Why Eccentric Heel Drops Are So Effective for Achilles Pain
Eccentric heel drops look simple, but the science behind them is surprisingly strong. When you lower your heel in a slow, controlled way, you create eccentric loading through the Achilles tendon. This is the same type of loading used in many of the best Achilles tendinopathy exercises around the world. It teaches the tendon how to handle force again without stressing it too quickly.
Tendons change slowly, but they do change. Research shows that controlled eccentric work helps with collagen remodeling, which means the fibers inside your tendon become more organized. When that happens, your tendon gets better at absorbing and releasing energy. This is why many runners notice less morning stiffness after a few weeks.
You’ll feel most of the work in the gastrocnemius and soleus, the two major calf muscles. These muscles attach directly into the Achilles. When they get stronger through calf eccentric training, the tendon becomes more resilient. If you often get tight or heavy calves during sessions, this guide on calf tightness during running explains why those muscles stiffen up and how easing that tension can reduce pressure on the tendon itself. Many people with mid-portion Achilles tendinopathy benefit from this type of work because it loads the exact area that often becomes irritated.
Let’s be honest. Rest alone rarely fixes a cranky tendon. When you stop moving, the tendon becomes less tolerant to load. That’s why your pain may return the moment you start jogging again. So here’s a question for you. Have you ever felt fine during a break and then sore the second you return to training? That’s a classic sign your tendon needs gradual load, not complete rest.
Eccentric heel drops help restore that load tolerance. They also increase tendon stiffness in a good way, giving you more support during running or fast walking. As stiffness improves, your stride feels smoother and your Achilles doesn’t feel as “fragile” during impact.
This is why so many rehab programs include some form of eccentric heel drop exercise. It’s reliable, repeatable, and backed by years of research. You don’t need fancy equipment. You just need structure, patience, and a plan that nudges your tendon forward at the right pace.
If you’re looking for a clear, structured way to rebuild strength and guide your weekly training, explore our Cycling Training Plans . These plans balance the right mix of strength work, technique, recovery, and progression so you can move with confidence again.
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What Makes the Alfredson Protocol So Effective for Achilles Recovery
The Alfredson Protocol is one of the most famous rehab programs in sports medicine, and there’s a good reason it’s still used today. It was created by Dr. Håkan Alfredson after he struggled with his own stubborn Achilles pain. When surgery was denied, he decided to test a high-volume eccentric Achilles training approach. The surprising part is that it worked so well he avoided surgery altogether.
The protocol uses two key movements. One is the straight-knee heel drop, which targets the gastrocnemius. The other is the bent-knee heel drop, which targets the soleus. Together, they create a full Achilles tendon strengthening routine that loads both major calf muscles and improves tendon adaptation.
The original format includes 180 heel drops per day, split into morning and evening sessions. It sounds like a lot, and it is, but the idea is to give the tendon steady, repeatable stimulus. Tendons respond best to consistent loading. When you follow this plan, the tendon learns to accept load and recover from it, which is exactly what someone with mid-portion Achilles tendinopathy needs.
Here’s the thing about the Alfredson Method. You do the lowering phase slowly, but you use your other foot to lift back up. This reduces irritation and focuses the work on the eccentric phase. Studies have shown this approach helps with collagen alignment and improves the tendon’s ability to handle running, climbing, and daily activities.
But does everyone need the full 180 reps? Not always. Modern rehab often uses lower volumes while keeping the same principles. Many runners start with fewer reps to avoid flare-ups, then increase over time. So, let me ask you something. How much load does your Achilles actually tolerate right now? Your answer matters, because too much too soon can overwhelm the tendon.
The Alfredson Protocol remains a powerful option for many people, but adapting the volume to your level can make the process smoother and more sustainable. What matters most is the steady, controlled loading that teaches the tendon to become strong again.
How to Perform Eccentric Heel Drops the Right Way
Eccentric heel drops only work if you perform them with good technique. The movement looks simple, but each part has a purpose. When you lower your body with control, you create steady tension through the Achilles and calf muscles. This tension is what drives tendon adaptation and helps reduce symptoms over time.
Start by standing on a step with the balls of your feet on the edge. Hold a rail or wall for balance. Lift up with both feet, then shift your weight to the affected side and slowly lower your heel as far down as it can comfortably go. This is the eccentric phase, and it’s the part that matters most.
Some people rush this movement, but slowing it down helps your tendon learn how to manage load. If you drop too quickly, you miss the benefit. If you’ve ever wondered, “Why does my Achilles feel worse after fast or sloppy reps?”, this is often the reason.
To make this easier to follow, here are the key steps:
- Lift up with both feet to avoid unnecessary irritation.
- Shift your weight onto the working leg before lowering.
- Lower your heel slowly for about three to four seconds.
- Use your other foot to help you rise back up.
- Avoid using momentum — focus on smooth movement.
- Stop if the pain becomes sharp rather than dull or achy.
If you want to make sure your ankles, hips and calves are ready for the load work, this post on 10 Mobility Exercises For Runners gives you a set of drills that support smoother movement and reduce the risk of excess strain.
You can also adjust variations based on your needs. For example, keeping the knee straight targets the gastrocnemius, while bending the knee shifts more load to the soleus. Both muscles play a role in Achilles tendon strengthening, so it helps to practice both if your symptoms allow.
If your tendon feels irritated afterward, that doesn’t mean the exercise is wrong. Tendons often feel a mild ache during loading, but this settles with time. Staying consistent is more important than being perfect.
Eccentric heel drops aren’t a quick fix, but they give your tendon the steady, reliable stress it needs to get stronger. The key is patience and proper form. When you combine both, progress becomes easier to see. Especially over a few weeks of consistent practice.
For runners, supporting the whole kinetic chain is crucial, and a strong core plays a huge role. Check out this detailed article on why your abs get sore after running to understand how abdominal and hip muscles influence your stride and tendon load.
How Much Pain Is OK During Eccentric Heel Drops?
One of the hardest parts of tendon rehab is knowing how much pain is “normal.” You don’t want to baby your tendon, but you also don’t want to push it so hard that it flares for days. That’s where simple pain monitoring guidelines can help.
With eccentric heel drop exercise and the Alfredson eccentric protocol, a little discomfort is expected. A mild, dull ache during the exercise is often part of tendon adaptation. Sharp or stabbing pain, however, is a warning sign. Think of it like a traffic light system for your Achilles rehab program.
Most people do well when pain during the exercise sits around a two or three out of ten and then settles within 24 hours. If your Achilles pain when running or walking is worse the next day, your tendon load tolerance may have been exceeded. That tells you to adjust the plan rather than quit altogether.
Here’s a simple way to think about it:
- Green light: mild ache during exercise, no worse the next day, keep going.
- Amber light: soreness that feels stronger but settles within 24 hours, reduce volume slightly.
- Red light: sharp pain, limping, or swelling that lasts more than a day, stop and reset.
This kind of load management helps your tendon feel challenged but not crushed. It also fits with what we know about gradual loading and tendon healing time. Tendons can take months to remodel, so your goal isn’t instant relief. Your goal is steady progress, week by week.
Ask yourself, “How does my Achilles feel the morning after a session?” Morning Achilles tightness that is equal or better than the day before is usually fine. If it is much worse, that is useful feedback.
You’re not failing if you need to adjust the plan. You’re simply listening to your body. Smart loading helps you stay in the game long enough for the tissue to rebuild.
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With expert feedback, tailored strength work, and clear session planning, you won’t have to guess what to do next. It’s a simple, supportive way to rebuild your rhythm and stay consistent as your body becomes stronger and more resilient.
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Choosing the Right Type of Eccentric Heel Drop for Your Achilles
When you’re trying to rebuild a painful Achilles, not all heel drops work the same way. Each variation places stress on the tendon in a slightly different way, and choosing the right one can help you progress faster. This is why understanding the difference between straight-knee, bent-knee, and loaded versions matters. They all support tendon adaptation, but they do it through different muscles.
A straight-knee position loads the gastrocnemius more. A bent-knee position loads the soleus more. Both feed directly into the tendon, but you may notice one feels easier or harder depending on where your symptoms are. If you have mid-portion Achilles tendinopathy, most people find a mix of both versions feels balanced and helps build strength evenly across the tendon.
The third option is adding extra weight. This is common once basic eccentric heel drop exercise variations feel easy. Loaded training helps improve Achilles tendon strengthening even further and increases tendon load tolerance, especially for active runners. Extra weight also encourages deeper collagen remodeling, which helps the tendon handle more impact during daily movement.
Here’s a detailed comparison to help you choose the right variation:
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| Variation | Main Muscle Loaded | Best For | Typical Progression |
|---|---|---|---|
| Straight-Knee Eccentric Heel Drop | Loads the gastrocnemius more than the soleus | Improving strength for running, jumping, and push-off power | Often the first step in building basic eccentric control |
| Bent-Knee Eccentric Heel Drop | Loads the soleus more deeply | Improving endurance and reducing morning Achilles tightness | Added once straight-knee reps feel smooth and steady |
| Weighted Eccentric Heel Drop | Loads the entire calf complex and tendon under higher force | Building high-level Achilles tendon strengthening for sports | Used after mastering body-weight eccentrics for 2–4 weeks |
These variations give you different ways to challenge the tendon without rushing the process. Ask yourself, “Which version feels challenging but still controlled?” That version is usually the right one for your current level. Remember, gradual loading is what helps the tendon rebuild safely.
When Should You Progress or Modify Them
As your tendon gets stronger, the same exercise that once felt challenging will start to feel easier. That’s a good sign. It means your tissue is adapting and your tendon load tolerance is improving. But it also means you’ll need to make small changes so your progress doesn’t stall. Knowing when to adjust your eccentric heel drop exercise routine is an important part of a successful Achilles rehab program.
Mobility also plays a role when you’re trying to progress safely. If you want a simple way to loosen the hips and improve the way your lower body moves, this guide on Deer Pose for Runners, Cyclists & Triathletes is a helpful option that supports smoother movement patterns and reduces unnecessary tension.
One sign you’re ready to progress is when you can complete all reps without losing form. If the lowering phase feels smooth and controlled, your tendon is handling the stress well. Another sign is when your Achilles tightness is improving in the morning. This means your tendon is responding to eccentric loading and collagen remodeling.
Here are simple ways to progress:
- Add a backpack with a small amount of weight.
- Increase the depth of the heel drop to improve stretch tolerance.
- Use a slower lowering phase to increase eccentric effort.
- Add more sets only when your tendon feels settled the next day.
- Mix in both straight-knee and bent-knee versions to load the gastrocnemius and soleus.
Sometimes, progressing means doing less, not more. If your symptoms start creeping back or if your Achilles pain when running increases, that may be a sign your tendon needs reduced volume for a few days. This isn’t failure , it’s smart load management, and it keeps your progress steady.
Ask yourself, “How does my tendon feel during the first few reps?” If it warms up and becomes more comfortable, that’s often a good sign. But if the pain sharpens or you start limping, your tendon may not be ready for the current level.
Remember, tendon adaptation is a slow and steady process. Progressing too fast can irritate the tissue, but moving too slowly can stall improvements. The goal is to find the middle ground where the tendon feels challenged, not overwhelmed.
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Common Mistakes That Slow Down Recovery
Even though eccentric Achilles training is simple, small mistakes can delay your progress. Many people try heel drops on their own but don’t see results because they miss a few key details. The good news is that these mistakes are easy to fix once you know what to look for.
One of the biggest problems is rushing the lowering phase. The whole point of eccentric loading is to control the movement. When you drop too fast, the tendon doesn’t receive enough time under tension to stimulate collagen remodeling. Think of it like watering a plant. If you pour too quickly, nothing soaks in. Your tendon needs slow, steady loading to grow stronger.
Another mistake is using only one variation of the exercise. Your gastrocnemius and soleus both connect into the Achilles. If you train only with a straight knee or only with a bent knee, you miss half the system. Balanced training helps the tendon handle more load and supports better tendon adaptation over time.
Some people also ignore pain signals. A mild ache is normal during Achilles tendon strengthening, but sharp or increasing pain is not. If your Achilles pain when running or walking gets worse, your current level of loading may be too high. This is where smart load management comes in. Adjusting sets, reps, or tempo can keep your progress moving in the right direction.
If you’re unsure whether what you’re feeling is normal training discomfort or something more serious, the Mayo Clinic’s overview of Achilles tendinitis symptoms and causes gives a simple breakdown of warning signs and common triggers.
A final mistake is expecting quick results. Tendons don’t change overnight. They respond to gradual loading, steady effort, and consistent practice. If you feel discouraged, ask yourself, “Have I given my tendon enough time to adapt?” Many athletes see improvement around week four, but the deeper changes often take longer.
Bringing It All Together So You Can Trust Your Achilles Again
By now, you know there’s nothing magic about eccentric heel drop exercise, but there is something powerful about how it works. Slow, steady eccentric loading gives your tendon a signal it understands. It tells the tissue, “I’ll load you, but I’ll do it safely.” Over time, that consistent message builds strength and confidence.
If you’re dealing with mid-portion Achilles tendinopathy, it’s easy to feel stuck after trying rest, stretching, or massage. That doesn’t mean you’re failing. It usually means your tendon hasn’t had the right type of strength work yet. A structured Achilles rehab program centered on eccentric Achilles training provides that missing piece.
The Alfredson eccentric protocol proved that tendons can recover through loading, not avoiding movement. Modern rehab follows the same idea: smarter loading instead of total rest. You’re not waiting for the pain to disappear, you’re helping the tendon adapt.
You’ll have days when the tendon feels tight or heavy, and that’s normal. Recovery isn’t a straight line. But with the right mix of Achilles tendon strengthening, good load management, and patience, your tendon can become stronger than it feels today.
If you’d like to understand how strength, endurance, and recovery all fit together, this guide on the 10 components of physical fitness can help you see where your tendon work fits inside your overall training.
