Yoga and Achilles tendonitis – Tips and tricks for pain relief

Doing yoga with Achilles tendonitis can aggravate the symptoms of a tendon that is already painful. Here are some basic principles you can apply to a variety of yoga poses to be kind to your injured Achilles tendon. We also answer commonly asked questions like: Can yoga cause Achilles tendonitis? And is yoga good for Achilles tendonitis? 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.

In this article:

1. Why might yoga with Achilles tendonitis cause more pain?

2. Can yoga cause Achilles tendonitis?

3. Is yoga good for Achilles tendonitis?

4. How to know when yoga is irritating your injured tendon

5. How to adapt yoga for Achilles tendonitis

6. How we can help

We've also made a video about this:

Before we get going, two caveats:

• This article is not about yoga after an Achilles tear or rupture – that is very different. You'll need to speak to a medical practitioner about when you can return to yoga after a tear or rupture.

• I have practised yoga, but I am not an instructor. I explain some principles here that you can apply to yoga, but these are not substitutes for yoga instruction. Therefore, please discuss these principles with your yoga instructor to ask them how you can incorporate them into different poses or into what's happening in your class today.

Why might doing yoga with Achilles tendonitis cause more pain?

Your Achilles tendon attaches your calf muscles to your heel bone.

The two main things that can aggravate an Achilles tendon with tendonitis are:

1. Compressing the tendon against your heel bone (usually when stretching it) and

2. making the tendon work too hard.

Stretching and compressing the tendon

When you stretch your Achilles tendon and the calf muscles by moving your foot into a dorsiflexed position (toes move towards your shin), like the classic runner’s calf stretch, it causes the tendon to pull tight over the heel bone, increasing the compression in that area.

Normally this isn't a problem. However, if your tendon is injured, stretching and compressing it in this way can make it hurt more (similar to pressing on a bruise).

In yoga, this would occur in poses like Downward Facing Dog (both heels on the mat), Warrior One and Two (the back leg), and Chair Pose.

Yoga poses that cause dorsiflexion at your ankle include Downward Facing Dog and Chair Pose.

Making the tendon work too hard

An injured tendon usually loses a bit of its strength and struggles to cope with the loads placed on it during normal activities.

To allow it to recover, you have to temporarily reduce the amount of work you ask it to do (this includes during yoga) to a level with which it can currently cope.

Your Achilles tendon has to work when you contract your calf muscles. This typically happens when we go up on our toes and/or when we then hold that position for quite some time.

An example from yoga would be when you lift up onto your toes during Downward Facing Dog.

Can yoga cause Achilles tendonitis?

Yes, if you overdo things.

Doing lots of strong calf stretches or holding the stretches for a very long time can cause excessive compression where the Achilles tendon attaches into the heel bone. This might lead to insertional Achilles tendonitis and can also cause heel bursitis.

Is yoga good for Achilles tendonitis?

If by asking this you mean “Can yoga be used as a treatment for Achilles tendonitis?” then the answer is no, not really.

Some people think that the stiff feeling that is one of the symptoms of Achilles tendonitis can be stretched away by doing yoga, but this usually only aggravates it.

That stiffness is not something that you can stretch away – it is due to changes inside the tendon caused by the injury and will reduce only as your tendon heals. Read more about the best treatment for Achilles tendinopathy here.

The explanations below will shed more light on these questions and answers and on how you can continue doing yoga while your Achilles tendon is recovering.

How to know when yoga is irritating your injured tendon

The two typical symptoms of Achilles tendonitis are stiffness and pain.

People usually have the stiffness first thing in the morning when they get up, or when they’ve been sitting still for quite some time after an activity. As they get moving, the stiffness gradually dissipates.

The pain can happen at various times. Often, there is a latent response, with the pain only coming on later in the day or the next day after the activity that caused it. The other times that we can feel pain with an Achilles tendon can be at the beginning of an activity. We then warm up, it goes away, and if we then do too much, it may or may not return.

Because the pain and/or the stiffness usually don’t occur during or shortly after the problem activity, it could be tricky to pinpoint whether it’s your yoga that’s causing or aggravating these symptoms. The best you can do is to look back at the 24 hours preceding the symptoms and try to figure out whether there’s a pattern.

So, ask yourself, how does my tendon feel in the 24 hours after a yoga session?

• If the answer is, “just the same as any other day”, your yoga session did not make your injury worse.

• If the answer is, “my tendon has been feeling a lot more uncomfortable” or “this morning it is feeling a lot stiffer when I try to walk”, the yoga session may be aggravating your tendonitis symptoms, and it needs to be adapted.

How to adapt yoga for Achilles tendonitis

1. Narrow your stances

This advice applies to any pose where you’re standing with your legs apart or one leg in front of the other (e.g. in Warrior One and Two). Bring your feet closer together; it will decrease the dorsiflexion at your ankle and therefore the compression of your injured tendon against the heel bone.

2. Place something under your heel(s)

You can roll up one end of your yoga mat or use a rolled-up towel. Place it under your heels in any pose to decrease the amount of dorsiflexion.

3. Relax your foot when dorsiflexion is not necessary

For example, in poses where you are stretching your hamstrings, rather than holding on to your foot or pulling your toes back towards you, try to relax your foot into a position where it is less dorsiflexed or not dorsiflexed.

4. Decrease the work your tendon has to do

In poses that require you to be on your toes for quite some time (in other words, poses that work your Achilles tendon), such as the “plank” part of the Sun Salutation, rather go onto your knees if possible and just concentrate on your upper body for now.

The trick is to help your tendon not to have to bear as much weight or work as hard as it would in the standard pose.

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

Alison Gould is a chartered physiotherapist and holds an MSc in Sports and Exercise Medicine. You can follow her on LinkedIn, Facebook, Instagram or Twitter.