilles tightness.

3. Eccentric Heel Drop (Alfredson Protocol)

This is the gold-standard exercise for Achilles tendinopathy, developed by Swedish orthopedic surgeon Håkan Alfredson. Stand on the edge of a step with your heels hanging off. Rise up on both feet, then lower slowly on only the affected foot over 3 seconds. The slow lowering phase — the eccentric contraction — is what stimulates tendon remodeling.

Protocol: 3 sets of 15 repetitions, twice daily, 7 days a week. Start with body weight; as this becomes easy, add weight using a backpack. This protocol was originally designed for painful tendons — Alfredson found that performing it into mild pain was actually more effective than pain-free loading. However, sharp or severe pain is a signal to stop.

• Days 1-2: Expect significant soreness — this is normal for the protocol
• Week 2-4: Soreness decreases as the tendon adapts
• Week 6-12: Most patients see significant pain reduction
• Months 3-6: Full resolution in most cases

4. Towel Stretch

Sit with your legs extended. Loop a towel around the ball of your foot. Keeping your knee straight, gently pull the towel toward you until you feel a stretch in the calf and Achilles. Hold 30-60 seconds, 3 repetitions each side. This is particularly useful first thing in the morning before getting out of bed, when the tendon is stiffest.

5. Runner’s Stretch (Downward Dog Variation)

From a push-up position, press back into a downward-facing dog shape. Alternate pressing one heel toward the floor, then the other, holding each for 5-10 seconds. Repeat 10 times each side. This dynamic stretch mimics the load pattern of walking and running, making it an excellent warm-up stretch.

6. Stair Stretch

Stand on a step with the heel of the affected foot hanging off the edge, knee straight. Allow your body weight to lower the heel below step level. Don’t force — let gravity do the work. Hold 30-45 seconds, 3 repetitions. This provides a longer-duration, lower-intensity stretch than the eccentric heel drop.

When to Stretch vs. When to Rest

This distinction is critical, and getting it wrong can worsen Achilles tendinopathy. The general rule: mild, achy tendon pain that warms up during activity can be managed with the Alfredson protocol and stretching. Sharp, severe, or worsening pain — especially pain that doesn’t improve after 20 minutes of activity — requires a different approach.

• Good to stretch: Morning stiffness that loosens with movement, low-level aching during activity, tightness after prolonged sitting
• Modify or rest: Pain worse than 4/10 during activity, pain that increases throughout a run, significant swelling at the tendon
• See a podiatrist urgently: Sudden sharp pain with a “pop,” complete inability to push off, visible gap in the tendon

Achilles Stretches for Specific Conditions

Insertional vs. Mid-Portion Tendinopathy

Location matters for treatment. Mid-portion tendinopathy (2-6 cm above the heel) responds excellently to the Alfredson eccentric heel drop protocol. Insertional tendinopathy (at the heel attachment) is more complex — the eccentric drop with the heel below step level can actually compress the insertion point and worsen symptoms. For insertional cases, we modify the protocol to keep the heel at or above step level.

Achilles Pain in Runners

For runners, training load management is as important as stretching. Sudden increases in mileage or intensity are the most common cause of reactive Achilles tendinopathy. The 10% rule — never increase weekly mileage by more than 10% — combined with the eccentric protocol and good footwear creates the most effective recovery environment.

Supporting Treatments That Accelerate Recovery

Stretching works best when combined with other evidence-based treatments. Here’s what I combine with the Alfredson protocol for faster results in my patients:

• Custom orthotics: A heel lift reduces strain on the Achilles by shortening the mechanical leverage. We often prescribe a small heel raise as a bridge while the tendon heals.
• Night splints: Keeping the ankle in slight dorsiflexion overnight prevents the tendon from contracting during sleep, reducing morning pain.
• Shockwave therapy (ESWT): For chronic degenerative tendinopathy, shockwave stimulates healing at the cellular level. We use this in combination with the eccentric protocol for cases that haven’t responded to stretching alone.
• PRP injections: Platelet-rich plasma delivers growth factors directly to the tendon. Most effective for degenerative cases with visible tendon thickening on ultrasound.
• Footwear modification: A stiff heel counter and slight heel elevation reduce Achilles load during daily activity.

Frequently Asked Questions

How long should I stretch the Achilles tendon?

Static stretches should be held 30 seconds, repeated 3 times. The Alfredson eccentric protocol requires 3 sets of 15 reps twice daily. In general, consistency over months matters more than session length. Most patients see significant improvement between 6 and 12 weeks of daily practice.

Is it okay to stretch a painful Achilles tendon?

Mild pain during the Alfredson eccentric protocol is expected and considered therapeutic. However, if pain exceeds 4-5 out of 10 or worsens significantly during or after exercise, reduce the load or see a podiatrist. Sharp or sudden pain during stretching is a signal to stop immediately.

Can tight hamstrings cause Achilles tendon pain?

Yes — indirectly. Tight hamstrings increase knee flexion during the stance phase of walking, which can shift more load onto the Achilles. Comprehensive flexibility work including hamstrings, hip flexors, and calf muscles creates a better overall kinetic chain environment for Achilles recovery.

Should I use heat or ice on the Achilles before stretching?

For chronic (non-acute) Achilles tendinopathy, gentle heat before stretching can improve tissue extensibility. Ice after stretching or exercise can help manage inflammation. For acute reactive tendinopathy with significant swelling, skip heat and use ice instead.

Bottom line: Achilles tendon stretching — especially the eccentric heel drop protocol — is one of the most evidence-supported treatments for tendinopathy. But it has to be the right exercise for the right type of tendinopathy, performed consistently and correctly. If you’ve been stretching for months without improvement, come in for an evaluation — you may need a modified protocol or additional treatment.

Sources

Dr. Tom Biernacki, DPM

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Dr. Tom Biernacki, DPM is a double board-certified podiatrist and foot & ankle surgeon at Balance Foot & Ankle Specialists in Southeast Michigan. With over a decade of clinical experience, he specializes in heel pain, bunions, diabetic foot care, sports injuries, and minimally invasive surgery. Dr. Biernacki is a member of the APMA and ACFAS, and his patient education content on MichiganFootDoctors.com and YouTube has reached over one million views.