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What exercise is OK with Achilles tendonitis if you can’t run?

Updated: Feb 7

Runners often ask us what other exercise is OK to do with Achilles tendonitis when this pesky injury has forced them to stop running for the time being. The activities and exercises in this article will help you to maintain – and hopefully even improve – your cardiovascular fitness as well as the strength and stability of the muscles you use for running, in parallel with your Achilles rehab exercises. Remember, if you need help with an Achilles injury, you're welcome to consult one of our team via video call.


What exercise can you do with Achilles tendonitis?

The terms tendinitis, tendonitis, tendinosis, and tendinopathy mean the same thing for all practical purposes, and we use these interchangeably in most of our articles.


In this article:


Why you should get some additional exercise during your Achilles rehab


The most obvious reason to remain active above and beyond your Achilles rehab programme is to maintain as much of your hard-won fitness as possible while you can’t run. This will enable you to get back to running safer and faster once your injury has recovered enough for you to run again.


But there’s also a psychological aspect to this.


If you’re lucky, your Achilles rehab programme will be over in a matter of weeks, but in most cases it will take several months, and in some cases a patient will be rehabbing their tendon for more than a year to get it back to its former pain-free state.


Now, Achilles rehab exercises are extremely boring. Up and down on your toes … up and down. As a runner, you are probably used to getting out of the house and getting your heart rate up several times a week. So, other forms of exercise are very useful for keeping you sane and motivated to stick to your rehab programme.


And if, like me, you get quite grumpy when you can’t run, being able to do at least some type of exercise will take the edge off … to the relief of your family, friends, and co-workers.



Cardio with Achilles tendonitis


Cycling

This would be the most sensible alternative to running. It exercises the leg muscles, and it’s non-impact. If you stay in the saddle, most of your bodyweight will be carried there, which will cut your Achilles tendon some slack.


In some cases, an injured Achilles tendon that is very sensitive to being stretched might not like cycling, so start off with a short, easy session at low resistance, and check how your tendon responds in the next 24 hours. If everything is fine, you can gradually increase your sessions to eventually fill the training void that not being able to run has left.


Cycling on a stationary bike allows you to better control the intensity and  avoid unexpected movements.
Cycling on a stationary bike allows you to control the intensity and avoid unexpected movements better.

Make sure that your saddle isn’t too low; the lower your saddle, the more your tendon will have to stretch as you bring your foot around. If you wear cycling shoes, check that the one on the injured side doesn’t press into the injured part of your tendon.


You could use an exercise bike or a real bicycle out on the road. Only go on a real bicycle if you are confident and competent riding on the road; you might injure your tendon further if you have to put your foot out suddenly to stop yourself from falling over. If you have a mountain bike, it’s better to stay on the roads and off the trails.


Swimming

Swimming can be a logistical pain, because you have to find a pool, unless you're very lucky and you have access to one all the time. However, it's another good cardiovascular exercise that is not going to affect your Achilles tendon.



Don’t push hard off the side of the pool with your feet. In fact, you’ll get a better workout if you don’t push off at all!


Here is some more detailed advice about swimming with Achilles tendonitis.


Trying something new

If you find cycling and swimming boring, or it is not feasible for you, why not try something new? Maybe something that you didn’t have the time for previously because you were running.


Activities like stand-up paddleboarding and kayaking will give you a good cardio workout without placing a great deal of stress on your Achilles tendon.


Paddle boarding is a fun activity to try when you can't run due to Achilles tendonitis.

What about walking?

Don't go out walking for miles, unless yours is a very mild case of Achilles tendonitis or you are in the later stages of your rehab programme.


If you’ve given up running for the time being to help your Achilles tendon to heal, it really does not make sense to delay your recovery by walking too much.




Gym workouts with an Achilles injury


Cardio in the gym

The stationary bike is your best cardio option (see above for advice on cycling with an Achilles injury). Beware of the cross-trainer, or the elliptical, as it's sometimes called; it can easily irritate an injured Achilles tendon. However, it should be fine in milder cases or in the later stages of rehab. The treadmill is obviously a no-no, and it’s also better to give the Stairmaster a rest.


The elliptical trainer can sometimes irritate a sensitive Achilles tendon, so test it carefully and see how yours reacts.
The elliptical trainer can sometimes irritate a sensitive Achilles tendon, so test it carefully and see how yours reacts.

Strength training in the gym

I would stay away from weight machines that involve your calves (other than what your physio has prescribed), because that might interfere with your Achilles rehab programme. It’s also advisable to avoid using machines that require you to push off with your feet.


Squats are usually OK to do with Achilles tendonitis - place plates under your heels if you find it pulls on your tendon.
Squats are usually OK to do with Achilles tendonitis - place plates under your heels if you find it pulls on your tendon.

Squats are usually doable. If you find that stretching into a squat at the ankle is a problem for your injured Achilles, put some weight plates under your heels, so you’re on more of a decline. The same goes for deadlifts. Read more about doing squats with Achilles tendonitis.


And obviously you can use this time to catch up on gym workouts for your core and upper body.


Strength training for runners during Achilles rehab – no equipment needed


The following exercise routine targets the muscles we use for running, including the core, and it shouldn’t affect your injured Achilles tendon. There are two warm-up exercises, eight strength exercises, and three cool-down exercises. Because the exercises are quite detailed, I have made a video to demonstrate and talk you through them (see below).


Please note the following:

  • Ideally, you would already have seen a health professional to get a rehab programme for your injured Achilles tendon.

  • Remember that these exercises are in addition to your Achilles rehab exercises, so the routine doesn’t include exercises for the calf muscles.

  • Feel free to adjust the number of repetitions or for how long you hold a position so that it suits your needs.

  • None of these exercises should make your Achilles injury worse; all of them should be pain-free. If any of them hurts or you feel like they're making you more sore in any part of your body the following day or the day after, please stop, and consult a health professional.

  • The routine is aimed at runners, but you don’t have to be a runner – anyone can benefit from it.


Enjoy your workout!



How we can help


Need help with your Achilles injury? You’re welcome to consult one of the team at TMA online via video call for an assessment of your injury and a tailored treatment plan.

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We're all UK Chartered Physiotherapists with Master’s Degrees related to Sports & Exercise Medicine. But at Treat My Achilles we don't just value qualifications; all of us also have a wealth of experience working with athletes across a broad variety of sports, ranging from recreationally active people to professional athletes. You can meet the team here.

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Steph Davies - Online Sports Injury Physiotherapist

About the Author

Steph Davies is a chartered physiotherapist with more than 15 years' experience and a Master’s Degree in Sports and Exercise Medicine. You can follow Steph on LinkedIn.

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