Stretching for tendinitis

If you have a sore Achilles or another painful tendon, stretching is often the first thing people try. It can help a little in some cases, but it isn't the main treatment. What helps tendons most is the right amount of load: exercises that gradually make the tendon and its muscle stronger, while you avoid the things that keep irritating it.

Is it tendinitis or tendinopathy?

A tendon is the tough cord that joins a muscle to a bone, such as the Achilles tendon at the back of your heel. "Tendinitis" means an inflamed tendon, and it's still a common name for tendon pain.¹ Health professionals now usually say "tendinopathy". That's because a painful tendon involves changes in its structure and how it repairs itself, not just simple inflammation.²

Tendon pain usually comes from putting more load on a tendon than it's ready for, for example by suddenly running further, doing the same movement over and over, or not resting enough between sessions.¹

Common signs are a tendon that's sore to touch, pain when you use it, and stiffness, especially first thing in the morning.¹

Why isn't stretching the answer?

Tendons are built to handle being pulled (tension). Being squashed (compression) is different. When a tendon is pressed hard against a bone, for example in a deep stretch, it may irritate a tendon that's already sore.³

This matters most when the pain is right where the Achilles attaches to the heel bone (insertional Achilles tendinopathy). Stretches that drop the heel down low, such as hanging your heel off a step, press the tendon against the bone. Exercises done this way work much less well for pain at the heel than for pain higher up the tendon.⁴ Doing the same exercises on flat ground, without dropping the heel below the level of the toes, seems to work better.⁵

For pain higher up the Achilles, gentle calf stretches may help a little if your ankle is stiff.⁶ They're an extra, not the main treatment.

What helps tendon pain?

Strengthening exercise. Exercise that gradually loads the tendon, as heavily as you can tolerate, is the first-line treatment for Achilles tendon pain.⁶ It should be done at least three times a week.⁶ There are several ways to do this, including slow heel raises and exercises where you lower your heel slowly. Different programs seem to work about as well as each other, so the best one is the one that suits your tendon and that you'll stick to.⁶

Holding exercises (isometrics). Holding a muscle contraction without moving, such as pushing up onto your toes and holding, can ease pain soon after you do it.⁷ They're useful for some people, but they don't seem to work better than other strengthening exercises.⁷

Keep moving, within your pain limits. Complete rest isn't recommended. Keep doing your usual activities as far as your pain allows.⁶ Your podiatrist can help you work out the right level.

Other treatments. Massage of the calf muscles and joint mobilisation may ease pain and stiffness for some people.⁶ Heel lifts in your shoes can take some strain off the Achilles for a while.⁶

Be patient. Tendons are slow to recover. Tendon pain can take months, or even longer, to settle fully.¹ It's worth sticking with a strengthening program for a good while before thinking about surgery.⁸

What to expect at FALL

We'll check where your pain is coming from, how your foot and leg move, and what you've been doing that may have overloaded the tendon. Then we'll put together a plan, usually with a strengthening program, advice on adjusting your training, and sometimes footwear changes or heel lifts. We'll progress your exercises as your tendon gets stronger.

When to see a podiatrist

See a podiatrist, physiotherapist or GP if your tendon pain doesn't improve after a few days, is getting worse, or you have morning stiffness or pain that worsens after activity.¹

Get urgent medical advice if you have sudden pain in your heel or calf, especially if you felt a snap or a feeling like being kicked in the back of the leg. This can mean the Achilles tendon has torn.⁹

If a sore tendon is holding you back, book an appointment with our podiatrists in Booragoon.

References

1. healthdirect Australia (2025). Tendinitis. https://www.healthdirect.gov.au/tendinitis
2. Millar NL, Silbernagel KG, Thorborg K, et al. (2021). Tendinopathy. Nature Reviews Disease Primers, 7(1), 1. https://doi.org/10.1038/s41572-020-00234-1
3. Cook JL, Purdam C (2012). Is compressive load a factor in the development of tendinopathy? British Journal of Sports Medicine, 46(3), 163–168. https://doi.org/10.1136/bjsports-2011-090414
4. Fahlström M, Jonsson P, Lorentzon R, Alfredson H (2003). Chronic Achilles tendon pain treated with eccentric calf-muscle training. Knee Surgery, Sports Traumatology, Arthroscopy, 11(5), 327–333. https://doi.org/10.1007/s00167-003-0418-z
5. Jonsson P, Alfredson H, Sunding K, Fahlström M, Cook J (2008). New regimen for eccentric calf-muscle training in patients with chronic insertional Achilles tendinopathy: results of a pilot study. British Journal of Sports Medicine, 42(9), 746–749. https://doi.org/10.1136/bjsm.2007.039545
6. Chimenti RL, Neville C, Houck J, et al. (2024). Achilles pain, stiffness, and muscle power deficits: midportion Achilles tendinopathy revision – 2024. Journal of Orthopaedic & Sports Physical Therapy, 54(12), CPG1–CPG32. https://doi.org/10.2519/jospt.2024.0302
7. Challoumas D, Pedret C, Biddle M, et al. (2021). Management of patellar tendinopathy: a systematic review and network meta-analysis of randomised studies. BMJ Open Sport & Exercise Medicine, 7(4), e001110. https://doi.org/10.1136/bmjsem-2021-001110
8. Challoumas D, Clifford C, Kirwan P, Millar NL (2019). How does surgery compare to sham surgery or physiotherapy as a treatment for tendinopathy? A systematic review of randomised trials. BMJ Open Sport & Exercise Medicine, 5(1), e000528. https://doi.org/10.1136/bmjsem-2019-000528
9. NHS Devon (n.d.). Achilles tendinopathy. MyHealth Devon. https://myhealth-devon.nhs.uk/my-condition/condition/achilles-tendinopathy/

Reviewed by Andrew Schox, Podiatrist, BSc(Hons) PGradDipPod MPod. Last reviewed October 2026.