How to maintain your Achilles tendon’s health after recovery
- Alison Gould
- 17 minutes ago
- 6 min read
If you’ve recovered from an Achilles injury – or are in the final stages of rehab – the next challenge is staying injury-free. Many people experience flare-ups not because their tendon is weak, but because strength, activity load, and recovery drift out of balance over time. This article explains how to maintain Achilles tendon health after recovery, manage training increases safely, and deal with flare-ups if they occur.
Remember, if you need help with an Achilles injury, you're welcome to consult one of our team via video call.
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.
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Who needs to read this article?
This article is for active people (gardeners, walkers, runners etc.) who have reached a stable point in their Achilles recovery. Your symptoms may be completely gone, or you may occasionally notice a very mild reminder that the tendon was injured in the past. This typically feels more like awareness than pain and would usually rate around 0-1 out of 10.
Any symptoms you notice are generally activity-related and short-lived, appearing briefly during or after exercise or the following morning before settling again. If you are managing daily life and training well and want to maintain this progress – especially while working toward a new goal or increase in activity – this guidance is for you.
Calf and general strength
Reaching this stage usually means you have reduced aggravating activities in the past and have rebuilt calf and Achilles strength through rehabilitation. Strong calf muscles improve the Achilles tendon’s ability to tolerate load and is a key reason why symptoms settle.
At this stage, the focus shifts from rebuilding strength to maintaining it. Strength and conditioning research suggests that one to two sessions per week is usually enough for maintenance. This means continuing the calf raise exercises you used during rehab at roughly the same level as during the final stage of your rehab.
Strength training twice a week is usually ideal, but it is absolutely fine to just do it once a week in some weeks.
Also, if you're doing lots of other types of exercise that also work and strengthen your calf muscles and Achilles tendons, you usually want to reduce the number of strength training sessions to avoid overworking those areas. So, depending on the training phase you're in (base building vs. competition), you might switch between two sessions and one session to balance your total training load.
Consistency is easier if strength work is linked to existing habits. For example, doing calf raises before a gym or Pilates class, or while preparing breakfast, can help you maintain strength without adding extra time to your day.
Adjusting for activity patterns
Activity levels naturally vary across the year due to weather, work, travel, and training cycles. These fluctuations affect how much load your Achilles experiences.
During periods of lower activity, it can be helpful to maintain – or even slightly increase – strength training to preserve tendon capacity. This is especially useful if you know that a more demanding period is approaching.
If you are preparing for an event or trip that involves more walking, running, or time on your feet, planning ahead is important. Strength exercises can be gradually progressed over several weeks by increasing load, repetitions, tempo, or by moving from double-leg to single-leg work, as long as symptoms remain settled over the following 24 hours.
For example, if you’re mostly stuck indoors due to icy winter conditions, but you know that you’re going to do a lot of hiking in the mountains when summer comes, you might even do up to three strength training sessions per week. Once the weather eases and you’re able to start increasing your walking and hiking endurance, you can then reduce your strength training to once or twice a week depending on how hard your calves have to work during your hiking sessions.
Activity increases and recovery
At the same time, overall activity volume should increase gradually. Sudden increases in load are one of the most common triggers for Achilles flare-ups. A practical guideline is to increase weekly activity (walking, running, dancing, etc.) by around 10%, using whichever measure is most relevant to you, such as time, distance, or step count. After three to four weeks of progression, schedule a lighter week to allow your body to adapt before building again.
Active people often fall into a “boom-and-bust” cycle when their activity level increases too quickly. Training feels fine initially, load increases sharply, symptoms return, and activity has to be reduced again.
Take running as an example: This pattern does not only relate to running distance or time. Increases in intensity or changes in how load is applied also matter. Faster running, hills, uneven or soft terrain, treadmill incline, and changes in footwear can all increase stress on the Achilles even if the total training volume stays the same.
Footwear changes are a common trigger, such as switching to flatter shoes, wearing unsupportive slip-ons, or spending more time in footwear that requires gripping with the foot. Training terrain changes – like hills, sand, or mud – or something like prolonged standing can also add unexpected load.
Not all of these factors are easy to measure, so the goal is awareness rather than precision. When several changes happen close together, the combined load may exceed what your Achilles can currently tolerate. Gradual exposure and regular recovery days reduce this risk.
Dealing with flare-ups
Even with careful management, flare-ups can still occur. When strength has been maintained and activity increases have been gradual, they usually settle more quickly.
Managing a flare-up typically means reducing aggravating activities rather than stopping everything completely. This may involve lowering step counts, choosing footwear with a higher heel-to-toe drop, or temporarily modifying exercises to reduce strain on the Achilles.
Strength exercises can usually continue at a reduced level. A practical approach is to decrease load or volume by around 25%-30% and assess symptoms over the following 24 hours. If symptoms improve, load can then be reintroduced gradually over subsequent sessions, ideally with rest days in between. It usually pays not to rush things – keeping the loads stable over a few training sessions before increasing it often works better than trying to increase it in every session.
It is also important to reflect on why the flare-up occurred. Often, it is not one single factor but several smaller changes happening close together. Reviewing recent activity levels, footwear, intensity, and recovery can help identify patterns and prevent recurrence.
With consistent maintenance and thoughtful planning, most active people can continue progressing toward new goals without slipping back into an injury cycle.
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.
We're all UK Chartered Physiotherapists with Master’s Degrees related to Sports & Exercise Medicine or at least 10 years' experience in the field. All of us have a wealth of experience working with athletes across a broad variety of sports and ranging from recreationally active people to professional athletes. You can meet the team here.
About the Author
Maryke Louw is a chartered physiotherapist with more than 20 years' experience and a Master’s Degree in Sports Injury Management. Follow her on LinkedIn and ResearchGate.
