This is an interesting physio story that rivals Greek mythology, and it might be the key to solving your Achilles pain! Dr. Hakan Alfredson is a surgeon and sports medicine professor who had Achilles tendon pain that would not go away. He asked his boss to schedule him for surgery, but he was refused because it was “not severe enough”. So naturally, Dr. Alfredson tried to aggressively load his Achilles and make it bad enough to warrant surgery. He filled a backpack with weights, stood at the edge of a step, and let his heels drop toward the ground, over and over and over. What happened? His Achilles GOT BETTER, and a new exercise protocol was born…
Here is the exact program to heal the heel. Be warned that it requires a good level of commitment!
Exercise: Stand on the edge of a step and rise up on your toes. Then lift the non-painful leg, and use the injured leg to lower your body quickly but controlled. Your heel should drop below the level of the step.
Rise back up using both legs and repeat.
Repetitions: 3 x 15 performed with a straight knee, followed by 3 x 15 performed with a bent knee.
Frequency: Twice Daily
Progression: Add a weighted backpack and slowly increase the load as the exercise becomes more comfortable. Just add enough to make it uncomfortable again.

- Chronic Achilles pain with mid-tendon (2-6cm up from the heel) tenderness
- Visible thickening of the Achilles tendon
- Pain provoked with heel raise, or repetitive loading (running or hopping)
NOT Advisable For:
- Acute (new) inflammatory Achilles Tendinitis
- Achilles rupture
- Other problems (ex. posterior ankle impingement, dislocation of the flexor tendons, irritation of the sural nerve, systemic inflammatory disease)
Disclaimer:
Consulting a physiotherapist is the best way to ensure that this or any other exercise program is correct and safe for you. These therapists will perform a thorough assessment of your hips, knees, ankles, etc. to determine if there are any existing weaknesses, alignment faults or flexibility issues that need to be addressed.
Rob McMillan – Registered Physiotherapist
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