Achilles Tendon Loading Program (Eccentric Heel Drops)

By Dr. Shayne Kelly, DO — Fellowship-Trained Sports Medicine Surgeon · Tri-City Orthopedics, Kennewick, WA

A home exercise program from Dr. Shayne Kelly, fellowship-trained sports medicine surgeon.

Educational information, not medical advice. This is not a substitute for the specific instructions Dr. Kelly and your physical therapist give you. Your timeline depends on your surgery, your body, and your progress. Follow your own care team’s directions. In an emergency, call 911.

How much pain is OK?

Published rehab research (the Silbernagel pain-monitoring model) uses this rule of thumb: pain up to about 5 out of 10 during exercise is acceptable — as long as it settles back to your usual level by the next morning and isn't trending worse week over week. If pain runs higher, is worse the next day, or keeps climbing, ease back on the weight or repetitions.

What to expect: Tendon recovery is measured in months, not weeks — published programs typically run 12 weeks, and progress often continues beyond them. Individual results vary.

The Program

This program strengthens the Achilles tendon by loading it as it lengthens. Mild soreness in the tendon during and after exercise is expected and acceptable; sharp pain is not — back off if pain is sharp or worsening day over day. Most published programs run 12 weeks. Not for use after Achilles surgery unless Dr. Kelly specifically prescribes it.

Eccentric Heel Drop — Knee Straight 3 sets of 15, twice a day

Stand on the edge of a step on the balls of both feet, heels off the edge. Rise up on both feet, shift your weight to the affected leg, then slowly — over 3-5 seconds — lower that heel below the level of the step with the knee straight. Use both feet to rise back up.

Eccentric Heel Drop — Knee Bent 3 sets of 15, twice a day

Same movement, but with the knee of the working leg slightly bent throughout the lowering, to load the deeper calf muscle.

Progression Increase load, keep 3 sets of 15

When the exercises become easy and comfortable, add load gradually — a backpack with books is the classic method — rather than adding repetitions.

Calf Stretch — Wall Hold 10 seconds, repeat 5 times, daily

While facing the wall, place the affected leg back with the knee straight and heel flat. Lean in until a gentle stretch is felt. Hold 10 seconds.

When to call

Call Dr. Kelly’s office at (509) 460-5588 for fever over 101°F, increasing redness or drainage at incisions, pain that is worsening instead of improving, or new numbness or tingling. For chest pain or trouble breathing, call 911.

Questions about your recovery?

Dr. Kelly sees patients at Tri-City Orthopedics in Kennewick.

Request an Appointment

When to call

Call Dr. Kelly’s office at (509) 460-5588 if your pain is worsening instead of improving despite these exercises, if you develop new numbness, tingling, or weakness, or if pain wakes you at night or keeps you from your daily activities. For chest pain or trouble breathing, call 911.

Questions about your recovery?

Dr. Kelly sees patients at Tri-City Orthopedics in Kennewick.

Request an Appointment