How To Stretch Achilles Tendon To Reduce Pain Using Resistance Exercise

Summary:

1. Stretch a stiff, painful Achilles tendon with resistance exercise rather than classical static stretching exercises to improve tendon stiffness, and possibly reduce pain

2. Strength training is as effective as static stretching for improve range of movement about a joint

3. You must use training intensities in excess of 70% 1-RM or maximal voluntary contraction to elicit changes in stiffness and tendon properties

4. There is insufficient evidence to suggest we need to strengthen the Achilles tendon to improve your pain

Achilles tendon pain is a common and debilitating injury for active people and athletes alike. It responds well to loading; here is my approach on how to stretch Achilles tendon using isometric exercise to reduce your pain, and build stiffness in the tendon.

Why You Don't Want To Just Stretch The Achilles Tendon

Tendons love load. They respond to it through a process called mechanotransduction which involves the mechanical stress of exercising the tendon (and the tendon cells, called tenocytes) being transformed into chemical signals that result in downstream changes in tendon structure (Docking & Cook, 2019).

Figure 1 is taken from Docking & Cook (2019) page 302.

There appears to be a goldilocks zone of adaptation; somewhere between 3-9% of tendon strain drives positive changes in the tendon including blood flow, stiffness, strain capacity and size (Docking & Cook, 2019).

We know to get these changes in stiffness shown above, we need exercise intensities in excess of 70% 1-RM or maximal-voluntary isometric action, and it doesn not appear that the contraction type is important for the degree to which stiffness or young modulus of the tendon changes (Bohm et al., 2015). So you can choose either eccentric, isometric or eccentric-concentric actions as you see fit!

So we know loading a tendon, with intense activity is important for change in the tendon, but we are unsure whether it is needed for improvements in pain as we will discuss below!

How To Stretch Achilles Tendon With Exercise

Resistance exercise is a useful tool for helping to stress the Achilles tendon at different lengths; you can do shorter and longer positions that stress the tendon to varying degrees relatively easily.

It is well known that strength training can be as effective as stretching regimes for improving range of movement about a joint; so in the case of the ankle, strengthening exercises that target dorsiflexion (ankle bending) will be as effective as stretching the region.

I would start with a heel raise at floor height first, aiming 2-3 x weekly. For isometric exercises you can do a total of 180 seconds over the 2-3 sessions in the week and get significant changes in tendon stiffness and morphology, and these would be no different between 70% or 90% of maximal contraction intensity (Tsai et al., 2024). For isotonic exercise (your standard calf raises), aim to do 2-3 sets of 3-8 repetitions per session.

One you have nailed that, then you want to progress to having your forefoot on a raised wedge, repeat the same movement just drop your heel slightly below the height of the wedge. Rinse and repeat with the same number of sets as above.

The progression will not only build strength but also simultaneously increase range of movement about the joint!

Do we need to get tendon change, or even load the tendon to reduce pain?

Maybe not! The systemic review in 2023 (Murphy et al., 2023) found no mediation studies in achilles tendon pain for exercise; this means we do not know if loading the achilles tendon and seeing an improvement in pain is actually down to changes in the force producing capacity of the tendon!

Another really recent paper Janssen et al., (2026) compared bicep curls to calf raises over an 8-week period... and guess what they found? Both groups saw improvements in symptoms of their achilles tendon pain and no differences between groups were found!

This does fit with our ever-increasing understanding of pain that emotions, fear avoidance behaviours, the immune, nervous and endocrine systems are key players in pain, pain sensitivity and recovery!

So whilst resistance exercise is good for stretching the achilles tendon under load and getting changes, we do not know if this is actually responsible for improving your pain!

Book your physiotherapy appointment today and let me help you reduce your achilles tendon pain and get you back to walking, running and sport pain free!

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References

Docking, S. I., & Cook, J. (2019). How do tendons adapt? Going beyond tissue responses to understand positive adaptation and pathology development: a narrative review. Journal of musculoskeletal & neuronal interactions, 19(3), 300.

Bohm, S., Mersmann, F., & Arampatzis, A. (2015). Human tendon adaptation in response to mechanical loading: a systematic review and meta-analysis of exercise intervention studies on healthy adults. Sports medicine-open, 1(1), 7.

Tsai, M. S., Domroes, T., Pentidis, N., Koschinski, S., Schroll, A., Bohm, S., ... & Mersmann, F. (2024). Effect of the temporal coordination and volume of cyclic mechanical loading on human Achilles tendon adaptation in men. Scientific Reports, 14(1), 6875.

Murphy, M. C., Travers, M., Chivers, P., Debenham, J., Docking, S. I., Rio, E. K., ... & Ardern, C. (2023). Can we really say getting stronger makes your tendon feel better? No current evidence of a relationship between change in Achilles tendinopathy pain or disability and changes in Triceps Surae structure or function when completing rehabilitation: A systematic review. Journal of science and medicine in sport, 26(4-5), 253-260.

Janssen, T., van Berkel, S., Edens, M., Weerwag, L., & de Vos, R. J. (2026). Effectiveness of eccentric calf muscle exercise therapy in patients with chronic midportion Achilles tendinopathy: a randomized controlled trial. Journal of Science and Medicine in Sport.