Heel Raises for Achilles Tendonitis: Your Step-by-Step Loading Guide

If there's one exercise that stands out above everything else for Achilles tendinopathy, it's the heel raise. Simple, equipment-optional, and backed by decades of research — done correctly, it's the most powerful tool in your recovery arsenal.

Done incorrectly, it can stall your progress or make things worse. This guide walks you through exactly how to perform heel raises for Achilles tendinopathy, which variation to use, how to progress over time, and what to watch for along the way.

Why Heel Raises Work

The Achilles tendon transmits the force generated by your calf muscles to your heel. When you perform a slow, loaded heel raise, you're creating a controlled tensile stress on the tendon — exactly the stimulus it needs to reorganise, strengthen, and build capacity.

"The key word is 'loaded.' Body-weight heel raises performed quickly are better than nothing, but the research consistently shows that heavy slow resistance loading — slow tempo, significant load, full range — produces the best tendon adaptations."

Which Variation Is Right for You?

Midportion Achilles Tendinopathy

If your pain is in the middle of the tendon (2–6 cm above the heel), the standard off-step heel raise is your primary tool. This allows a full range of motion including a heel drop below the step level.

Insertional Achilles Tendinopathy

If your pain is right at the heel where the tendon attaches, avoid dropping the heel below the step level. This position compresses the tendon insertion against the bone and is a common reason insertional cases fail to respond. Perform heel raises on flat ground only, or use a slight heel raise in your shoe to offload the insertion.

The 3-Phase Heel Raise Protocol

Phase 1: Isometric Holds (Weeks 1–2)

Goal: settle irritability, begin loading safely.

• Stand with both feet on flat ground or a step
• Rise up onto your toes (using both feet)
• Hold for 30–45 seconds with maximum calf activation
• Lower slowly (3–4 seconds). Rest 2 minutes between sets.
• Perform 4 sets, once or twice daily

Phase 2: Heavy Slow Resistance — Bilateral (Weeks 2–5)

Goal: build tendon capacity with controlled, loaded movement.

• Stand on the edge of a step (midportion) or flat ground (insertional)
• Rise up for 3 seconds, hold 2 seconds, lower for 3 seconds
• Add load: weighted backpack, weight vest, or dumbbells
• 3 sets of 15 reps, progressing toward 3 sets of 6–8 reps with heavier load
• Rest 2–3 minutes between sets. Every other day.

Phase 3: Single-Leg Loading (Weeks 5–12)

Goal: match the demands of real-world activity — walking, running, and sport all require single-leg loading.

• Transition all bilateral work to single-leg heel raises
• Same tempo: 3 seconds up, 2 second hold, 3 seconds down
• Continue progressive loading — aim for body weight +30–50% on single leg
• As capacity builds, begin introducing speed: faster calf raises and hopping progressions

The Most Common Mistakes

• Going too fast: a quick bounce heel raise doesn't load the tendon adequately. Slow is the key.
• Not adding load: body weight is a starting point, not an endpoint. The research showing best results used significant added load.
• Exercising daily with heavy load: rest days between loading sessions are essential for tendon adaptation.
• Stopping too soon: many people quit when pain settles, before the tendon has built real capacity. Aim to complete the full 12-week protocol.

Frequently Asked Questions

How much pain is OK during heel raises?

Up to 3–4 out of 10 during the exercise is generally acceptable. Pain should not be increasing set to set, and should return to your baseline level within 24 hours. Consistently scoring 5+ means the load is too high — reduce the weight or switch to bilateral.

Do I need a step for heel raises?

For midportion tendinopathy, a step allows a beneficial range of motion including the heel drop. For insertional cases, flat ground is preferable. If no step is available, flat-ground bilateral heel raises with significant load are still highly effective.

Can I do heel raises if I have a calf strain as well?

Calf strains and Achilles tendinopathy require similar but not identical approaches. If you have significant calf pain that worsened with a specific incident, get it assessed before beginning loading. A calf strain should usually be allowed to settle before heavy loading begins.

For the full treatment picture — including what to do before and after the heel raise protocol — read the exercise-first approach to Achilles treatment. If you want to understand the recovery timeline so you know what to expect, this honest breakdown of recovery time is worth reading alongside this guide.